Assessing Workforce Diversity:

A Tool for Mental Health Organizations

on the Path to Health Equity
The purpose of this tool is to help you assess the approach is to diversify the workforce. Workforce
successes and challenges of your mental health diversity helps improve access to health and health
organization in building a diverse workforce. care for communities of color.iii It is a key strategy for
Additionally, this tool highlights the importance of a improving health outcomes, addressing health
diverse workforce in effectively addressing mental disparities, and fostering cultural and linguistic
health disparities for the populations in your competence in service delivery. Workforce diversity
community. includes all staff at an organization, not just clinicians.
Most of us are aware of the disparities in mental health
The population in the access, service, and outcomes across diverse
“Diversity is being asked populations. The American Psychiatric Association
Pacific Southwest is
to the party. Inclusion is recently noted that racial, ethnic, gender, and sexual
increasingly diverse.
being asked to dance.”i minorities often suffer from poor mental health
Mental health providers
Equity ensures that outcomes due to multiple factors, including
work with community
everyone has access to inaccessibility of high quality mental health care
members from a
the same opportunities. services; cultural stigma surrounding mental health
widening range of
cultures, countries of care; discrimination; and overall lack of awareness
origin, languages spoken at home, and personal about mental health.iv,v We also know that cultures
identities. We are working with communities that are define mental illness, wellness, and treatment in
diverse across race, gender, ethnicity, religion, different ways.vi Despite this knowledge, many of us
nationality, language, sexual orientation, lifestyle, and still struggle to create and maintain a workforce that
other salient identity characteristics. understands these beliefs and attitudes and reflects
our communities’ populations. This tool can help us
Increasing workforce diversity is a critical step in assess, reflect, and integrate our knowledge of the
achieving health equity. ii Though there are various importance of a culturally responsive workforce to the
approaches to addressing health disparities, one mental health and wellness of those to whom we
provide services.

Pacific Southwest MHTTC 1

Diversity matters to service access and outcomes, and and awareness, a willingness to change and grow,
it also matters to the bottom line. A Kellogg Foundation transformational leadership, and action, organizations
report found “that businesses with a more diverse can ensure equitable health care to all the populations
workforce have more customers, higher revenues and in their communities.
profits, greater market share, less absenteeism and
turnover, and a higher level of commitment to their Consider the following processes in using this tool:
organization.”vii Knowing the importance of workforce • Convene a team that represents all levels of the
diversity to fiscal success can be a way to achieve buy- organization and invite team members to
in from stakeholders and decision makers. complete this assessment tool together.
• Review your assessment findings. Identify areas
How to Use this Tool in which you excel and also areas in which you
This tool was developed to help organizations providing may want to focus attention.
mental health services explore the extent to which they • Identify action steps to address areas where your
are implementing various workforce diversity organization is more limited and incorporate
strategies. It is organized into six areas: 1) Leadership these action steps into an existing organizational
and Governance; 2) Recruitment; 3) Orientation, plan (e.g., strategic, cultural competency, or
Onboarding, and Ongoing Training; 4) Retention and diversity plan).
Professional Development; 5) Communication; and 6)
Partnership and Community Engagement. The tool You will find a list of resources at the end of this tool
takes into consideration the National Standards for that can help your organization address areas that you
Culturally and Linguistically Appropriate Servicesviii have identified for growth or change. Additionally,
(CLAS), and it is also inspired by other tools and there is a short glossary of terms to assist you in
guidelines designed to promote equity, diversity, and creating a shared language for beginning workforce
cultural and linguistic competence. With self-reflection development within your organization.

The Tool
Review each area in its entirety before you respond to individual items. Respond in terms of what is currently
happening in your organization, to the best of your/your team’s knowledge. If there is a practice within your
organization related to a particular area that is not listed in this tool, add it under “Other.”

Area 1: Leadership and Governance Goal

• A fully committed leadership and governance body ensures workforce diversity is a guiding philosophy within
the organization.
• Strategies to support workforce diversity are integrated throughout all levels of the organization and are
infused in the needs assessment, planning, policy development, decision making, and program implementation.
Not Somewhat Often Always
True True True True
1. Our organization has adopted some or all the following: vision,
mission, values, and/or guiding principles that promote
workforce diversity to reflect community demographics.
2. Our organization clearly communicates our philosophy and
culture related to equity and diversity inside and outside our
organization.

