Skip to main content

Advertisement

Log in

Culturally Competent Systems of Care for Children’s Mental Health: Advances and Challenges

  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

There has been a remarkable growth in cultural diversity in the United States over the past 20 years. The population of minority groups has increased at a much faster rate than the European-background population in America, and faster even among children and youth. At the same time, minority youth face increasing disparities in their mental health and in access to mental health services. These are related to the multiple challenges they already face in socioeconomic status, but are aggravated by the lack of culturally competent services that can address their specific mental health needs within the context of their culture, family, and community. This paper reviews the current knowledge about the mental health of culturally diverse youth in the United States, and provides guidance on approaches to address the disparities they face.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • J. Abreu (1999) ArticleTitleConscious and nonconscious African–American stereotypes: Impact on first impression and diagnostic ratings by therapists Journal of Consulting and Clinical Psychology 67 IssueID3 387–393 Occurrence Handle10.1037//0022-006X.67.3.387 Occurrence Handle10369059

    Article  PubMed  Google Scholar 

  • InstitutionalAuthorNameAmerican Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders EditionNumber4 American Psychiatric Press Washington, D.C.

    Google Scholar 

  • A. Angold A. Erkanli E. Farmer J. Fairbank B. Burns G. Keeler E. Costello (2002) ArticleTitlePsychiatric disorder, impairment, and service use in rural African-American and white youth Archives of General Psychiatry 59 IssueID10 893–901 Occurrence Handle10.1001/archpsyc.59.10.893 Occurrence Handle12365876

    Article  PubMed  Google Scholar 

  • E. Arnold M. Elloitt L. Sachs H. Bird H. Kraemer K. Wells H. Abikoff et al. (2003) ArticleTitleEffects of ethnicity on treatment attendance, stimulant response/ dose, and 14-month outcome in ADHD Journal of Consulting and Clinical Psychology 71 IssueID4 713–727 Occurrence Handle10.1037/0022-006X.71.4.713 Occurrence Handle12924677

    Article  PubMed  Google Scholar 

  • B. Aslami (1997) ArticleTitleInterracial psychotherapy: A report of the treatment of an inner-city adolescent Journal of the American Academy of Psychoanalysis 25 IssueID3 347–356 Occurrence Handle9513120

    PubMed  Google Scholar 

  • A. Baker (1999) ArticleTitleAcculturation and reacculturation influence: Multilayer contexts in therapy Clinical Psychology Review 19 IssueID8 951–967 Occurrence Handle10.1016/S0272-7358(99)00005-7 Occurrence Handle10547712

    Article  PubMed  Google Scholar 

  • I. Borowski M. Resnick M. Ireland R. Blum (1999) ArticleTitleSuicide attempts among American Indian and Alaska Native youth: Risk and protective factors Archives of Pediatrics and Adolescent Medicine 153 IssueID6 573–580 Occurrence Handle10357296

    PubMed  Google Scholar 

  • W. Bracero (1998) ArticleTitleIntimidades: Confianza, gender, and hierarchy in the construction of Latino-Latina therapeutic relationships Culture of Diversity Mental Health 4 IssueID4 264–277

    Google Scholar 

  • R. Bussing B.T. Zima T Belin (1998) ArticleTitleVariations in ADHD treatment among special education␣students Journal of the American Academy of Child and Adolescent Psychiatry 37 968–976 Occurrence Handle10.1097/00004583-199809000-00017 Occurrence Handle9735616

    Article  PubMed  Google Scholar 

  • D. Cabaniss M. Oquendo M. Singer (1994) ArticleTitleThe impact of psychoanalytic values on transference and countertransference: A study in transcultural psychotherapy Journal of the American Academy of Psychoanalysis 22 IssueID4 609–621 Occurrence Handle7775204

    PubMed  Google Scholar 

  • A. Callan R. Littlewood (1998) ArticleTitlePatient satisfaction: Ethnic origin or explanatory model? International Journal of Social Psychiatry 44 IssueID1 1–11 Occurrence Handle9574847

    PubMed  Google Scholar 

  • I. Canino G. Canino W. Arroyo (1998) ArticleTitleCultural considerations for childhood disorders: How much was included in DSM-IV? Transcultural Psychiatry 35 IssueID3 343–355

