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By Abe Proctor of The Skanner
Published: 18 January 2006

Mental health professionals have always faced special treatment challenges in communities of color. How do you implement theories and techniques developed by White researchers? Does it matter whether mental health practitioners in communities of color are themselves people of color?

For some time, the answers have been clear: Yes, it does matter if mental health professionals are people of color, and specific theories and techniques must always be viewed through a culture-specific lens.

And in North Portland's Cascadia Behavioral Healthcare, where such a philosophy has been followed for years, a person who understands that philosophy is now leading the nonprofit community mental health organization's cultural care efforts. Norm Monroe was just named the group's new vice president of Cultural Relations and Community Development.

"My department is charged with improving diversity in (Cascadia's) recruitment and, within our clinical practice, instilling how to treat people of color, especially in diagnosis," Monroe said of his new duties.

Culturally specific mental health diagnosis and treatment are nothing new, Monroe said, especially among caregivers who have long worked in poor and minoritycommunities, where chronic economic distress can exacerbate the pressures of mental illness.

"Mental health treatment for people of color and minorities, and some of our immigrant groups, has not followed along traditional lines," he said. "The misdiagnosis of Black males is pretty evident inside of traditional psychological and mental health systems."

Monroe has a history of breaking new ground. He was the first African American basketball player at Oregon State University, where he went on to earn a degree in social sciences, followed by a master's in social work from Portland State University. After a stint as a marriage and family counselor, his desire to focus on the big picture steered him toward government.

He spent four years in the Portland mayor's office working on systemic law enforcement issues, and then more than 20 years working in the Multnomah County Chair's office. Cascadia CEOLeslieFord approached him in 2004 to help with structural and policy concerns, and he agreed, joining the agency's board.

"Norm has been working with us on a part-time basis for some time now," Ford said. "He brings a wealth of experience. He's been active in Oregon politics for at least 30 years and has been intimately involved in the creation of all kinds of projects and programs at the community level.

"He really understands what it takes to make systems move and how important it is that all of the planning and implementation processes be inclusive and welcoming to everyone who participates, whether they're staff or clients or other kinds of stakeholders."

One of Monroe's aspirations is to standardize and institutionalize the notion of culturally specific mental health treatment at Cascadia.

"What we want to do is to create a culture, a mode of operations, that is understood by all, instead of just practiced by one or two practitioners," he said.

Institutional goals aside, Monroe said he has six major professional objectives for 2006. The first is to instill the goal of recovery into Cascadia's practices. Everyone, he said, can recovery from mental illness.

"To me, the whole issue of recovery is a community affair," Monroe said. "We have to take the agency into the community, and vice versa — we have to bring the community into the agency.

"That's easier said than done. We can't see ourselves as an isolated entity; we're committed to community wellness. Therefore, we have to understand what goes on in the community and how the issues that confront people in everyday life lead to some of the problems that folks experience."

Monroe said this lesson was driven home to him in graduate school when he was given the daunting task of having to change someone's behavior after an hour of counseling. He was flying blind, with no context, he said — he didn't know where his patient came from, what his patient's life was like, whether his patient had any sort of familial or community support structure at all. The experience left him convinced that healthy communities produce healthy people, and that healthy communities can help sick people be well again.

"People have been trying to cure themselves for eons," he said. "It's the whole community that has the key to getting cured. We need to remove the stigma of mental illness from the public and get everyone involved in the concept of wellness."

Cascadia Behavioral Healthcare is on the corner of North Killingsworth Street and Albina Avenue. To learn more, visit www.cascadiabhc.org.

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