3. Our organization implements an equity or diversity action plan.

4. Our organization is governed by an advisory board, which

promotes equity, inclusivity, and diversity.

Pacific Southwest MHTTC 2

5. Our organization adheres to the CLAS and equity policies,
procedures, and practices that support workforce diversity.
6. Our organization establishes workplace norms and backs up and
promotes these norms with written non-discrimination,
grievance, and other related policies, and protocols for
addressing staff complaints of harassment and other
inappropriate workplace behaviors.

Other:

Area 2: Recruitment Goals

• Finding and hiring diverse qualified candidates in an inclusive, culturally appropriate manner is a specific goal.
• Hiring includes analyzing the real requirements of a job, attracting diverse potential employees to the job
through innovative means, screening and selecting applicants in culturally sensitive ways, and extending an
offer to a potential hire.
Not Somewhat Often Always
True True True True
1. Our organization utilizes community demographics to guide
recruitment – including racial and/or tribal demographic data.
2. Our organization has policies and practices in place that ensure
equity in: creation of job descriptions, determination of
appropriate qualifications, and need for different level skill sets
resonant with position.
3. Our organization announces job openings through a variety of
media formats, modalities, and languages of communities
served. Our organization works with community-based partners
and organizations to advertise job openings.
4. Our organization has policies and practices in place that ensure
an interviewing and selection process that is fair and equitable.
5. Our organization has policies and practices in place to ensure
involvement of community stakeholders (local leaders,
community gatekeepers, elders, healers, etc.) in key hires. It
might also include organizations involved in referrals, funding,
or systems of care; or individuals with lived experience.
6. Our organization promotes an expectation and standard that all
staff - regardless of cultural identity - demonstrate the capacity
to serve diverse populations.

Other:

Pacific Southwest MHTTC 3

 Area 3: Onboarding, Orientation, and Ongoing Training Goals
• Providing culturally responsive onboarding, orientation, and training ensures that new staff are acclimatized
to the organizational culture and climate
• Training is designed to increase their ability to translate awareness and knowledge of equity and diversity
into practice
Somewhat Often Always
Not True
True True True
1. Our organization implements onboarding and orientation
activities that support integration of new staff into our
organizational culture and climate in culturally responsive ways.
Examples include: offer new hires opportunities to shadow
other team members, identify new hires with a mentor who can
share information regarding the organization that will ease
entry, offer accommodations to address special needs.
2. Our organization conducts regular staff and organizational
assessment to identify staffing needs related to cultural
competence, diversity, inclusion, and equity.
3. Our organization provides training that invites staff to engage
in reflection of own culture, identify differences and
similarities, and celebrate diversity of all staff.
4. Our organization provides ongoing staff training about the
mental health needs, opportunities, barriers, beliefs, and
practices of the various cultures of the communities we serve.
5. Our organization fosters a work climate, through formal and
informal means, that addresses workforce diversity challenges
and promotes respect for groups, communities, clients, and
colleagues of different backgrounds.
6. Our organization ensures compensation that is fair and
equitable, according to roles, responsibilities, and market value.
Other:

Area 4: Retention and Professional Development Goals

• Professional development opportunities ensure that staff see pathways for growth, promotion, and enhanced
job satisfaction leading to retention of qualified and diverse staff.
Somewhat Often Always
Not True
True True True
1. Our organization has a mechanism for and takes immediate
action when bias, microaggressions, or any discrimination or
intolerance is manifested to ensure that all staff feel protected
by the organization.
2. Our organization provides culturally responsive professional
development opportunities for staff. For example, we invite
 alternative therapists/providers (such as spiritual healers,
curanderos, etc.) to in-service trainings, arrange externships
for staff (e.g. religious or spiritual leaders, or with groups that
provide support for LGBTQ youth), and educate staff about
traditional cultural practices that can be used as mental health
practice.
3. Our organization creates an environment of inclusion, respect,
and appreciation of staff diversity through events,
ceremonies, food, and other practices that celebrate diversity.
4. Our organization continues to ensure compensation that is fair
and equitable based on performance, longevity, and skill-sets
needed and utilized by the organization.
5. Our organization tracks number and types of training, training
assessments, performance reviews, etc. to ensure staff
receive appropriate and relevant professional development
and are able to improve skills and abilities for future
promotions.
6. Our organization offers coaching, mentoring, reflective
practice, and/or other forms of staff support that can enhance
staff retention and professional development.
Other:

