NAMI National’s Cultural Competence Assessment Results

1. NAMI National’s Cultural Competence Assessment Results “Using Data to Move from Good to Great”

2. Presentation Overview • Identify Assessment Focus & Features • Present Summary of Results • Identify Key Findings & Recommendations • Present Implementation Considerations

3. NAMI National’s Assessment Focus • Cultural Competence- A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals, and enables this system, agency or those professionals to work effectively in cross cultural situations. (Cross, et. al., 1989)

4. Assessment Features • Cultural competence was viewed as a dynamic process. • All levels of the organization were involved. • Both internal and external stakeholders provided feedback.

5. Assessment Features • 8 major domains served as the basis for measuring NAMI National’s cultural competence: 1. Organizational Values 2. Policies, Procedures, Governance 3. Planning, Monitoring, Evaluation 4. Communication

6. Major Domains Cont’d 5. Human Resource Development 6. Community and Consumers’ Participation 7. Facilitation of a Broad Service Array 8. Organizational Resources Note: The term consumer refers to individuals with mental illness and their family members.

7. Assessment Features • 12 Indicators provided insight about the 8 domains: Leadership, Vision & Mission, Staff Composition, Cultural Concepts, Work & Service Climate, Collaboration, Policies & Procedures, Service Delivery, Staff & Volunteer Development, Communication, Outcomes Management, and Performance Evaluation

8. Assessment Features Four-Stage continuum used to define NAMI National’s status • Stage 1- Unaware & Not Yet Competent • Stage 2- Aware & Not Yet Competent • Stage 3- Aware & Competent • Stage 4- Intrinsically Aware & Competent

9. Assessment Features • A NAMI National Cultural Competence Assessment Team representing key stakeholders was formed. • Team members were responsible for ensuring adequate representation in the assessment process and a process that was culturally and linguistically appropriate for all stakeholders.

10. Assessment Features • Data was collected from multiple sources including organizational records, work products, and internal and external stakeholders. • A variety of methods were used including surveys, focus groups, and product review.

11. Assessment Results Who Participated? • Executive Director- completed an on-line organizational survey that generated a profile of NAMI National and information about 4 of the 8 domains • 207 internal stakeholders representing 46% of the individuals invited to participate • 21 external stakeholders representing 12% of the individuals invited to participate

12. Assessment Results Who Participated? • 7 focus groups comprised of individuals representing Board of Directors, Cultural Competence Assessment Team, Multicultural Leaders, Consumer Council, President’s Council, Veterans Council, Executive Directors Group, Spanish speaking consumers and families, and NAMI National office staff

13. Overall Assessment Results • NAMI National is at Stage 2: Culturally Aware and Not Yet Culturally Competent • Data suggests NAMI National has engaged in activities that communicates the value it places on “becoming culturally competent”

14. NAMI National’s Cultural Competence StageAcross Domains and Methods Organizational Values • Internal Stakeholders Stage 2 • External Stakeholders Stage 2.5 • Focus Groups Stage 2.5

15. NAMI National’s Cultural Competence StageAcross Domains and Methods Policies, Procedures, Governance • Records/Products Review Stage 2 • Executive Director Survey Stage 2 • Internal Stakeholders Stage 2 • External Stakeholders Stage 2 • Focus Groups Stage 2

16. NAMI National’s Cultural Competence StageAcross Domains and Methods Planning, Monitoring, Evaluation • Internal Stakeholders Stage 2 • Focus Groups Stage 2

17. NAMI National’s Cultural Competence StageAcross Domains and Methods Communication • Records/Products Review Stage 2 • Executive Director Survey Stage 2 • Internal Stakeholders Stage 2 • External Stakeholders Stage 3 • Focus Groups Stage 2.5

18. NAMI National’s Cultural Competence StageAcross Domains and Methods Human Resource Development • Records/Products Review Stage 2 • Executive Director Survey Stage 2 • Internal Stakeholders Stage 2 • Focus Groups Stage 2

