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Diversity: A Need Acknowledged Yet a Slow Motion of Change

We live in an age of diversity. The American melting pot metaphor has today manifested itself profoundly, given the dramatic shifts in demographics that are fast changing the face of the American society. People from all different countries, races, languages and religions of the world are constantly attracted to America, the world’s greatest nation, where they hope to find freedom, new opportunities and a better life. Yet rather than being melted in assimilation into the American mainstream way of life, many of the more recent immigrants of the past thirty or more years prefer to keep the cultural norms and beliefs of their homelands, including their overview of mental health, where they perceive a unique mystery to mental illness and find its possible treatment to transcend beyond science, and therefore, help is sought in the realms of religion and the supernatural, and stigma remains very pervasive as a barrier.

America is presently seen more as a mosaic of multiculturalism. Americans are often proud to acknowledge that it is this very mixture of peoples and cultures that makes America to be filled with its strength and richness. Nonetheless, we also realize multiculturalism as bringing its challenges for America to contend with. This is because the usual mind-set of “a one system to fit all sizes” cannot be sustained any longer. To understand ourselves as belonging to a world of variety and interdependence on one another for resources and progressive economies, multiculturalism as the embodiment of diversity could at best be embraced in a positive light, but that often fails due to misunderstanding of cultures. Consequently, disparities to opportunities and access abound and to the detriment of our collective wellbeing and progress as a nation in our infrastructures including our mental health system.

The American Surgeon General’s report of 1999 declared that, “the U.S. mental health system is not well equipped to meet the needs of racial and ethnic minority populations,” the very “groups generally considered to be underserved by the mental health services system. While practitioners and social services providers work with all kinds of people, they often do not understand or feel comfortable with those whose cultural backgrounds are different from their own.” Consequently, many ethnic groups “experience mental health service delivery as a product of white, European culture, shaped by research primarily on white, European populations. They also find clinicians and administrators to operate to represent white middle-class orientation, with its cultural values and beliefs but biases and stereotypes of other cultures.” Change is therefore critical.

The result is the establishment of the Cultural Competence Continuum, a conceptual framework, which demands that clinicians and systems develop flexibility in thinking and behavior and learn to adapt professional tasks and work styles to the values, expectations, and preferences of specific clients and population groups (Pinderhughes 1989, pp. 163). Cultural competence is the ability to work effectively within the cultural context and values of others which is an effort to enhance a positive outcome of the client, and ultimately, for the gains of the organization. It is also coming to the realization that there is a deeper meaning to diversity where there must be the understanding that disparities in social and economic opportunity among groups often reflect the continuing impact of racism, sexism and other forms of prejudice and bigotry.

NAMI believes in diversity. The Multicultural Action Center (MAC) of NAMI National reports that it is “created to focus attention on systems reform to eliminate disparities in mental health care for diverse communities and ensure culturally-competent services and treatment for all Americans.” This effort is yet to see bigger results. I myself, like many others, surely believe in the noble cause of NAMI in her advocacy of good quality life for people with mental illness and their families. Also as a person who believes in the fundamental nature of diversity, NAMI’s new initiative, Build it Together – Taking NAMI to the Next Level – Becoming a Diversity Organization, comes as good news where the Multicultural Action Center is concentrating on helping NAMI state organizations become more diverse and inclusive. As much as NAMI fights against stigma attached to mental illness, NAMI must also resist all other prejudices. NAMI Massachusetts is making the effort to respond to the call. It, however, has to have a true commitment demonstrable by its board of directors and all the twenty affiliates of NAMI Massachusetts to work together in concert and challenge our conscience to establish an effective diversity and inclusion process at all levels of operation of the organization to remove and end continued disparities.

Hannah Martinez, President

NAMI Dorchester/Mattapan/Roxbury Affiliate

February 18^th, 2014