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Culturally responsive training aims to help N.H. mental health workers, institutions care for diverse populations

A person sits by the water with their back against a round sculpture.
Wikimedia Commons
Topics like racial trauma aren’t always given the same weight as other conditions in professional training, said Nicole Sublette, a clinical mental health counselor in New Hampshire.

A free five-part training is starting this Friday to help up to 100 behavioral health care workers and leaders to meet the social and cultural needs of diverse populations.

Nicole Sublette, one of the mental health counselors running the training with Southern New Hampshire Area Health Education Center, hopes it can help clinicians to recognize how their own privilege, power and biases can impact the care they provide for their patients.

“We [as clinicians] have to be super aware,” she said. “And it's not just race. It's gender. It's LGBTQIA. It's ability. It’s disability. It's age. It's religion. It's language.”

And she said it’s not just clinicians who need the training. The work to provide quality care to Granite Staters from a variety of backgrounds and identities also has to be ongoing from leadership, at an institutional level. The training will include steps institutions and leaders can take to become more culturally responsive organizations.

Untrained clinicians can cause unintentional harm to clients 

Topics like racial trauma aren’t always given the same weight as other conditions in professional training, said Sublettte.

“We understand if we are seeing a client with chronic pain, OCD, or PTSD, that we need to pursue training or supervision in that area before continuing our work,” Sublette said. Without training, she said, clinicians could run the risk of exacerbating an issue, even if their intention is to be helpful.

“The same is true when we're working with clients of color, many of whom are experiencing the effects of racial trauma,” Sublette said.

People of color with a mental health diagnosis are also less likely than their white peers to be receiving treatment according to the National Alliance of Mental Health Illness.And for Sublette, that’s part of why there is such urgency to her work.

A photo of Nicole Sublette, who is smiling and wearing a necklace.
Courtesy of Nicole Sublette
Nicole Sublette
Nicole Sublette is one of the clinicians running the training.

She said many Granite Staters of color she’s worked with have had negative experiences seeking mental health care in the past.

“They're actually being retraumatized in session,” Sublette said. “Which makes them have thoughts of actually giving up on seeking care.”

She said clients of color sometimes expect her, as one very few therapists of color in New Hampshire, to be the right therapist for them. It’s a complicated dynamic.

“Just because I'm a person of color does not mean I'm the best fit for every client [of color] that walks through the door.” She said “Someone who sees me feels like, oh, my gosh, I have to see Nicole because she's the only one that looks like me. But not every diagnosis is in my wheelhouse.”

While finding a mental health care provider who is a good fit can be difficult for anyone, people with marginalized identities can have an even harder time finding supportive care.

How New Hampshire mental health centers are approaching culturally responsive training 

NHPR reached out to New Hampshire’s 10 community mental health centers to see if they were aware of the training Sublette is running, and if they had staff planning to attend.

The 10 mental health centers are non-profit agencies contracted with the New Hampshire Bureau of Behavioral Health to provide publicly funded mental health services. Collectively, they work with tens of thousands of Granite Staters.

The Greater Mental Health Center in Manchester alone saw over 11,500 residents last year and has a total staff of 480 people. According to their data, that center works with hundreds of people of color in the area, although their clientele skews disproportionately white and non-Hispanic compared to the population of the city. In the past few years, they have seen a significant increase in LGBTQ patients.

Of the six mental health centers NHPR spoke with or corresponded with, four were already aware of the training, and had made some effort to inform staff of the opportunity, including Manchester. Staff can count the training towards their continuing education requirements.

“Trainings like this that are free and come with continuing education credits are rare and we strive to engage in these types of training,” said Janet Salisbury, chief clinical officer at Community Partners, the mental health center in Strafford County.

A few centers pointed to specific members of their leadership teams they knew would be in attendance.

All six of the centers said they have multiple opportunities for staff to take other cultural competency training throughout the year, but not all of them have mandated this type of training.

Phil Wyzik, who runs the community mental health center in the Monadnock region, said he’s in the process of creating a new curriculum with experts from Keene State College to help the organization become more culturally responsive.

He’s struggling with whether or not to make future staff training mandatory.

Wyzik said, while he wants all staff to have the training, “engagement happens best when it's voluntary, not when it's forced.”

But the voluntary dynamic can mean some of the staff who may stand to benefit the most from this type of training may be the least likely to attend it.

And even when there’s interest, leaders of the mental health centers NHPR spoke with said it can be difficult for clinicians to actually find the time.

“Many times our clinicians choose to see clients instead [of attending a training] because the need is strong right now. It’s hard for them to make that choice,” said Cynthia Whitaker, who runs the mental health center in Nashua.

Bill Rider, with the Greater Mental Health Center in Manchester, hopes it doesn’t always have to be a choice between clients or training. He thinks the recent rise in telehealth gives some clinicians more flexibility to prioritize attending training they value.

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