19. NAMI National’s Cultural Competence StageAcross Domains and Methods Community & Consumer Participation • Internal Stakeholders Stage 3 • Focus Groups Stage 2.5 Note: The term consumer refers to individuals with mental illness and their family members

20. NAMI National’s Cultural Competence StageAcross Domains and Methods Facilitation Broad Service Array • Records/Products Review Stage 2 • Internal Stakeholders Stage 2 • Focus Groups Stage 2

21. NAMI National’s Cultural Competence StageAcross Domains and Methods Organizational Resources • Executive Director Survey Stage 2 • Internal Stakeholders Stage 2 • Focus Groups Stage 2

22. Key Findings Organizational Values • The level of engagement and the level in which needs are met vary from constituent to constituent because cultural competence is not yet recognized as a core value at all levels of the NAMI National culture. • NAMI National engages in a few activities that celebrate and recognize individuals within the organization who behave in ways that are respectful of different cultures.

23. Rationale • Consistent embracing of cultural competence as a core value at all levels of the NAMI National organization will ensure that people within NAMI National behave in ways that engage NAMI National’s diverse constituents and their needs are met.

24. RECOMMENDATION • Facilitate a shared understanding of NAMI’s mission and the impact cultural competence has on achieving it.

25. Proposed Actions • NAMI National’s Board members could formalize definitions of culture and cultural competence and ensure all levels of the NAMI National organization understand and integrate the definitions into their daily operational practices. • NAMI National’s Board members and staff could revisit NAMI National’s mission statement and determine if it communicates the importance of cultural competence and modify if necessary.

26. Proposed Actions Cont’d • NAMI National Board members could identify places to communicate NAMI National’s definition of culture and cultural competence so that all constituents are made aware of how NAMI National views these terms. For example, web-site, Advocate magazine, standards document, employee handbook, etc.

27. Proposed Actions Cont’d • At Senior Management meetings and all staff meetings, the Executive Director could allow time on the agenda for different departments to highlight examples of how they have advanced NAMI National’s mission by behaving in a culturally competent manner. • NAMI National’s Board could reach consensus regarding practices Board members will engage in that demonstrate how they value cultural competence.

28. Proposed Actions Cont’d • In its standards development work, the Standards Work Group should ensure that cultural competence standards are developed and integrated into the organization’s overall standards. • Identify and share “best practices” that state organizations and local affiliates engage in to become culturally competent.

29. Proposed Actions Cont’d • Find ways to celebrate successes at all levels of the organization including Board, staff, departments, state organizations, local affiliates, partners, etc. • For example, highlight “best practices” on web-site; feature a Board member, staff or department in the Advocate; enhance funding of grants are awarded to chapters and affiliates that will facilitate sustaining their work.

30. Proposed Actions Cont’d • NAMI National leaders (for example, Board members, Executive Director, Center of Leadership Development, etc.) could share with NAMI constituents their thoughts about cultural competence and its value to the organization. • For example, host leaders’ web broadcast; create pod casts; host a blog; publish an article in a newsletter; present a leaders’ panel at a conference, etc.

31. Key Findings Policies, Procedures, Governance • NAMI National has established a Standards Work Group to distill a set of standards that will move NAMI towards greatness and its strategic plan goals. This Work Group presents a timely opportunity to establish cultural competence standards and policies. • While some procedures have been established that address cultural competence practices, such as guidelines for developing culturally competent materials, most constituents are not aware of them.

32. Rationale • Establishing and adopting cultural competent standards, policies, and procedures will facilitate NAMI National providing services that are more culturally and linguistically accessible and appropriate; responsive to the needs of its diverse constituents; and are likely to improve services provided to individuals with serious mental illness.

33. RECOMMENDATION • Leverage the Standards Work Group to develop and integrate cultural competence standards, policies, and procedures into NAMI National’s standards and policy development work.