Area 5: Communication Goals

• Building an equitable, diverse, and inclusive organization requires ongoing, accessible communication of the
organization’s mission and values, policies, and procedures.
• Our organization has an overall commitment to diversity, health equity, and cultural and linguistic
competence.
Somewhat Often Always
Not True
True True True
1. Staff members communicate with each everyone respectfully
and in a manner that is culturally resonant, inclusive, free of
assumptions or bias, supportive, welcoming, and that
recognizes each person as an individual. This applies to
communication that is oral (in person or by phone/virtually),
in writing, and in any messaging efforts.
2. Our organization has written and oral policies and procedures
ensuring that all staff members are regularly informed,
trained, and accountable about communicating in a manner
that is respectful, culturally-responsive, and inclusive.
3. Our organization does formal or informal assessments to
identify needs related to translation or interpretation,
additional training, or other support that might be needed to
ensure staff capacity is commensurate with service recipient
needs.
4. Our organization provides information about language and
how different cultures talk about mental health in staff
training to enhance staff understanding and use of mental
health terms that are non-stigmatizing, understandable, and
resonant in communities served.
5. Our organization communicates expectations that all
messaging, outreach, and promotion strategies reflect the
languages, lifestyle, culture, beliefs and practices of the
diverse communities served.
Other:

Area 6: Partnership and Community Goals

• Our organization has relationships with partners, vendors, and the community that support and promote
equity, diversity, and inclusion to strengthen the organization’s capacity and commitment to diversity; attract
a more diverse workforce and patient population; ensure culturally and linguistically competent services; and
help everyone feel supported and valued.
Somewhat Often Always
Not True
True True True
1. Our organization knows the changing demographics of the
community we serve, through our own community outreach
and engagement and/or by seeking input or data from other
appropriate sources.
2. Our organization fosters relationships with culturally diverse
community partners and organizations to ensure that our
understanding of communities is current and relevant. For
example, this might include tribal councils; natural
healers/curanderos or other traditional providers; other
culture-specific or island-specific clubs, groups, or
organizations; as well as other mental health providers.
3. Our organization develops and maintains relationships with
other services and support agencies to ensure appropriate and
relevant referrals related to mental health or other needed
supports.
4. Our organization engages diverse, and culturally and
linguistically appropriate supply and service vendors.
5. Our organization implements activities that build capacity
within the community to support diversity in our organization -
- such as offering internships, volunteer programs, and trainings
that engage community members. We place emphasis and
consideration on those who reflect our focus populations, or
marginalized and minority groups, or who have lived mental
health experience (especially in areas such as major depressive
episode, serious mental illness, and suicide).
Other:
We’ve Completed the Assessment. Now What?
Completing this assessment represents a commitment to increasing workforce diversity. You’re already making
progress! After you use this tool, we encourage you to reflect on the results as an organization. As a next step,
we recommend that you use the results to engage in action planning with your team. You may want to create a
workforce diversity plan, or you may want to integrate your commitments into an existing strategic plan. Here
are some ways to identify the workforce diversity priorities that resonate with your team.

• Review each section, and the assessment as a whole, and identify how your organization is doing in each
area and overall.
• Note sections with more “not true” or “somewhat true” responses, which is where you might want to focus
more attention and improvement.
• You may also find areas where you have only one “not true” or “somewhat true” response that is significant
or important in your organization or community. Consider your strengths in this area and talk about how
to leverage your success on most metrics to build additional successes in the area where there is a
challenge.
• Consider using the information that you gather from completing and reviewing your responses to this tool
to have an open discussion with staff, either in small groups and/or as an organization.

Additional Resources
We have included resources that can help you explore some of the diversity areas and criteria in greater depth.
Within the resources, you can find additional tools that can help you further assess your successes and
opportunities in particular areas.

