Skip to main content
SpringerLink
Log in

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

  • Articles
  • Published:
The journal of mental health administration Aims and scope Submit manuscript

Abstract

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.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Acosta FX, Cristo MH: Development of a bilingual interpreter program: an alternative model for Spanish-speaking services.Professional Psychology 1981; 12(4):474–482.

    Article  Google Scholar 

  2. Bluestone H, Vela RM: Transcultural aspects in the psychotherapy of the Puerto Rican poor in New York City.Journal of the American Academy of Psychoanalysis 1982; 10:269–283.

    PubMed  CAS  Google Scholar 

  3. Inclan J: Variations in value orientations in mental health work with Puerto Ricans.Psychotherapy 1985; 22:324–334.

    Google Scholar 

  4. Rogler LH, Malgady RG, Costantino G, et al.: What do culturally sensitive mental health services mean? The case of Hispanics.American Psychologist 1987; 42:565–570.

    Article  PubMed  CAS  Google Scholar 

  5. Rogler LH, Malgady RG, Rodriguez O:Hispanics and Mental Health: A Framework for Research. Malabar, Fla.: Robert E. Krieger Publishing Company, 1989.

    Google Scholar 

  6. Ruiz R: Cultural and historical perspectives in counseling Hispanics. In: Sue DW (ed.):Counseling the Culturally Different: Theory and Practice, New York: Wiley and Sons, 1981.

    Google Scholar 

  7. Ruiz P, Ruiz PP: Treatment compliance among Hispanics.Journal of Operational Psychiatry 1983; 14:112–114.

    Google Scholar 

  8. Szapocznik J, Scopetta M, King O: Theory and practice in matching treatment to the special characteristics and problems of Cuban immigrants.Journal of Community Psychology 1978; 6:112–122.

    PubMed  CAS  Google Scholar 

  9. Rodriguez O, Lessinger J, Guarnaccia P, et al.: Final Report: Bilingual/Bicultural Psychiatric Programs at Bronx Psychiatric Center, Lincoln Hospital, and Pilgrim Psychiatric Center, Hispanic Research Center, Fordham University, New York, 1991.

    Google Scholar 

  10. Sue S, Zane N: The role of culture and cultural techniques in psychotherapy, a critique and reformulation.American Psychologist 1987; 42:37–45.

    Article  PubMed  CAS  Google Scholar 

  11. Marin G, Marin BVO:Research with Hispanic Populations. Newbury Park, Calif.: Sage Publications, 1991.

    Google Scholar 

  12. Baer HA: Sociological contributions to the political economy of health: lessons from medical anthropologists.Medical Anthropology Quarterly 1986; 17:129–131.

    Google Scholar 

  13. Singer M: Developing a critical perspective in medical anthropology.Medical Anthropology Quarterly 1986; 17:128–129.

    Article  Google Scholar 

  14. Baer HA, Singer M, Johnson J: Introduction: toward a critical medical anthropology.Social Science and Medicine 1986; 23:95–98.

    Article  PubMed  CAS  Google Scholar 

  15. Singer M, Davison L, Gerdes G: Culture, critical theory and reproductive illness behavior in Haiti.Medical Anthropology Quarterly 1988; 2:370–385.

    Article  Google Scholar 

  16. Marcos LR, Gill RM: Muddling through mental health policies.American Journal of Psychiatry 1983; 140:854–856.

    Google Scholar 

  17. Bloom B:Changing Patterns of Psychiatric Care. New York: Human Sciences Press, 1975.

    Google Scholar 

  18. Gaviria M, Stern G: Problems in designing and implementing culturally relevant mental health services for Latinos in the U.S.Social Science and Medicine 1980; 14B:65–71.

    CAS  Google Scholar 

  19. Rodriguez O: Overcoming barriers to clinical services among chronically mentally ill Hispanics: lessons from the evaluation of the Project COPA demonstration.Hispanic Research Center Research Bulletin (11)1. New York: Fordham University, 1986.

    Google Scholar 

  20. Rodriguez O:Hispanics and Human Services: Help Seeking in the Inner City. Monograph No. 13. Hispanic Research Center. New York: Fordham University, 1987.

    Google Scholar 

  21. Scott JF, Delgado M: Planning mental health programs for Hispanic communities.Social Casework 1979; 60(8):451–456 (October).