    Google Scholar 

  • G. Constantino R. Malgady L. Rogler (1994) ArticleTitleStorytelling through pictures: Culturally sensitive psychotherapy for Hispanic children and adolescents Journal of Clinical Child Psychology 23 IssueID1 13–20

    Google Scholar 

  • M. Cooley-Quille R.C. Boyd E. Frantz J. Walsh (2001) ArticleTitleEmotional and behavioral impact of exposure to community violence in inner-city adolescents Journal of Clinical Child Psychology 30 IssueID2 199–206 Occurrence Handle10.1207/S15374424JCCP3002_7 Occurrence Handle11393920

    Article  PubMed  Google Scholar 

  • L. Cooper D. Roter R. Johnson D. Ford D. Steinwachs N. Powe (2003) ArticleTitlePatient-centered communication, ratings of care, and concordance of patient and physician race Annals of International Medicine 139 IssueID11 907–916

    Google Scholar 

  • T. Cross B. Bazron K. Dennis M. Isaacs (1989) Towards a culturally competent system of care CASSP Technical Assistance Center, Georgetown University Child Development Center Washington, DC

    Google Scholar 

  • S. Cuffe J. Waller M. Cuccaro A. Pumariega C Garrison (1995) ArticleTitleRace and gender differences in the treatment of psychiatric disorders in young adolescents Journal of the American Academy Child and Adolescent Psychiatry 34 IssueID11 1536–1543 Occurrence Handle10.1097/00004583-199511000-00020

    Article  Google Scholar 

  • D. deAnda (1984) ArticleTitleBicultural socialization: Factors affecting the minority experience Social Work 29 101–107

    Google Scholar 

  • M. DeLa Rosa R. Vega M Radisch (2000) ArticleTitleThe role of acculturation in the substance abuse behavior of African-American and Latino adolescents: Advances, issues, and recommendations Journal of Psychoactive Drugs 32 IssueID1 33–42 Occurrence Handle10801066

    PubMed  Google Scholar 

  • M. De Rios (1997) ArticleTitleMagical realism: A cultural intervention for traumatized Hispanic children Cultural of Diversity Mental Health 3 IssueID3 159–170

    Google Scholar 

  • S. Disalver (2001) ArticleTitleUnsuspected depressive mania in pre-pubertal Hispanic children referred for the treatment of ‘depression’ with history of social ‘deviance’ Journal of Affective Disorders 67 IssueID1–3 187–192 Occurrence Handle10.1016/S0165-0327(01)00445-1 Occurrence Handle11869767

    Article  PubMed  Google Scholar 

  • Y. Doi R. Roberts K. Takeuchi S. Suzuki (2001) ArticleTitleMultiethnic comparison of adolescent major depression based on the DSM-IV criteria in a U.S.-Japan study Journal of the American Academy Child and Adolescent Psychiatry 40 IssueID11 1308–1315 Occurrence Handle10.1097/00004583-200111000-00011

    Article  Google Scholar 

  • E.H. Erickson (1968) Identity, Youth, and Crisis W.W. Norton & Co New York

    Google Scholar 

  • InstitutionalAuthorNameFour Racial/Ethnic Panels (1999) Cultural competence standards for managed care mental health for four racial/ethnic underserved/ underrepresented populations Center for Mental Health Services, Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services Rockville, Md

    Google Scholar 

  • E. Garrison I. Roy V. Azar (1999) ArticleTitleResponding to the mental health needs of Latino children and families through school-based services Clinical Psychology Review 19 IssueID2 199–219 Occurrence Handle10.1016/S0272-7358(98)00070-1 Occurrence Handle10078420

    Article  PubMed  Google Scholar 

  • A.C. Gaw (1993) Psychiatric care of Chinese Americans A.C. Gaw (Eds) Culture, ethnicity and mental illness American Psychiatric Press Washington DC 245–280

    Google Scholar 

  • S. Glover A. Pumariega (1998) The importance of children’s mental health epidemiological research with culturally diverse populations M. Hernandez M. Isaacs (Eds) Promoting cultural competence in children’s mental health services Brookes Publishing Baltimore

