Initiative for Decreasing Disparities in Depression CME:
Provider Self-Assessment CME Model Incorporating Cultural and Linguistic Competence in the Diagnosis and Treatment of Depression

About This CME Activity

This on-line CME activity is designed to help you improve care for your patients of diverse racial and ethnic groups who experience depression. Effectively diagnosing and treating depression can enhance both their mental and physical well-being. Part of that effective treatment is using culturally and linguistically competent approaches to patient care. To deliver this type of care, health care providers need to look beyond clinical encounters with individual patients to their family and community cultural contexts.

This CME activity provides an opportunity to assess the extent to which you currently demonstrate cultural and linguistic competence in your care of diverse patients with depression. It then will help you develop a personalized plan for future learning on this topic.

Please read the next sections to understand the rationale for this CME activity and how the activity works.

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Georgetown University Hospital and the Georgetown University Center for Child and Human Development. The Georgetown University Hospital is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The Georgetown University Hospital designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Learning Objectives

Following this activity, participants should be able to:

• report a heightened awareness of the knowledge and skills needed to implement culturally and linguistically competent approaches to diagnosing and treating depression,
• describe changes in attitude related to cultural and linguistic competence in practice, and
• identify opportunities for further learning to enhance knowledge and skills to incorporate cultural and linguistic competence into the diagnosis and treatment of depression.

Target Audience

The primary audience for this activity is primary care physicians. However, non-physicians are also encouraged to take the course. Award of CME is only available to physicians elegible to receive AMA PRA Category 1 Credit(s)™.

Acknowledgement

The coordinators of this CME Activity would like to gratefully acknowledge support in part from the Praxis Partnership program “The Initiative for Decreasing Disparities in Depression” (I3D).

Introduction

Continuing disparities in the diagnosis and effective treatment of depression persist. Many of these contributing factors can be grouped into three broad categories.

First, larger societal issues such as poverty, racism and discrimination, unemployment and underemployment, and inadequate housing have an impact on health/mental health status of diverse racial and ethnic groups.

Second, differential access to services has been demonstrated to be a factor in disparities. Access involves more than availability and affordability of services. Access also refers to an active connection with the patient. Thus, acceptability of services—how they are offered, where they are offered and by whom—is a significant factor in access.

Third, cultural and linguistic factors have been identified as contributing to disparities including language barriers, diverse belief systems related to health, mental health, healing and well-being, culturally influenced help-seeking behaviors, attitudes toward care providers, and individual preferences and approaches to care.

While continuing medical education (CME) can not address all of these issues, all may be positively impacted in the long run by health and mental health care providers who are aware of disparities and societal issues that contribute to them, and who have the knowledge and skills necessary to diagnose and treat depression effectively in culturally and linguistically diverse patient populations.

One of the five essential elements of cultural and linguistic competence is the capacity for self-assessment at both the organizational and individual levels. This continuing education activity will help you to assess yourself on cultural and linguistic competence in relation to the diagnosis and treatment of depression.

This continuing education activity allows you to assess your awareness, knowledge and/or skills in six domains:

• Values and Belief Systems -- perspectives on health, illness, mental health, well-being, care-seeking behaviors, traditional health practices, and spirituality of your patients and their communities as well as family/community dynamics.
• Cultural Influences on Illness and Related Problems -- health and mental health disparities and risk factors for culturally and linguistically diverse groups and communities.
• Depression and Health -- awareness of the relationship between illness and the risk for depression and the impact of depression on treatment and clinical course of diabetes, cardiovascular disease and HIV/AIDS
• Clinical Management -- screening, assessment/diagnosis, treatment/discharge planning, and use of community-based resources.
• Cross-Cultural Communication -- cross-cultural communication, utilization of different modes of communication, and the provision of interpretation/translation services.
• Promotion of Cultural and Linguistic Competence in Systems of Care and Communities -- the practitioners’ role in providing information that enables individuals to intervene on their own behalf, advocate and build community capacity for improved health, mental health, and well being.