Enhancing the Delivery of Health Care: Eliminating Health Disparities through a Culturally & Linguistically Centered Integrated Health Care Approach

INTEGRATION:

The Future of Health Care in America Research shows that treating behavioral health conditions as early as possible, holistically, close to a person’s home and community, and in a culturally and linguistically appropriate manner leads to the best health outcomes. Integrated behavioral and physical health care is gaining significant momentum across the nation as a preferred approach to providing optimal care for behavioral health conditions. This approach is more accessible and less stigmatizing than referral to specialty behavioral health care settings.

The World Health Organization (2011) has recommended integrating mental health services into primary care as the most viable way of closing the gap in prevention and treatment of mental illness. Primary care settings are often the first point of contact for all health issues and therefore, the gateway to identifying undiagnosed or untreated behavioral health conditions. A successful approach would require primary care settings to incorporate early screening, identification and treatments for behavioral health disorders, while ensuring the presence of a culturally diverse workforce that treats the whole health patient/consumer.

Providing health care to the community at the “point of entry” in the system is the key to wellness. In particular, racial and ethnic minority populations and individuals with limited English proficiency (LEP) are more likely to seek and receive behavioral health care in primary care settings. Many reasons have been cited for this trend, including lack of access to mental health specialists, income and insurance issues, stigma surrounding mental illness, the level of trust in the relationship with the family physician, language and cultural barriers that hinder communication and delivery of services (President’s New Freedom Commission on Mental Health, 2003). Integrated health care approaches must respect the whole person, work across the life span, include prevention and early intervention methods, and be person centered, strength based and recovery focused. Providers that respect the cultures, languages and world views of the people they serve are more successful in engaging and activating individuals, families and communities to be an active participant in their own health care.