    PubMed  CAS  Google Scholar 

  22. Trevino FM, Bruhn JG, Bunce H III: Utilization of community mental health services in a Texas-Mexico border city.Social Sciences and Medicine 1979; 13:331–334.

    Google Scholar 

  23. Mechanic D: Toward the year 2000 in U.S. mental health policy making and administration. In: Rochefort DA (ed.):Handbook of Mental Health Policy in the United States. Greenwood, Conn.: Greenwood Press, 1989.

    Google Scholar 

  24. Elpers JR: Development and utilization of incentive systems for mental health operations: successful and unsuccessful knowledge utilization in California and Los Angeles.The Journal of Mental Health Administration 1989; 16:9–20.

    Article  CAS  Google Scholar 

  25. Clifford DL: A consideration of simple measures of organizational structure.Evaluation and Program Planning 1987; 10:231–237.

    Article  PubMed  CAS  Google Scholar 

  26. Sorensen JE, Zelman W, Hanbery GW: Managing mental health organizations with 25 key performance indicators.Evaluation and Program Planning 1987; 10:239–247.

    Article  PubMed  CAS  Google Scholar 

  27. Mechanic D: Issues in the sociology of organizations and the administration of mental health services. In: Mechanic D (ed.):Politics, Medicine and Social Science. New York: John Wiley and Sons, 1974.

    Google Scholar 

  28. Baer HA, Singer M, Johnson J (eds.): Special issue: toward a critical medical anthropology.Social Science and Medicine 1986; 23(2).

  29. Frankenberg R (ed.): Gramsci, Marxism and phenomenology: essays for the development of critical medical anthropology.Medical Anthropology Quarterly 1988; 2(4).

  30. Singer M, Baer H (eds.): Socialist health/capitalist health: is there a difference?Medical Anthropology 1989; 11(2).

  31. Schatzman L, Strauss A:Field Research: Strategies for a Natural Sociology. Englewood Cliffs, N.J.: Prentice Hall, 1973.

    Google Scholar 

  32. The Puerto Rican New Yorker, A Recent History of their Distribution and Population Household Characteristics. New York: New York Department of City Planning, 1985, Table 5.

  33. 1990 Census. Comparative 1980–1990 Population and Housing Data. Based on 1990 Public Law File 94-171 and the 1980 Census. New York City and Boroughs. New York: New York Department of City Planning, March 6, 1990, Table 3.

  34. Schick FL, Schick R:Statistical Handbook on U.S. Hispanics. Phoenix: Oryx Press, 1991, Tables F1-1 and F1-3.

    Google Scholar 

  35. Lee FR: Panel approves revised plan for New York’s council seats.New York Times July 26, 1991, Sec. A, p. 1.

  36. Pachon HP: Politics and public policy, the Hispanic community.Vital Speeches of the Day 1988(May 15):464–466.

  37. Comas-Diaz L, Griffith EEH (eds.):Clinical Guidelines in Cross-Cultural Mental Health. New York: Wiley-Interscience, 1990.

    Google Scholar 

  38. Lopez S, Hernandez P: When culture is considered in the evaluation and treatment of Hispanic patients.Psychotherapy 1987; 24:120–126.

    Google Scholar 

  39. Sue DW, Sue D:Counseling the Culturally Different: Theory and Practice. New York: Wiley-Interscience, 1988.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hispanic Research Center, Fordham University, Thebaud Hall, 10458, Bronx, NY

    Orlando Rodriguez Ph.D. (Director)

  2. Hispanic Research Center, Fordham University, Fordham, USA

    Johanna Lessinger Ph.D.

  3. Department of Human Ecology and the Institute for Health Care Policy and Aging Research, Rutgers University, Rutgers, USA

    Peter Guarnaccia Ph.D.

Authors
  1. Orlando Rodriguez Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Johanna Lessinger Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Guarnaccia Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This study was supported in part by Grant MH30569 from the Division of Services Research, National Institute of Mental Health, and by Contract C-003234 from the New York State Office of Mental Health. The opinions are those of the authors and do not reflect the policies or views of the U.S. Department of Health and Human Services or the New York State Office of Mental Health.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodriguez, O., Lessinger, J. & Guarnaccia, P. The societal and organizational contexts of culturally sensitive mental health services: Findings from an evaluation of bilingual/Bicultural psychiatric programs. The Journal of Mental Health Administration 19, 213–223 (1992). https://doi.org/10.1007/BF02518987

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02518987

Keywords

Search

Navigation