    Google Scholar 

  • S. Glover A. Pumariega C. Holzer M. Rodriquez (1999) ArticleTitleAnxiety symptomatology in Mexican–American adolescents Journal of Child Family Studies 8 IssueID1 47–57 Occurrence Handle10.1023/A:1022994510944

    Article  Google Scholar 

  • J. Grunbaum K. Basen-Engquist D. Pandey (1998) ArticleTitleAssociation between violent behaviors and substance use among Mexican-American and non-Hispanic white high school students Journal of Adolescent Health 23 IssueID3 153–159 Occurrence Handle10.1016/S1054-139X(98)00010-X Occurrence Handle9730358

    Article  PubMed  Google Scholar 

  • P. Guarnaccia S. Lopez (1998) ArticleTitleMental health and adjustment of immigrant and refugee children Child Adolescent Psychiatric Clinics of North America 7 IssueID3 537–553

    Google Scholar 

  • R. Herrera (1996) Crisis intervention: An essential component of culturally competent clinical case management P. Manolea (Eds) The cross-cultural practice of clinical case management in mental health Haworth Press New York 99–117

    Google Scholar 

  • V. Hong A. Pumariega C. Licata (2002) Race, minority status, cultural isolation, and psychiatric diagnosis in children in public mental health University of South Florida, Research and Training Institute for Children’s Mental Health Tampa, FL 313–317

    Google Scholar 

  • R. Hough A. Hazen F. Soriano P. Wood K. McCabe M. Yeh (2002) ArticleTitleMental health care for Latinos: Mental health services for Latino adolescents with psychiatric disorders Psychiatric Services 53 IssueID12 1556–1562 Occurrence Handle10.1176/appi.ps.53.12.1556 Occurrence Handle12461215

    Article  PubMed  Google Scholar 

  • M. Kilgus A. Pumariega S. Cuffe (1995) ArticleTitle(1995) Race and diagnosis in adolescent psychiatric inpatients Journal of the American Academy Child and Adolescent Psychiatry 34 IssueID1 67–72 Occurrence Handle10.1097/00004583-199501000-00017

    Article  Google Scholar 

  • J. Kistner C. David B. White (2003) ArticleTitleEthnic and sex differences in chidlren’s depressive symptoms: Mediating effects of perceived and actual competence Journal of Clinical Child Adolescent Psychology 32 IssueID3 341–350 Occurrence Handle10.1207/S15374424JCCP3203_03

    Article  Google Scholar 

  • G.P. Knight L.M. Virdin K.A. Ocampo M. Roosa (1994) ArticleTitleAn examination of the cross-ethnic equivalence of measures of negative life events and mental health among Hispanic and Anglo-American children American Journal of Community Psychology 22 IssueID6 767–783 Occurrence Handle7639202

    PubMed  Google Scholar 

  • J. Koss-Chioino L. Vargas (1999) Working with Latino youth: Culture, development, and context San Francisco Jossey Bass

    Google Scholar 

  • R. Malgady L. Rogler E. Dharma (1996) ArticleTitleCultural expression of psychiatric symptoms: Idioms of anger amongst Puerto Ricans Psychological Assessment 8 IssueID3 265–268 Occurrence Handle10.1037//1040-3590.8.3.265

    Article  Google Scholar 

  • M. Miller A. Pumariega (2001) ArticleTitleCulture and eating disorders: A historical and cross-cultural review Psychiatry: Interpersonal Biology Processes 64 IssueID2 93–110 Occurrence Handle10.1521/psyc.64.2.93.18621

    Article  Google Scholar 

  • L. Mufson M. Weissman D. Moreau R. Garfinkel (1999) ArticleTitleEfficacy of interpersonal psychotherapy for depressed adolescents Archives of General Psychiatry 56 IssueID6 573–579 Occurrence Handle10.1001/archpsyc.56.6.573 Occurrence Handle10359475

    Article  PubMed  Google Scholar 

  • R. Olvera (2001) ArticleTitleSuicidal ideation in Hispanic and mixed ancestry adolescents Suicide and Life Threatening Behavior 31 IssueID4 416–427 Occurrence Handle10.1521/suli.31.4.416.22049 Occurrence Handle11775717

    Article  PubMed  Google Scholar 

  • M. O’Sullivan B. Lasso (1992) ArticleTitleCommunity mental health services for Hispanics: A test of the culture compatibility hypothesis Hispanic Journal of Behavioral Sciences 14 IssueID4 455–468

