The Office of Behavioral Health (OBH) appreciates and values the rich diversity that exists among Colorado's 5 million residents and recognizes Colorado's diverse population includes unique behavioral health needs among individuals. Behavioral Health agencies statewide have experienced challenges in attempting to provide effective, culturally competent services to all. Similarly, clients have struggled with finding culturally competent behavioral health services to effectively meet their needs.
The behavioral health needs of Colorado residents cannot be denied, as "One out of five people in Colorado need mental health services each year, yet fewer than a third of them receive care. The lack of care resulted in suicide, lost productivity and homelessness, among other costs, for many of the 600,000 Coloradans who went untreated in 2000... Significant disparities exist in access to mental health care for racial, ethnic and sexual minority groups, for people with disabilities, and for people living in rural areas of the state." - The Status of Mental Health Care in Colorado, The Colorado Trust.
Barriers involving community outreach, linguistics, a lack of training options and a lack of resources have negatively impacted service delivery, client retention and treatment outcomes for those individuals struggling to connect to culturally responsive agencies and treatment providers.
To learn more about OBH's Culturally Informed and Inclusive Behavioral Health Program services, expand the drop downs below:
OBH's Historical Commitment to Culturally Competent Behavioral Health Care
The Office of Behavioral Health (OBH) has a longstanding history of maintaining a strong focus and commitment to advancing cultural competence within the behavioral health field, with the overall goal of improving behavioral health services and treatment outcomes for all Coloradans.
- In 2001 the Cornerstone Cultural Competency committee formed as a part of the Cornerstone Initiative. The committee developed an agency needs assessment and hosted a daylong workshop about "Organizational Cultural Competency." This group also contributed to Denver University's qualitative study on the Cornerstone system of care.
- In January 2001, as the former Division of Mental Health (DMH), OBH championed the Multicultural Issues committee, which later came to be known as the Multicultural Advisory Committee. This committee was comprised of internal and external stakeholders, treatment providers and community leaders who focused on ways to define cultural competency, assess cultural competence, develop trainings, review existing resources and assess statewide efforts in mental health agencies regarding the advancement of culturally competent practices. In March 2002 the group spearheaded the Cultural Competence Initiative and proposed they convene a panel of experts to exchange knowledge, research and ideas around cultural competence. The initiative also sought to provide suggestions to the National Association of state Mental Health Program Directors. With their renewed focus and redefined goals, the committee renamed itself the "Mental Health Services Cultural Competency Plan Advisory Committee." This group oversaw several sub-committees to include the "Consumer Involvement Outreach" subcommittee, the "Training I" subcommittee, the "State Plan Principles of cultural Competency" committee and the "Clearinghouse II" subcommittee. The collective committees developed a cultural competency implementation plan, however, challenges arose in the form of funding deficits and the groups disbanded in March 2003.
- In 2004 OBH developed and introduced the "Colorado Mental Health Services Cultural Competency Policy Plan" with the over-arching goal of achieving cultural competency at all levels within an organization.
- From 2005 through 2006 OBH participated in the Colorado Department of Human Services' Cultural Competency Committee, which conducted the first cultural competency pilot survey for the Colorado Mental Health Institute-Pueblo (CMHI-P). Using the survey's results, OBH assisted in the development of strategies to better recognize and celebrate culture and diversity through cultural celebrations and activities at CMHI-P.
- In March 2005 OBH developed the Cultural Competency subcommittee, which focused on recognition and inclusion of the Hispanic culture within the behavioral health field. This group focused on the unique treatment needs and barriers to treatment within the Hispanic community, specifically around substance abuse issues. It also focused on culturally specific celebrations, changing demographics, trends and varying treatment needs specific to different geographical locations
- From July 2005 through November 2006 OBH launched a task-oriented committee, in conjunction with the Metaphysical Research society that focused on putting into operation cultural responsiveness. They developed a set of culturally competent guiding principles and worked to establish a process of integrating culturally responsive practices in mental health work. The committee's work culminated in a structural guideline, a treatment providers' reference to assess their clients' cultural needs, develop and implement culturally sensitive and inclusive treatment plans and evaluate treatment outcomes.
- In Sept 2008 OBH organized the Cultural Competency Workgroup, which met on a quarterly basis, to respond to the Cultural Competency 5 year plan. The group originated as an internal workgroup but expanded by inviting external stakeholders. The group discussed development of a training curriculum for treatment providers to increase the knowledge base and skill set of culturally competent behavioral health.
- In 2008 and 2009 OBH re-addressed the 2004 "Colorado Mental Health Services Cultural Competency Policy Plan" and incorporated policy development, best practices, a certification plan, and consumer/community outreach planning.
- In January 2010 OBH was asked to participate as a member of the "Latino Behavioral Health Roundtable Committee," which eventually came to be known as the "Latino Roundtable," hosted by OBH. This group was primarily comprised of several external subject-matter experts and OBH employees. Accomplishments of this group included development of a mission statement, goals, objectives, development of several regional trainings and an annual retreat.
- In 2010 OBH sought out Carla King and Associates, Inc. in order to undergo a Cultural Competency Plan Review. In August 2010 OBH received a Cultural Competence Plan Review that outlined a five-year plan. The review recommended policy development, development of best practices, consumer outreach, training development and ways in which to provide technical assistance to consumers.
