Skip to main content

Advertisement

Springer Nature Link
Log in

Creating Culturally Competent and Responsive Mental Health Services: A Case Study Among the Amish Population of Geauga County, Ohio

  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

Providing effective mental health services requires knowledge about and cultural competence across a wide array of beliefs and practices. This study provides an example of a successful project to improve public mental health service delivery in an Amish community. County boards of mental health in a rural area of Northeast Ohio contacted researchers in 1998 to provide assistance in reaching the Amish community because of a concern that mental health services were not being utilized by the Amish population. Following meetings with community leaders, changes were made to improve the relationships of service providers and public funding agencies with the local Amish community, disseminate information about mental health concerns and services, and improve accessibility to mental health services. In 2013, a follow-up analysis of records found a 320% increase in public mental health service utilization by the Amish community within the first five years after these changes were made.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

Notes

  1. For the purposes of this paper, the authors operationalize “cultural competence” using Betancourt et al.’s definition: “understanding the importance of social and cultural influences on patients’ health beliefs and behaviors; considering how these factors interact at multiple levels of the health care delivery system (e.g., at the level of structural processes of care or clinical decision-making); and, finally, devising interventions that take these issues into account to assure quality health care delivery to diverse patient populations.”1(p. 297)

  2. Noted Amish scholar Hostetler borrows Hall’s notion to describe the Amish as a “high-context culture.”18 In high-context cultures, deep connections and unspoken knowledge exist between actors.18 This practice emphasizes importance of place within networks and allows new contacts to place one another socially.

References

  1. Betancourt JR, Green AR, Carrillo JE, et al. Defining Cultural Competence: A Practical Framework for Addressing Racial/Ethnic Disparities in Health and Health Care. Public Health Reports. 2003;118(4):293–302.

    Article  Google Scholar 

  2. Holden K, McGregor B, Thandi P, et al. Toward Culturally-Centered Integrative Care for Addressing Mental Health Disparities among Ethnic Minorities. Psychological Services. 2014;11(4):357–368.

    Article  Google Scholar 

  3. Fiscella K, Franks P, Gold MR, et al. Inequality in Quality: Addressing Socioeconomic, Racial, and Ethnic Disparities in Health Care. The Journal of the American Medical Association. 2000;283(19):2579–2584.

    Article  CAS  Google Scholar 

  4. Ford-Paz RE, Reinhard C, Kuebbeler A, et al. Culturally-Tailored Depression/Suicide Prevention in Latino Youth: Community Perspectives. The Journal of Behavioral Health Services & Research. 2015;42(4):519–533.

    Article  Google Scholar 

  5. Croff RL, Rieckmann TR, Spence JD. Provider and State Perspectives on Implementing Cultural-Based Models of Care for American Indian and Alaska Native Patients with Substance Use Disorders. The Journal of Behavioral Health Services & Research. 2014;41(1):64–79.

    Article  Google Scholar 

  6. Friesen BJ, Cross TL, Jivanjee P, et al. Meeting the Transition Needs of Urban American Indian/Alaska Native Youth through Culturally Based Services. The Journal of Behavioral Health Services & Research. 2015;42(2):191–205.

    Article  Google Scholar 

  7. Statistics. Amish Population by State/Province, 2015. Young Center for Anabaptist & Pietist Studies, Elizabethtown College. Available online at https://groups.etown.edu/amishstudies/files/2016/09/Amish-Population-by-State-2015.pdf. Accessed on March 24, 2018.

  8. Statistics. Twelve Largest Amish Settlements in 2013. Young Center for Anabaptist & Pietist Studies, Elizabethtown College. Available online at https://groups.etown.edu/amishstudies/files/2016/09/Twelve-Largest-Amish-Settlements-2013.pdf. Accessed on March 24, 2018.

  9. Raber AB. The New American Almanac. Baltic, OH: Raber’s Book Store, 2016.

    Google Scholar 

  10. Cates JA. Serving the Amish: A Cultural Guide for Professionals. Baltimore, MD: Johns Hopkins University Press, 2014.

    Google Scholar 

  11. Knabb JJ, Vogt RG. Assessing Old Order Amish Outpatients with the MCMI-III. Journal of Personality Assessment. 2011;93(3):290–299.

    Article  Google Scholar 

  12. Cates JA. Facing Away: Mental Health Treatment with the Old Order Amish. American Journal of Psychotherapy. 2005;59(4):371.

    Article  Google Scholar 

  13. Kraybill DB, Johnson-Weiner KM, Nolt SM. The Amish. Baltimore, MD: Johns Hopkins University Press, 2013.

    Google Scholar 

  14. Nolt SM. Moving Beyond Stark Options: Old Order Mennonite and Amish Approaches to Mental Health. Journal of Mennonite Studies. 2011;29:133.

    Google Scholar 

  15. Cates JA, Graham LL. Psychological Assessment of the Old Order Amish: Unraveling the Enigma. Professional Psychology: Research and Practice. 2002;33(2):155–161.

    Article  Google Scholar 

  16. Coblentz EB. Epidemiology of Mental Disorders and Help-Seeking Behavior among the Amish: A Dissertation. Akron, OH: University of Akron, 1991.

  17. Campanella K, Korbin JE, Acheson L. Pregnancy and Childbirth among the Amish. Social Science & Medicine. 1993;36(3):333–342.

    Article  CAS  Google Scholar 

  18. Hostetler JA. Amish Society, Fourth Edition. Baltimore, MD: Johns Hopkins University Press, 1993.

    Google Scholar 

  19. Kraybill DB. The Riddle of Amish Culture, Revised. Baltimore, MD: Johns Hopkins University Press, 2001.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anthropology, Case Western Reserve University, 11220 Bellflower Road, Cleveland, OH, 44106-7125, USA

    Sarah C. Miller-Fellows MA, MPH, Jill E. Korbin PhD & Lawrence P. Greksa PhD

  2. Geauga County Board of Mental Health and Recovery Services, 13244 Ravenna Road, Chardon, OH, 44024, USA

    Jim Adams MDiv

Authors
  1. Sarah C. Miller-Fellows MA, MPH
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Jim Adams MDiv
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Jill E. Korbin PhD
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Lawrence P. Greksa PhD
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Sarah C. Miller-Fellows MA, MPH.

Ethics declarations

Conflict of Interest

The authors have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miller-Fellows, S.C., Adams, J., Korbin, J.E. et al. Creating Culturally Competent and Responsive Mental Health Services: A Case Study Among the Amish Population of Geauga County, Ohio. J Behav Health Serv Res 45, 627–639 (2018). https://doi.org/10.1007/s11414-018-9612-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11414-018-9612-0