    Google Scholar 

  • J. Ponterotto L. Casas C. Suzuki C. Alexander (Eds) (2001) Handbook of multicultural counseling Sage Publications Thousand Oaks, CA

    Google Scholar 

  • G. Powell J. Yamamoto A. Romero A. Morales (Eds) (1983) The Psychosocial development of minority group children Brunner/Mazel New York

    Google Scholar 

  • A. Pumariega J. Swanson C. Holzer A. Linskey R. Quintero-Salinas (1992) ArticleTitleCultural context and substance abuse in Hispanic adolescents Journal of Child Family Studies 1 IssueID1 75–92 Occurrence Handle10.1007/BF01321343

    Article  Google Scholar 

  • A. Pumariega P. Johnson D. Sheridan S. Cuffe (1995) ArticleTitleRace, gender, age, depressive symptomatology, and substance abuse in high-risk adolescents Cultural of Diversity Mental Health 2 IssueID2 115–123

    Google Scholar 

  • A. Pumariega S. Glover C. Holzer N. Nguyen (1998) ArticleTitleUtilization of mental health services in a tri-ethnic sample of adolescents Community Mental Health Journal 34 IssueID2 145–156 Occurrence Handle10.1023/A:1018788901831 Occurrence Handle9620159

    Article  PubMed  Google Scholar 

  • A. Pumariega D. Atkins K. Rogers L. Montgomery C. Nybro R. Caesar D. Millus (1999) ArticleTitleMental health and incarcerated youth. II: Service utilization in incarcerated youth Journal of Child Family Studies 8 IssueID2 205–215 Occurrence Handle10.1023/A:1022092002435

    Article  Google Scholar 

  • A. J. Pumariega M. D. Kilgus L. Rodriguez (2005) Adolescence P. Ruiz (Eds) Lewinsohn’s textbook on addictions EditionNumber4 Lippincott, William & Wilkins Philadelphia 1021–1037

    Google Scholar 

  • W. Randall R. Parrila (2001) ArticleTitleEthnicity, disability, and risk for abuse Developmental Disability Bulleten 29 IssueID1 60–80

    Google Scholar 

  • R. Roberts C. Roberts Y. Chen (1997) ArticleTitleEthnocultural differences in prevalence of adolescent depression American Journal of Community Psychology 25 IssueID1 95–110 Occurrence Handle10.1023/A:1024649925737 Occurrence Handle9231998

    Article  PubMed  Google Scholar 

  • L. Rogler D. Cortes (1993) ArticleTitleHelp-seeking pathways: A unifying concept in mental health care American Journal of Psychiatry 150 IssueID4 554–561 Occurrence Handle8465869

    PubMed  Google Scholar 

  • J. Rosello G. Bernal (1999) ArticleTitleThe efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents Journal of Consulting Clinical Psychology 67 IssueID5 734–745 Occurrence Handle10.1037//0022-006X.67.5.734

    Article  Google Scholar 

  • E. Rothe J. Lewis H. Castillo-Matos O. Martinez R. Busquets I. Martinez (2002) ArticleTitlePost traumatic stress disorder in Cuban children and adolescents after release from a refugee camp Psychiatric Services 53 IssueID8 970–976 Occurrence Handle10.1176/appi.ps.53.8.970 Occurrence Handle12161671

    Article  PubMed  Google Scholar 

  • D. Rowland (1994) Lessons form the Medicaid experience E Ginzberg (Eds) Critical issues in US Health Reform Westview Press Boulder CO 190–207

    Google Scholar 

  • P. Ruiz J. Langrod (1997) Hispanic Americans J. Lowisohn P. Ruiz R. Millman J. Langrod (Eds) Substance abuse: A comprehensive textbook EditionNumber3 Williams and Wilkins Baltimore

    Google Scholar 

  • J. Salvendy (1999) ArticleTitleEthnocultural considerations in group psychotherapy International Journal of Group Psychotherapy 49 IssueID4 429–464 Occurrence Handle10530045

    PubMed  Google Scholar 

  • M. Smith R. Mendoza (1996) ArticleTitleEthnicity and pharmacogenetics Mount Sinai Journal of Medicine 63 285–290 Occurrence Handle8898529

