Behavioral health disparities affect the health of diverse communities across the U.S., including racial and ethnic groups; lesbian, gay, bisexual, transgender, and questioning (LGBTQ) populations; people with disabilities; transition-age youth; and young adults. One of the main causes of these disparities is lack of access to culturally and linguistically appropriate services. But for many substance abuse prevention staff working at the state and local levels, providing appropriate services to groups experiencing these disparities can be challenging.
To equip practitioners with the knowledge and skills needed to promote health equity by reducing behavioral health disparities, the CAPT has developed a menu of tools and trainings—including two recent webinars for SAMHSA prevention grantees (now archived)—designed to deepen practitioner understanding of health disparities, overall, and their impact on substance use and prevention; increase cultural and linguistic competency; and ultimately, promote health equity in their communities.
“Addressing behavioral health disparities is an increasing priority for SAMHSA and the Department of Health and Human Services, because we now understand more about how health disparities contribute to health inequity,” says CAPT National and Cohort Services Manager and webinar presenter Molly Lowe. “If we want to have equitable health for all people, and prevent substance abuse among different types of people and groups in different areas, we need to make sure that we’re addressing these sorts of disparities that are occurring, and that the prevention workforce is prepared to do so.”
An Urgent Need
To ensure effectiveness, the CAPT tailored webinar content addressing the urgent needs expressed by the field.
“We hear a lot from grantees about specific challenges they are facing in addressing behavioral health disparities,” says CAPT Training and Technical Assistance Specialist Jessica Goldberg. “Many struggle with knowing how to talk about disparities; they’re searching for a common language to describe the issues. Others want to know where to go to better identify and understand populations in need. There’s a real commitment among practitioners to addressing behavioral health disparities, but many feel overwhelmed by the prospect. It’s often difficult for them to envision the concrete steps needed to develop an action plan.”
To help participants address these issues, the CAPT webinars focused on the knowledge grantees need to address behavioral health disparities at all levels of their work. Presentations highlighted the connections between behavioral health disparities and cultural competency, how to collect data on populations that may be experiencing disparities, ways to engage stakeholders and other partners in these approaches, and approaches for identifying and addressing behavioral health disparities among identified sub-populations throughout the strategic planning process.
“We tried to show grantees, ‘You’re already doing a lot of this work by implementing culturally competent approaches,’” says Lowe, who underscored the fact that this is not brand new work for grantees. “We want them to know, 'You're not starting from scratch, and you're already doing more than you think. You just need to be paying closer attention, and take more deliberate steps, to reducing behavioral health disparities.’”
A portion of the webinar discussion also explored strategies for implementing the Enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, a requirement for SAMHSA prevention grantees. These standards provide a blueprint for implementing culturally and linguistically appropriate services.
The webinars also featured concrete examples of how grantees and sub-recipients are addressing health disparities in their states and communities. For example, a representative from the Standing Together Embracing Prevention (STEP) Coalition from Deer River, Minnesota described lessons learned addressing behavioral health disparities among the American Indian youth with whom they work. She described how the coalition brought key American Indian leaders to the prevention table and sought the community's input in developing culturally appropriate prevention materials that resonated with their target audience.
Building on the two webinars, the CAPT developed a two-day, face-to-face training program that it will be able to customize to meet individual grantee needs.
“The beauty of a two-day in-person training is that it allows us time to focus on skills development,” Lowe says. “We can go deeper into issues of culture and what that means when we’re thinking about cultural competence and health disparities. And we can begin to explore the concrete steps practitioners can take to produce real change in their communities.”
To build practitioners' skills, the training uses case studies to explore issues experienced by a variety of at-risk populations, including active-duty military service members, youth living in rural poverty, Hispanic youth, and LGBTQ adults. “The training is very interactive, and is designed to give participants techniques and approaches that they can apply to their programs," Goldberg says.
The CAPT is also developing a health disparities toolkit (available January 2016), comprising resources developed for the webinars and training, to support grantees in their disparities work, and plans to deliver the webinar series again to the new cohort of Partnerships for Success (PFS) 2015 grantees.
"Our goal is for grantees to understand that effective prevention means addressing behavioral health disparities—that the two are inextricably linked," says Lowe. "We’re pleased to now have the programming and resources to help them see the connections, and to develop the skills needed to achieve behavioral health equity in their communities."
For more information on this webinar series, contact CAPT National and Cohort-Based Services Manager Molly Lowe at email@example.com.