- Also in 2010, OBH worked together with external stakeholders to develop a two-day training for the Certified Addictions Counselor training program entitled "Culturally Informed Treatment."
- In 2012 OBH began participating in the System of Care initiative, which included a strong focus on cultural competency. The group developed 43 recommendations specific to improving culturally competent behavioral health services, including the recommendation to create an Office of Cultural Affairs within the state of Colorado.
- In June 2012 OBH created and filled the position of Manager of Cultural Competency Programming.
- In the summer of 2012 the "Latino Roundtable" reorganized as the Multicultural Behavioral Health Committee. It most recently underwent a transformation to the "Providers for the Advancement of Cultural Competence" (PACC) Network Committee. This committee presently serves as an open forum in which providers and the OBH can communicate about OBH activities related to cultural competency, as well as provider efforts, challenges, solutions and ideas about the current needs of their community, specific to culturally competent behavioral healthcare.
- In October 2012 OBH convened the Cultural Competency Advisory Council (CCAC), a group of subject matter experts and behavioral health experts with a shared primary focus area of cultural competence. This group meets every other month and participates in policy development, workforce development and resource development and review, among other tasks.
- In early 2014 OBH awarded the task of developing a Behavioral Health Equity Report to the OMNI Institute, which was completed in late 2015 and released in January 2016. To review the report, click here.
- In late 2015 the OBH convened a policy workgroup to develop agency policies reflective of the National CLAS Standards. Those behavioral health policies can be viewed here.
- Defining Cultural Competence
Defining Cultural Competence
The Office of Behavioral Health (OBH)has from time to time reviewed and developed terms to reflect OBH's understanding of culture, cultural competence and linguistic competence. Presently OBH supports the conceptual frameworks/models, guiding values and principles developed by the National Center for Cultural Competence and the U.S. Department of Health and Human Services, Office of Minority Health.
Additionally, OBH supports the National Standards on Culturally and Linguistically Appropriate Services (CLAS).
- Cultural Competence Advisory Council
Cultural Competence Advisory Council (CCAC)
This group is comprised of subject matter experts in the area of cultural competence and behavioral health and includes both internal and external stakeholders. This group is scheduled to meet on the third Tuesday afternoon of even numbered months at OBH.
The CCAC Mission Statement: Assist OBH with the elimination of disparate outcomes in behavioral health through advisement of effective changes in policy, procedure and accountability by infusion of culturally and linguistically responsive and inclusive practices in behavioral health services.
- Policies and Procedures
Agency Policies and Procedures
The Office of Behavioral Health (OBH) has enacted the creation of seven policies reflective of the National CLAS (Culturally and Linguistically Appropriate Services) Standards. The policies are designed to provide behavioral health agencies with guidance and direction in implementing the National CLAS Standards into their daily practices. Visit the policies page to learn more about CLAS Standards Policies and Procedures.
- Agency Assessments
Agency Assessments and Trainings
Since 1999, the OBH has sought to promote and advance cultural competence through the utilization of appropriate, valid and informative assessment tools. The OBH has utilized the information gathered as the basis for cultural competency training development. Past trainings were designed to address the identified areas of growth for OBH and community behavioral health agencies alike.
Assessing an agency's level of cultural competency is an essential part of identifying agency strengths and ways in which your organization can improve the delivery of culturally competent behavioral health care. With the permission of the National Center for Cultural Competence, the OBH is pleased to offer the following agency assessments upon request:
- Cultural and Linguistic Competence Family Organization Assessment (CLCFOA)
- Cultural and Linguistic Competence Policy Assessment (CLCPA)
The OBH is pleased to provide consultation, technical assistance and cultural competency training opportunities to agencies, as requested. Trainings can be tailored to agency needs.
In 2010, the OBH developed the "Culturally Informed Treatment" curriculum, which is currently being taught as part of the Certified Addictions Counselor training program. This curriculum was updated in 2013 by the Cultural Competency Advisory Council.
OBH has several trainings presently available, covering the following topics:
- Cultural Considerations for Behavioral Health Providers
- Working with the Offender Culture
- Considering the Impact of Generational Culture on Behavioral Health Practices
- Military Culture
- Stigma About Behavioral Health Across Cultures
- Related Resources
- National Center for Cultural Competence
- Office of Minority Health, U.S. Department of Health and Human Services
- Cultural Competence in Mental Health Services, Child Welfare Information Gateway
- Mental Health America
- American Psychological Association Guidelines for Psychological Practice with Lesbian, Gay, and Bisexual Clients
National Certification Bodies
- The National Board of Certification for Medical Interpreters
- Certification Commission for Healthcare Interpreters
- National Council on Interpreting in Health Care
- American Translators Association
- Office of Health Equity, Colorado Department of Public Health &, Environment
- Cultural Competency Consulting
- The Colorado Trust
Resources for Providers
- Cultural Assessment Resource Guide, Revised2013. Colorado Office of Behavioral Health.
- Evidence-Based Practice with Diverse Populations: An Assessment and Treatment Overview, 2014.University of Denver Center for Community Engagement & Service Learning.
- Cross-Cultural Barriers to Mental Health Services in the United States, 2011.Cerebrum, The Dana Foundation.
Resources for Engagement Efforts:
Shelly Solopow, LPC CACII