There are increased efforts to improve patient-provider relations and engagement within North American mental health systems. However, it is unclear how these innovations impact care for ethnic minorities, a group that continues to face social and health disparities. This study examined one such engagement innovation-person-centered care planning-to gain a better understanding of this overall process. We specifically explored how mental health providers trained in person-centered care planning work with their patients of Latinx and Asian backgrounds. In-depth interviews were conducted with mental health providers in community clinics, and narratives were analyzed via phenomenological methods. Findings revealed that regardless of specific practice innovations, it was providers' own embeddedness in their mental health organizational culture that became conspicuous as a determinant of care. This culture contained implicit preferences for clients considered to be ideal (e.g., are verbal, admit a problem or illness, accept services, and are individually oriented). These clients were experienced as ideal largely because they helped the system operate efficiently. Findings suggest that these organizational norms, preferences, and expectations-and bureaucratic demands for efficiency-may engender an implicit organizational bias that creates barriers for culturally different groups. These biases may also hinder practice innovations, whether patient-centered, disparities-focused, or otherwise. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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隐性组织偏见：心理健康治疗文化和规范是参与多样性的障碍。


人们正在加大力度改善北美精神卫生系统内的患者与提供者的关系和参与。然而，目前尚不清楚这些创新如何影响对少数族裔的护理，该群体继续面临社会和健康差距。这项研究检验了这样一种参与创新——以人为本的护理计划——以更好地理解整个过程。我们特别探讨了接受过以人为本的护理规划培训的心理健康服务提供者如何与拉丁裔和亚洲背景的患者一起工作。对社区诊所的心理健康服务提供者进行了深入访谈，并通过现象学方法对叙述进行了分析。调查结果显示，无论具体的实践创新如何，提供者自身在其心理健康组织文化中的融入成为护理的决定因素。这种文化包含对被认为是理想的客户的隐含偏好（例如，善于口头、承认问题或疾病、接受服务以及以个人为导向）。这些客户之所以被认为是理想的客户，很大程度上是因为他们帮助系统高效运行。研究结果表明，这些组织规范、偏好和期望——以及官僚对效率的要求——可能会产生隐性的组织偏见，为文化不同的群体制造障碍。这些偏见也可能阻碍实践创新，无论是以患者为中心、以差异为中心还是其他方面。 （PsycINFO 数据库记录 (c) 2020 APA，保留所有权利）。