Exit this survey
This survey will provide insights on the degree to which our organizations and services are culturally and linguistically accessible to our diverse community. We benefit most from your thoughtful and honest responses.

You may also find that this checklist provides concrete examples of ways that you as agency leaders can foster more welcoming and inclusive environments.

These questions have been adapted from the Georgetown Institute's Behavioral Health Instrument.
PROMOTING CULTURAL DIVERSITY AND CULTURAL COMPETENCY
Self-Assessment Checklist for Personnel Providing Behavioral Health Services and Supports to Children, Youth and their Families

Question Title

* 1. Name of Your Organization

Question Title

* 2. Are you a SAGE West Collaborative MOU signatory?

Question Title

* 3. Briefly describe how your organization serves consumers who speak Spanish as a primary language.

Question Title

* 4. What services is your organization unable to provide due to a language or cultural barrier?

Question Title

* 5. Describe your organization's staffing

  Full Time Staff Part Time Staff
Number of bilingual (Spanish-English) staff
Number of native Spanish speakers

Question Title

* 6. Use of interpreters

  Yes No Unknown
Does your organization use interpreters?
Are they certified?
Are they professionally trained?
Are they native language speakers?

Question Title

* 7. Physical Environment, Materials and Resources

  Things we do frequently Things we do occasionally Things we do rarely or never N/A
1) We display pictures, posters and other materials that reflect the cultures and ethnic backgrounds of children, youth, and families served by my program or agency.
2) We insure that magazines, brochures, and other printed materials in reception areas are of interest to and reflect the different cultures of children, youth and families served by my program or agency.
3) When using videos, films, CDs, DVDS, or other media resources for mental health prevention, treatment or other interventions, we insure that they reflect the cultures of children, youth and families served by my program or agency.
4) When using food during an assessment, we ensure that meals provided include foods that are unique to the cultural and ethnic backgrounds of children, youth and families served by my program or agency.
5) We ensure that toys and other play accessories in reception areas and those, which are used during assessment, are representative of the various cultural and ethnic groups within the local community and the society in general.

Question Title

* 8. Physical Environment, Materials and Resources

  Things we do frequently Things we do occasionally Things we do rarely or never N/A
1) We display pictures, posters and other materials that reflect the cultures and ethnic backgrounds of children, youth, and families served by my program or agency.
2) We insure that magazines, brochures, and other printed materials in reception areas are of interest to and reflect the different cultures of children, youth and families served by my program or agency.
3) When using videos, films, CDs, DVDS, or other media resources for mental health prevention, treatment or other interventions, we insure that they reflect the cultures of children, youth and families served by my program or agency.
4) When using food during an assessment, we ensure that meals provided include foods that are unique to the cultural and ethnic backgrounds of children, youth and families served by my program or agency.
5) We ensure that toys and other play accessories in reception areas and those, which are used during assessment, are representative of the various cultural and ethnic groups within the local community and the society in general.

Question Title

* 9. Physical Environment, Materials and Resources

  Things we do frequently Things we do occasionally Things we do rarely or never N/A
1) We display pictures, posters and other materials that reflect the cultures and ethnic backgrounds of children, youth, and families served by my program or agency.
2) We insure that magazines, brochures, and other printed materials in reception areas are of interest to and reflect the different cultures of children, youth and families served by my program or agency.
3) When using videos, films, CDs, DVDS, or other media resources for mental health prevention, treatment or other interventions, we insure that they reflect the cultures of children, youth and families served by my program or agency.
4) When using food during an assessment, we ensure that meals provided include foods that are unique to the cultural and ethnic backgrounds of children, youth and families served by my program or agency.
5) We ensure that toys and other play accessories in reception areas and those, which are used during assessment, are representative of the various cultural and ethnic groups within the local community and the society in general.