34. Proposed Actions • Review member composition of Standards Work Group to ensure there is representation reflective of NAMI National’s diverse constituents. This Work Group provides NAMI National with an opportunity to get feedback at the onset of development. • The Standards Work Group should review existing cultural competence standards and policies developed by other organizations.

35. Proposed Actions Cont’d • Develop culturally appropriate training for internal and external stakeholders that educates them about NAMI National’s cultural competence standards, policies, and procedures. Include in this training performance expectations. • NAMI National’s Policy platform makes sure that diversity and cultural competence is included. Inclusion will ensure all of NAMI’s diverse constituents have access to and receive quality services.

36. Key Finding Planning, Monitoring, Evaluation • A limited amount of data is collected on an on-going, systematic basis to determine if programs, products and services are meeting the needs of NAMI National’s diverse constituents. Similarly, data is used minimally to drive improvement in the organization’s cultural competence.

37. Key Finding Planning, Monitoring, Evaluation • There is no accountability system in place to ensure that NAMI National’s Board members, staff, state organizations, and local affiliates behave in ways that demonstrate an appreciation and value of diversity and inclusion.

38. Key Finding Planning, Monitoring, Evaluation • There is a work group in place focused on expanding the organization’s capacity to collect meaningful data about its constituents. This work group presents an opportunity for NAMI National to ensure that appropriate data is collected and used to ensure the organization becomes culturally competent.

39. Rationale • In the absence of a comprehensive data collection system, some of NAMI National’s work is driven by assumptions. This makes the organization vulnerable and puts it at-risk. At present, NAMI National is limited in its ability to know its constituents, prioritize its work and adequately leverage its resources.

40. RECOMMENDATION • Leverage existing data collection work group focused on expanding the organization’s capacity to collect meaningful data that considers data elements and data methods appropriate to NAMI’s diverse culture and linguistic needs.

41. Key Finding Communication • NAMI National solicits feedback from its constituents. Feedback is obtained primarily from its Leadership Councils, Consumer Council, Presidents Council, Veteran’s Council, and Executive Directors Group) whose composition is not wholly representative of all of NAMI National’s constituents.

42. Key Findings Communication • Given the feedback NAMI National receives is not representative of all its constituents, NAMI National can do a better job soliciting input to ensure cultural competence. • While NAMI National has translated its materials into Spanish, these are not necessarily culturally competent since some materials are only translated and not adapted to the constituents’ culture.

43. Key Findings Communication • NAMI National utilizes a variety of methods to communicate. Reliance on electronic formats inadvertently create access barriers for some of NAMI National’s constituents. • While NAMI National has attempted to make its materials diverse (for example, translated in another language, used pictures of different racial/ethnic groups, etc.), the content is not always culturally appropriate nor is the medium, etc.

44. Key Finding Communication • NAMI National needs to develop additional materials that meet the needs of all its constituents. For example, materials that target the GLBT community, African Americans, Asian Americans, Native Americans, etc.

45. Key Finding Communication • NAMI National’s educational programs have not fully taken into account learning differences and the cultural beliefs of its diverse constituents. As such, NAMI National’s programs vary in their perceived benefit.

46. Rationale • The best way NAMI National can ensure that it is communicating the “right” message to its constituents, utilizing the “right” format and “frequency”, is to engage constituents in providing feedback prior to NAMI National developing the content, and identifying the format, method, and frequency.

47. RECOMMENDATION #1 • Solicit feedback from diverse constituents at the onset of developing a plan, program, product, etc.

48. RECOMMENDATION #2 • Consider constituents’ culture and linguistic needs when framing a message, and/or developing a program or product.

49. RECOMMENDATION #3 • Re-examine existing communication tools and identify changes that can be made to enhance these so that they meet the needs of the intended constituents.

50. Key Findings Human Resource Development • Constituents disagree on whether or not NAMI National’s Board and Staff are representative of NAMI’s diverse constituents. • The Board’s nomination and election process impacts its ability to attract and maintain a diverse Board. • NAMI National’s Senior Management team does not reflect the diversity of NAMI National’s constituents.