NIMH Grant Funds Cultural Competency Research

A five-year National Institute of Mental Health (NIMH) grant is establishing a new Asian American Center on Disparities Research at the University of California, Davis. The award to UC Davis totals $3.9 million, which includes a subcontract with Claremont McKenna College. The principal investigator and director of the Center is Nolan Zane.

The Center will conduct and facilitate research specific to Asian American populations and their mental health treatment, including medication and psychotherapy evaluations.

As a program leader in one of the Center's three projects, CMC Assistant Professor of Psychology Wei-Chin Hwang will oversee a large project to determine whether therapist cultural competency is related to mental health treatment outcomes for ethnic minority clients. Over a five-year span, this project will track the treatment progress of thousands of patients being treated by hundreds of clinicians. Dr. Stanley Sue is the co-leader of the Therapist Factors Research program. Other projects included in the award are the Clinical Effectiveness Research Program and the Medication Research Adherence Program, led by Drs. Gordon Hall of the University of Oregon and Tonya Fancher of UC Davis, respectively.

Hwang says that while there is a current push for clinicians to be more culturally competent and sensitive in treating mental-health patients, there is no evidence to validate whether cultural competency has a positive, measurable impact on treatment outcomes. "Such evidence is necessary if we are to scientifically support the need to train healthcare practitioners to be more culturally competent and effective," he says.

Recent reports by the National Institutes of Health and the Institute of Medicine indicate that ethnic health disparities do exist. In fact, ethnic minorities not only experience a disproportionate amount of illness burden, but they also are less likely to receive quality health and mental health services and experience worse treatment outcomes.

"The question is," Hwang says, noting the changing racial and ethnic composition in the United States, "whether our healthcare system is adequately prepared to meet the needs of America's diversifying population. One critical aspect of providing quality healthcare services is to properly train clinicians to be more culturally competent."

Hwang joins nearly a dozen key participants from UC Davis and the University of Oregon in building the new center. Hwang, whose editorial titled "Mental Illness, Racial Identity and the Virginia Tech Shooting" appeared in The Seattle Times in May, says training clinicians to be more culturally competent can be complicated because it requires therapists to not only understand the culture of others, but also understand their ethnic selves in relation to others. Not only will clients from different cultural backgrounds come in with different types of problems and expectations of therapy (for instance, the stigma associated with mental illness in many cultures), therapists also must be aware of cultural differences in communication and rapport-building, which may influence the client-therapist working relationship.

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