Cultural competence and consumer involvement: Practice and theory

Background: The Mental Health HIV Services Collaborative (MHHSC), a 5-year program funded by the Center for Mental Health Services, awarded grants to 20 organizations across the United States to provide culturally competent mental health services specific to the needs of HIV-positive individuals in primarily African-American and Latino communities. By definition, the provision of culturally competent services required consumer input, and the MHHSC stipulated that each site have a Consumer Advisory Board (CAB). Methods: Abt Associates evaluated the implementation of the MHHSC and consumer involvement during multiple site visits. The site visit reports were coded using the NVIVO software package. Results: CAB members were unprepared to transition from clients to advisors. The MHHSC demonstrated that, in operationalizing a framework for consumer involvement, articulating a primary theoretical rationale of empowerment or service improvement is critical to defining the consumer and organization's role in a partnership. Further, institutional liaisons are integral to establishing the purpose of consumer involvement efforts and facilitating engagement between consumers and organizations. Conclusions: Consumer involvement efforts in the MHHSC provide an important evidence-base on the implementation of partnership models between consumers and organizations to facilitate cultural competence. Data collected indicate that organizations must close a gap in the principal framework for assessing cultural competence published by the Health Resources and Services Administration (HRSA). Absent from HRSA's framework is a theoretical rationale for consumer involvement and the role of institutional liaisons as bridges between consumers and organizations.