Orlando Rodriguez

Concepts of Culture and Their Role in the Development of Culturally Competent Mental Health Services.

The purpose of this article is to review different ways that culture has been used in developing the notion of culturally competent mental health services and to provide an enhanced definition of culture through a critical review of these ideas. We discuss different dimensions of culture that emerge as important issues in the development of bilingual/bicultural psychiatric programs. We provide a multifaceted definition of the influences of culture on the assessment of clients in culturally competent mental health programs. We illustrate the issues raised in this review with case examples from an evaluation of three inpatient bilingual/bicultural psychiatric programs.

Conducting research in culturally diverse inner-city neighborhoods: some lessons learned.

Social, behavioral, and health research among disenfranchised groups in inner cities poses problems in collecting data. It is a challenge to achieve data of sufficient quantity and quality necessary to be scientifically usable. This article describes the experiences of a research team during two phases of data collection in a mental health intervention study in New York’s South Bronx. Challenges in addressing human subject concerns, the formation of a fieldwork team, enrollment and retention of respondents, and administration of instruments are described and solutions are discussed. Emphasis is placed on researchers’ approaches to the selection, orientation, and safety of interviewers, interviewer-respondent race and ethnic matching, contacts and rapport with respondents, and the handling of such interpersonal issues as distrust, poor cooperation, and family dynamics. The procedures developed took into consideration the culture and life conditions of the population to ensure a satisfactory response rate and high-quality data.

The societal and organizational contexts of culturally sensitive mental health services: Findings from an evaluation of bilingual/Bicultural psychiatric programs

The Hispanic mental health literature focuses mostly on cultural and clinical issues. This paper argues that researchers and practitioners concerned with mental health services for Hispanics and other minority groups need to pay more attention to the societal and organizational contexts that facilitate or impede the development of effective culturally sensitive psychiatric programs. Utilizing data from an evaluation of three New York psychiatric programs for seriously mentally ill (SMI) Hispanic patients, the paper discusses societal and organizational factors that influenced the programs’ development. Among societal forces were the significance of Hispanics as a voting bloc, the political organization of Hispanic mental health professionals, the philosophy of ethnic assimilation in American society, prevailing views about the place of cultural knowledge in psychiatric treatment, and fiscal crises, and the shortage of Hispanic mental health professionals. Among organizational factors, hospital administrative support and program leadership mediated the effects of societal forces upon the programs, while ethnic competition and lack of coordination between the program and other organizational units acted as barriers to the programs’ development. The findings are relevant to any innovative mental health service in an organizational setting.

The Experiences of Project Liberty Crisis Counselors in the Bronx

This exploratory study collected qualitative interview data from Bronx-based crisis counselors associated with the post-9/11 recovery program Project Liberty. Two focus groups from a single area provider were conducted to identify key thematic issues regarding program implementation. As conditions in the Bronx were demanding, the descriptions of relief efforts as told by these workers are informative for developing models for emergency service response in marginalized areas as well as in locations that are not directly impacted by events but are in relatively close proximity.