Cultural Competemility Training and Use of a Standardized Assessment Tool in Reducing Misdiagnosis of Black Patients with Schizophrenia Spectrum Disorders and Psychotic Disorders.

Abstract

Research studies have highlighted disparities in diagnosing schizophrenia between Black and White patients, with Black individuals being diagnosed at rates three to five times higher than their White counterparts. Moreover, studies have postulated that a lack of cultural awareness and biases leads to providers' misinterpretation and misdiagnosis of these patients. This quality-improvement project aimed (a) to enhance cultural competemility, the synergistic process between cultural humility and cultural competence in health care providers (HCPs) serving Black patients, promoting cultural sensitivity among providers serving all patients; (b) to introduce the Brief Psychiatric Rating Scale (BPRS-24) as a standardized tool for evaluating suspected schizophrenia spectrum disorders and psychotic disorders across all patients; and (c) to reduce the disparities in schizophrenia spectrum disorders and psychosis diagnostic rates across all patients, with a focus on enhancing accuracy for Black patients. HCPs completed the Inventory for Assessing the Process of Cultural Competemility Among Healthcare Professionals (IAPCC-HCP) before and after training based on Campinha-Bacote's model of cultural competemility (CCM). In addition, they received training in the use of the BPRS-24. After training, HCPs incorporated the BPRS-24 into clinical practice for assessing patients initially diagnosed with schizophrenia spectrum disorders or psychosis. After introducing the BPRS-24 in clinical practice, it was used in 87.5% of assessments, with improved cultural skills and knowledge among HCPs. Using the BPRS-24 and cultural competemility training, misdiagnosis was identified in 48.4% of the sample, regardless of race.