Question Title

* 10. Communications Styles

  Things we do frequently Things we do occasionally Things we do rarely or never N/A
6) For children and youth who speak languages or dialects other than English, we attempt to learn and use key words in their language so that we are better able to communicate with them during assessment, treatment or other interventions.
7) We attempt to determine any familial colloquialisms used by children, youth and families that may impact on assessment, treatment or other interventions.
8) We use visual aids, gestures, and physical prompts in our interactions with children and youth who have limited English proficiency.
9) We use bilingual or multilingual staff or trained/certified interpreters for assessment, treatment and other interventions with children and youth who have limited English Proficiency.
10) We use bilingual staff or multilingual trained/certified interpreters during assessments, treatment sessions, meetings, and for other events for families who would require this level of assistance.
11a) When interacting with parents who have limited English proficiency we always keep in mind that limitation in English proficiency is in no way a reflection of their level of intellectual functioning.
11b) When interacting with parents who have limited English proficiency we always keep in mind that their limited ability to speak the language of the dominant culture has no bearing on their ability to communicate effectively in their language of origin.
11c) When interacting with parents who have limited English proficiency we always keep in mind that they may or may not be literate in their language or origin or English.
12) When possible, we ensure that all notices and communiqués to parents, families and caregivers are written in their language of origin.
13) We understand that it may be necessary to use alternatives to written communications for some families, as word of mouth may be a preferred method of receiving information.
14a) We understand the principles and practices of linguistic competency and apply them within my program or agency.
14b) We understand the principles and practices of linguistic competency and advocate for them within my program or agency.
15) We understand the implications of health/mental health literacy within the context of my roles and responsibilities.

Question Title

* 11. Values and Attitudes

  Things we do frequently Things we do occasionally Things we do rarely or never N/A
16) We use alternative formats and varied approaches to communicate and share information with children, youth and/or their family members who experience disability.
17) We avoid imposing values that may conflict or be inconsistent with those of cultures or ethnic groups other than our own.
18) In group therapy or treatment situations, we discourage children and youth from using racial and ethnic slurs by helping them understand that certain words can hurt others.
19) We screen books, movies, and other media resources for negative cultural, ethnic, or racial stereotypes before sharing them with children, youth and their parents served by our program or agency.
20) We intervene in an appropriate manner when we observe other staff or parents within our program or agency engaging in behaviors that show cultural insensitivity, bias or prejudice.
21) We understand and accept that family is defined differently by different cultures (e.g. extended family members, fictive kin, godparents).
22) We recognize and accept that individuals from culturally diverse backgrounds may desire varying degrees of acculturation into the dominant or mainstream culture
23) We accept and respect that male-female roles in families may vary significantly among different cultures (e.g. who makes major decisions for the family, play and social interactions expected of male and female children).
24) We understand that age and life cycle factors must be considered in interactions with individuals and families (e.g. high value placed on the decisions of elders or the role of the eldest male in families).
25) Even though our professional or moral viewpoints may differ, we accept the family/parents as the ultimate decision makers for services and supports for their children.
26) We recognize that the meaning or value of behavioral health prevention, intervention and treatment may vary greatly among cultures
27) We recognize and understand that beliefs and concepts of emotional well-being vary significantly from culture to culture.
28) We understand that beliefs about mental illness and emotional disability are culturally-based. We accept that responses to these conditions and related treatment/interventions are heavily influenced by culture.
29. We understand the impact of stigma associated with mental illness and behavioral health services within culturally diverse communities.
30) We accept that religion, spirituality and other beliefs may influence how families respond to mental or physical illnesses, disease, disability and death.
31) We recognize and accept that folk and religious beliefs may influence a family's reaction and approach to a child born with a disability or later diagnosed with a physical/emotional disability or special health care needs.
32) We understand that traditional approaches to disciplining children are influenced by culture.
33) We understand that families from different cultures will have different expectations of their children for acquiring self-help, social, emotional, cognitive, and communication skills.
34) We accept and respect that customs and beliefs about food, its value, preparation, and use are different from culture to culture.
35) Before visiting or providing services in the home setting, we seek information on acceptable behaviors, courtesies, customs and expectations that are unique to families of specific cultures and ethnic groups served by our program or agency.
36) We seek information from family members or other key community informants that will assist in service adaptation to respond to the needs and preferences of culturally and ethnically diverse children, youth, and families served by our program or agency.
37) We advocate for the review of our program's or agency's mission statement, goals, policies, and procedures to insure that they incorporate principles and practices that promote cultural diversity and cultural and linguistic competence.
38) We keep abreast of new developments in pharmacology particularly as they relate to racially and ethnically diverse groups.
39) We either contribute to and/or examine current research related to ethnic and racial disparities in mental health and health care and quality improvement.
40) We accept that many evidence-based prevention and intervention approaches will require adaptation to be effective with children, youth and their families from culturally and linguistically diverse groups.

T