Family Readiness for Consultation and Addressing Stigma

Families must also be “ready” for consultation. Family members (as well as staff) often have culture-based perceptions about what “mental health” means and may be resistant to meeting a mental health consultant who will work with them and their child. Especially when working across cultural boundaries, it is important for ECE staff to work closely with parents so that they understand that having a mental health consultant work with them doesn’t mean that they are not good parents. Cultural mistrust “the lack of trust by members of minority groups of a dominant group or culture” may also influence establishing relationships and engaging in consultation. These barriers can include shame, stigma, mistrust of the mental health services based on previous individual, family, or community experiences, conflicting ideas about what constitutes mental health and illness, culturally-based help-seeking behaviors, historical oppression, and individual and institutional discrimination (Duran et al 2009; Mackrain et al 2011; Schudrich, 2010).

Ways to Reduce Stigma

ECMH consultants can play an important role in helping to reduce the stigma that is sometimes associated with the words “mental health”. The consultant can work with the program director and staff to find ways to educate and communicate with families about the role of the consultant. Some key strategies might include:

• Using alternate names for mental health, including those that may be culturally based.
• Having the consultant become familiar to children and families through their day-to-day presence in the ECE program.
• Locating services in the ECE center or other location agreeable to families.
• Having a staff member (teacher, family services worker) the family trusts and who understands the cultural significance of mental health introduce the idea of mental health consultation for their child or family.
• Using culturally accepted explanations about confidentiality and for behavioral or mental health related concerns.
• Having culturally appropriate written materials that explain mental health consultation services (what families can expect and how they can help) in the languages spoken by the families served.
• Demonstrating sensitivity to culture-based expectations, roles, and relationships.
• Considering the role of other members of the family or family’s immediate community.
• Addressing any prior experiences in seeking help, including bias and discrimination.
• Working with a “cultural broker” to understand how to sensitively approach families about mental health and help families’ understand and accept mental health consultation services.
• Engaging family representatives from the cultural community as guides and ambassadors to plan consultation services to be culturally and linguistically responsive and accessible
• Building relationships with spiritual/community leaders (faith-based, culture-based) that can support families’ seeking help for mental health or other concerns.