Contact the Pacific Southwest MHTTC if you would like to have a follow up conversation about your organization’s
assessment or support creating a customized action plan to enhance workforce diversity.

Email: [email protected]
Phone: 1-844-856-1749
www.MHTTCnetwork.org

Resources to Build Workforce Diversity

Guidance on the National CLAS Standards: The Blueprint

https://www.thinkculturalhealth.hhs.gov/clas/blueprint
The Blueprint is an implementation guide to help you advance and sustain culturally and linguistically appropriate
services within your organization. It offers concise, practical information on how to use the National Standards for
Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care at your organization.

Diversity & Inclusion Impact Report

https://www.aurorahealthcare.org/-/media/aurorahealthcareorg/documents/about-us/diversity-inclusion-
impact-report.pdf
This report is a single collection of a comprehensive story showcasing efforts to heighten self-awareness, identify
opportunities, and develop innovative ways to make a collective impact. It addresses establishing a D&I (diversity
& inclusion) model of raising awareness, taking ownership and action, and building relationships. The report also
includes examples of organization’s efforts in recruitment, retention, supplier diversity, and professional
development.
Community Toolbox: Building Culturally Competent Organizations
https://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/culturally-competent-organizations/main
This resource includes a conversational description of what it means to be a culturally competent organization,
why it is important, and how to become culturally competent. It includes a checklist, tools, and a PowerPoint
presentation that can be used to educate staff or others.

Cultural and Linguistic Competence Planning and Capacity Building Strategic Plan
The Ohio Department of Health, Division of Family and Child Health Services,
Title V Maternal and Child Health Programs, May 2014.
http://servingohiobetter.org/site/wp-content/uploads/2016/10/20120_ODH_Maternal_full_v5-2.pdf
This strategic plan has goals, strategies, and action items to develop the tools and processes for Ohio’s Department
of Health to infuse cultural and linguistic competency practices throughout the division. Each goal area of the plan
includes relevant CLAS standards for that section. Goal areas include: leadership and governance, workforce
development, language services and signage, and engagement and communications.

5 Things We Learned About Creating Successful Workplace Diversity

(and UNEION employee-developed diversity training program)
Harvard Business Review
https://hbr.org/2018/03/5-things-we-learned-about-creating-a-successful-workplace-diversity-program
This article shares some broad experiences and strategies related to building workplace diversity.

Recruitment and Retention: A Journey Toward a More Inclusive Workforce

https://www.aicpa.org/career/diversityinitiatives/downloadabledocuments/recruitment-retention-toolkit.pdf
This toolkit is aimed at HR leaders, practice leaders, and others charged with attracting, recruiting, and retaining
a diverse workforce in their organization. This toolkit was written to help leaders understand how recruiting and
retaining a diverse workforce can help them better achieve their companies’ overall talent recruitment and
retention goals. It is also meant to provide support on how to integrate diversity recruiting and retention
techniques into broader day-to-day business and personal activities.

Glossary of Terms

Cultural and Linguistic Competence

Ohio Department of Health: Cultural and Linguistic Competence Planning and Capacity Building
http://servingohiobetter.org/site/wp-content/uploads/2016/10/20120_ODH_Maternal_full_v5-2.pdf
The capacity for individuals and organizations to work and communicate effectively in cross-cultural situations
through the adoption and implementation of strategies to ensure appropriate awareness, attitudes, and actions
and through the use of policies, structures, practices, procedures, and dedicated resources that support this
capacity.

Culturally and Linguistically Appropriate Services (CLAS)

Services that are respectful of and responsive to individual cultural health beliefs and practices, preferred
languages, health literacy levels, and communication needs and employed by all members of an organization
(regardless of size) at every point of contact.
 CLAS Standards
The framework for culturally and linguistically appropriate services issued by the U.S. Department of Health
and Human Services, Office of Minority Health. The National CLAS Standards are intended to inform, guide,
and facilitate practices related to culturally and linguistically appropriate health service delivery.

Discrimination (bias, microaggressions)

US Legal.com
https://definitions.uslegal.com/d/discrimination/
Discrimination refers to the treatment or consideration of, or making a distinction in favor of or against, a person
or thing based on the group, class, or category to which that person or thing belongs rather than on individual
merit. Discrimination can be the effect of some law or established practice that confers privileges on a certain
class or denies privileges to a certain class because of race, age, sex, nationality, religion, or handicap. On an
individual level it can be biased or prejudicial behavior on the part of one individual to another leading to
microaggressions and other harmful behaviors.