    PubMed  Google Scholar 

  • D. Sue (1981) Counseling the culturally different Wiley Interscience New York

    Google Scholar 

  • K. Suhail R. Cochrane (2002) ArticleTitleEffect of culture and environment on the phenomenology of delusions and hallucinations International Journal of Social Psychiatry 48 IssueID2 126–138 Occurrence Handle10.1177/002076402128783181 Occurrence Handle12182508

    Article  PubMed  Google Scholar 

  • L. Sussman L. Robins F. Earls (1987) ArticleTitleTreatment seeking for depression for Black and White Americans Social Science and Medicine 24 187–196 Occurrence Handle10.1016/0277-9536(87)90046-3 Occurrence Handle3824001

    Article  PubMed  Google Scholar 

  • J. Swanson A. Linskey R. Quintero-Salinas A. Pumariega C. Holzer (1992) ArticleTitleDepressive symptoms, drug use and suicidal ideation among youth in the Rio Grande Valley: A bi-national school survey Journal of the American Academy Child and Adolescent Psychiatry 31 IssueID4 669–678

    Google Scholar 

  • J. Szapocznik M.A. Scopetta W. Tillman (1978) What changes, what remains the same, and what affects acculturation in Cuban immigrant families J. Szapocznik M. Herrera (Eds) Cuban Americans: Acculturation, adjustment, and the family Washington DC COSSMHO

    Google Scholar 

  • J. Szapocznik W. Kurtines (1989) Breakthroughs in family therapy with drug abusing and problem youth Springer New York

    Google Scholar 

  • L. Teplin K. Abram G. McClelland M. Dulcan A. Mericle (2002) ArticleTitlePsychiatric disorders in youth in juvenile detention Archives of General Psychiatry 59 IssueID12 1133–1143 Occurrence Handle10.1001/archpsyc.59.12.1133 Occurrence Handle12470130

    Article  PubMed  Google Scholar 

  • U.S. Census (2000) Population Reports. http://www.census.gov/population/index.htlm

  • U.S. Office of Minority Health (2000) Assuring cultural competence in health care: Recommendations for national standards and an outcomes-focused agenda. U.S. Department of Health and Human Services, Public Health Service

  • InstitutionalAuthorNameU.S. Office of the Surgeon General (2001) Mental health: Culture, race, and ethnicity. A supplement to: Mental health: A report of the surgeon general U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health Rockville, MD

    Google Scholar 

  • K. Williams D. Chambless G. Steketee (1998) ArticleTitleBehavioral treatment of obsessive-compulsive disorder in African-Americans: Clinical issues Journal of Behavior Therapy and Experimental Psychiatry 29 IssueID2 163–170 Occurrence Handle10.1016/S0005-7916(98)00004-4 Occurrence Handle9762593

    Article  PubMed  Google Scholar 

  • L. Willis D. Coombs W. Cockerham S. Frison (2002) ArticleTitleReady to die: A post-mortem interpretation of the increase of African-American adolescent male suicide Social Science and Medicine 55 IssueID8 907–920 Occurrence Handle10.1016/S0277-9536(01)00235-0 Occurrence Handle12220093

    Article  PubMed  Google Scholar 

  • J. Zhang-Wong M. Beiser R. Zipursky G. Bean (1998) ArticleTitleAn investigation of ethnic and gender differences in the pharmacodynamics of haloperidol Psychiatry Research 81 IssueID3 333–339 Occurrence Handle10.1016/S0165-1781(98)00114-0 Occurrence Handle9925184

    Article  PubMed  Google Scholar 

  • J. Zito D. Safer S. Dosreis M. Riddle (1998) ArticleTitleRacial disparity in psychotropic medications prescribed for youths with Medicaid insurance in Maryland Journal of the American Academy Child and Adolescent Psychiatry 32 IssueID2 179–184 Occurrence Handle10.1097/00004583-199802000-00010

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrés J. Pumariega M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pumariega, A.J., Rogers, K. & Rothe, E. Culturally Competent Systems of Care for Children’s Mental Health: Advances and Challenges. Community Ment Health J 41, 539–555 (2005). https://doi.org/10.1007/s10597-005-6360-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-005-6360-4

Keywords

Navigation