Janice L Cooper and Yumiko Aratani
There are acknowledged disparities in access to quality children’s mental health services and in outcomes based on race/ethnicity and English language proficiency in the United States. To assess how states currently make operational key principles of cultural and linguistic competence and to assess barriers, we surveyed United States state child mental health directors on their policylinked strategies to increase cultural and linguistic competence and reduce disparities. Based on previous research, strategies to address system-level challenges were identified. They included: the existence of cultural advisory bodies, implementation of a cultural competence plan, workforce development, measurement and self-assessments and leadership. Forty states participated in the survey. Our findings indicate that state-led efforts remain limited. Only seven states had updated strategic plans, and eleven reported having regular assessments on disparities. Twenty-three states reported implementing cultural and linguistic competence training for providers. States face numerous barriers to their efforts to devise and implement policy-linked strategies to reduce disparities. With the Affordable Care Act of 2010 and the enhanced national standards for culturally and linguistically appropriate services in health and health care, states should advance policy to address disparities in children’s mental health based on race/ethnicity and English language proficiency.