Equity
Society for Human Resources Management
http://www.talentintelligence.com/blog/bid/377611/inclusion-and-the-benefits-of-diversity-in-the-workplace
Equity ensures that everyone has access to the same opportunities. However, since we do not all start from the
same place, equity acknowledges the need to take steps to compensate for advantages or barriers that we come
into a situation with.

Diversity
Society for Human Resources Management
http://www.talentintelligence.com/blog/bid/377611/inclusion-and-the-benefits-of-diversity-in-the-workplace
Diversity means having people from different backgrounds or with different identity characteristics in a given
setting, group or organization. Ideally, at a minimum, diversity starts with an organization’s staffing or workforce
reflecting the population they are serving and/or want to serve. This might include characteristics such as race,
gender, ethnicity, religion, nationality, sexual orientation, and age. It can also include other factors, such as native
and/or fluent languages, or socioeconomic factors like single-parent head of household.

Health Disparities
American Psychological Association
https://www.apa.org/topics/health-disparities/index.aspx
Health disparities definitions vary, but they all address differences in health status between one population group
in comparison to a more advantaged group and most address issues of social justice and equity.

Health Equity
Boston Public Health Commission
http://www.bphc.org/whatwedo/health-equity-social-justice/what-is-health-equity/Pages/what-is-health-
equity.aspx
Health equity means that everyone has a fair opportunity to live a long, healthy life. It implies that health should
not be compromised or disadvantaged because of an individual or population group's race, ethnicity, gender,
income, sexual orientation, neighborhood, or other social condition.
Inclusion
Society for Human Resources Management
http://www.talentintelligence.com/blog/bid/377611/inclusion-and-the-benefits-of-diversity-in-the-workplace
https://generalassemb.ly/blog/diversity-inclusion-equity-differences-in-meaning/ Accessed 12/11/18
The achievement of a work environment in which all individuals are treated fairly and respectfully, have equal
access to opportunities and resources, and can contribute fully to the organization’s success. “Diversity is being
asked to the party. Inclusion is being asked to dance.”

Workforce Diversity
Diversity: A World of Change
https://www.diversity.com/page/What-is-Diversity
Diversity refers to both an obvious fact of human life—namely, that there are many different kinds of people—
and the idea that this diversity drives cultural, economic, and social vitality and innovation. Workforce diversity
extends this definition to include race, sex and gender identity, ethnicity, physical ability, religion, belief systems,
sexual orientation, age, parental status, economic status, geographic background, etc. that can enhance the
workplace environment.

Endnotes
i
https://generalassemb.ly/blog/diversity-inclusion-equity-differences-in-meaning. Accessed 12/11/18.

ii
The Colorado Trust (2013) Health Equity and Racial and Ethnic Workforce Diversity.
http://www.coloradotrust.org/sites/default/files/CT_Workforce_Diversity_Brief_FINAL.pdf

iii
Smedley BD, Butler AS, Bristow LR, eds. (2004) In the Nation’s Compelling Interest: Ensuring Diversity in the Health-Care
Workforce. Washington, DC: Institute of Medicine.

iv
https://www.psychiatry.org/psychiatrists/cultural-competency/mental-health-disparities. Accessed December 12, 2018.

v
“Measuring Disparities across the distribution of mental health care expenditures.” J Ment Health Policy Econ. 2013
Mar;16(1):3-12.
vi
“One Size Does Not Fit All: Taking Diversity, Culture and Context Seriously,” Adm Policy Ment Health. 2010 Mar; 37(1-2):
48–60. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874609.
vii
Turner, A. et al (2013) The Business Case for Racial Equity” Prepared by Altarum Institute and funded by Kellogg
Foundation. https://scholar.harvard.edu/files/davidrwilliams/files/the_business_case_for_racial_equity_10-23-
13_1_0.pdf.

viii
National Standards for Culturally and Linguistically Appropriate Services.
https://www.thinkculturalhealth.hhs.gov/clas/standards