Minnesota Hospital Association


January 16, 2019

Matching clinical care with cultural values

When the Karen people were forced to flee their homes in Burma, a large population began to resettle in Minnesota. Like the experience of so many refugees, a difficult transition lie ahead. While adjusting to a new culture and managing the emotional and physical trauma of war, many new Americans are at a higher risk for mental health and chemical dependency issues.

Providers at HealthEast, part of Fairview Health Services, serve the largest Karen population in the Twin Cities. They recognized that American treatment programs were being lost in translation and decided to do something about it.

“Karen patients came to me looking for help to find a treatment program,” said Dr. Shana Sniffen, HealthEast Clinics – Roselawn. “Yet, the substance use treatment system wasn’t working for them, so we had to fix the system.”

So, in 2013, Dr. Sniffen and Karen community leaders founded the Karen Chemical Dependency Collaboration (KCDC). The community-driven collaboration includes Karen community members, interpreters, faith leaders, law enforcement and corrections officers, and health care professionals.

The goal of KCDC is to address issues related to mental health and substance use in culturally appropriate ways. The collaboration seeks to provide resources to the community and empower members to respond to these issues while adapting to U.S. systems, as well as helping U.S. systems adapt to working better with various cultural communities.

For example, KCDC developed a culturally specific outpatient substance use treatment program at HealthEast. Additionally, KCDC is working on system-level changes to make addiction care services accessible and effective for people who do not speak English.

KCDC has also trained Karen pastors and faith leaders to facilitate treatment referrals and build community supports. They developed the first Karen-AA group in the Twin Cities, created a bilingual Karen and English resource website (www.TohMoo.org) and trained Karen interpreters to use mental health and substance use terminology.

In 2017-18, five part-time staff, along with HealthEast Mental Health and Addiction Care staff, helped more than 650 people through treatment and support groups, community education and accessing resources on TohMoo.org. KCDC also provided education to 150 mental health professionals and providers, and published an academic paper about the program. This important work is possible thanks to $300,000 in grants, including funds from the HealthEast Foundation. Through these efforts, KCDC continues to work to meet the increasing needs of the Karen people for mental health and recovery support in the Twin Cities.