Description |
Background: Pacific Islanders (PIs) in the United States experience significant mental health disparities, including higher rates of depression, anxiety, and suicide compared to other ethnic groups. Limited research on culturally competent interventions for this population contributes to low engagement, misdiagnosis, and inadequate care delivery. Mental health providers often lack culturally tailored resources to integrate PI cultural values and traditional healing practices into clinical care. This project aimed to bridge this gap by implementing and evaluating a Cultural Competency Toolkit (CCT) for mental health clinicians. Problem: Despite increasing recognition of health disparities in PI communities, clinicians in outpatient mental health settings lack standardized cultural competency training. Without structured guidance, providers may struggle to engage PI patients effectively, assess cultural influences on mental health, and apply culturally aligned interventions. This project aimed to implement and evaluate the feasibility and impact of a structured CCT to enhance clinician knowledge, patient engagement, and culturally responsive treatment strategies. Methods: Over 12 weeks, the project team implemented this quality improvement initiative at an outpatient mental health clinic founded in 2003 by a PI couple who recognized the urgent need for culturally responsive counseling services in their community. The intervention introduced seven cultural and therapeutic models, including the Talanoa Method, Fonofale Model, Fa'afaletui Method, Uloa Method, Lokahi Wheel, Kaimana Intervention, and Acceptance and Commitment Therapy. Clinicians received training on these models and integrated them into practice with PI clients. The project team collected data through qualitative feedback, structured surveys, and clinician interviews to assess engagement, identify implementation challenges, and evaluate effectiveness. Intervention: The CCT provided culturally tailored assessment tools for mental health evaluation, training on PI values such as family-centered care, spirituality, and communal decision-making, and structured implementation guidelines for psychiatric assessment, treatment planning, and case documentation. Providers engaged in self-reflection exercises to assess biases and improve cultural awareness. Results: Clinicians reported an 88.9% increase in confidence in delivering culturally competent care and greater awareness of cultural barriers. Most clinicians (77.8%) reported using the Kaimana Intervention and Lokahi Wheel, citing familiarity and ease of integration. Fewer clinicians used lesser-known models, attributing this to limited training and uncertainty about implementation. Several clinicians (44.4%) noted improved client engagement as a positive outcome, with clients responding positively to the CCT's cultural relevance and alignment with their values. However, the clinic's relocation disrupted full implementation for some providers. Conclusions: This project demonstrated that the CCT effectively enhanced clinician cultural competency, patient engagement, and culturally responsive care. The findings support the need for structured training, implementation support, and workflow integration. Future efforts should expand the CCT's use, refine clinical application guidelines, and evaluate patient-reported outcomes to sustain impact and reduce disparities. |