Qualified Bilingual Staff Program* 

QBS are a critical link to providing effective communication and quality care to the limited-English proficient (LEP) communities and individuals we serve.

The QBS Model & Program were designed by Kaiser Permanente National Diversity & Inclusion and adapted by DBHDS to capitalize on an organization’s existing workforce diversity and ensure qualified linguistic services and culturally competent care at every point of contact.

DBHDS adaptation is specifically designed to build terminology in behavioral health, substance abuse, and developmental services setting and discuss the unique role that bilingual staff may have interpreting in these settings. Organizations are encouraged to holed QBS Training in their facility.

Request a Question, Persuade, and Refer Multicultural/Multilingual Gatekeeper Training Today!

Do you have the training and experience to be a DBHDS Qualified Cultural Navigator in Behavioral Health? READ MORE

Qualified cultural navigators are individuals who are trained to provide support, information and guidance to new immigrants. Not only do they have the lived experience of having been immigrants/refugees themselves or having worked very closely with refugees for a long period of time, but they have specific knowledge regarding issues of stress, trauma, the psychological impact of immigration and acculturation, and how to support individuals in crisis. 

DBHDS provides a qualification process for Qualified Cultural Navigators as a way to recognize this unique set of skills that are not always reflected in school transcripts or resumes. Under this qualification pathway, participants complete a series of workshops and trainings designed to provide them with competencies needed to be competitive in entry level positions in behavioral healthcare.

The required programs are designed to connect them with nationally recognized interventions and best practices, which combined with their bicultural and bilingual skills, provide an excellent candidate pool for a diverse and culturally competent entry-level workforce.

To be considered as a Qualified Cultural Navigator in Behavioral Health, please read the application found here in its entirety. Once you have collected all the necessary material you may apply at this LINK.

You may find a sample application HERE

Email all required certificates, qualifications, and other information to OCLC Email 

Please allow two months for your application to be processed and for you to receive your certificate.

Email any questions to OCLC Email Include your full name, phone number, and email address in your correspondence.


DBHDS offers QPR for Refugee Gatekeeper training in multiple languages across the state. Trainers are certified as QPR Gatekeeper Facilitators and are available across the state.

The QPR Refugee Gatekeeper training is offered in

Mental Health ESL*

Virginia Feeling Good Refugee Mental Health Training Video

Virginia Feeling Good Refugee Mental Health Video Guide


WEBINAR – Administration and Implementation of the Refugee Health Screener – 15

Arabic, Amharic, Dari, Spanish, Tagalog

These classes are offered by request and when resources are available. You can make a request for a training by emailing the OCLC. 


Taysir Al Janabi, Caseworker, Commonwealth Catholic Charities- Roanoke

Laxman Chamlagai, Medical Liaison, Church World Services – Richmond

Selamawit. Gonfa, Medical Liaison, Catholic Charities Diocese of Arlington – Fredericksburg

Rabab Hassan, Peer coach, Harrisonburg Public Schools, Harrisonburg

Ibrahim Maroof, MPH, Medical Liaison, Commonwealth Catholic Charities – Hampton Roads

Eva P. Stitt, PhD., Refugee Mental Health Analyst, DBHDS – Hampton Roads






An annual conference designed to explore the implementation, funding, sustaining, and evaluation of language services in government services. Always a FREE event.

Roanoke Annual Language Access Conference for Providers and Front Line Workers

Northern Virginia Conference on Refugee Wellness

Email any questions to OCLC Email Include your full name, phone number, and email address in your correspondence.

Annual Statewide Refugee Mental Health Summit


Navigating Virginia’s Behavioral Health System – A guidebook for Newcomers, Refugee Leaders, Community Support Partners & Volunteers.

Refugee Health Screener (RHS) – 15 Screening Tool in 16 langugaes

Virginia Refugee Mental Health ESL Module*

In partnership with Old Dominion University, the Initiative has developed a 1 hour ESL module designed to introduce English language learners to concepts of mental health and wellness in English. The module is free for utilization by any ESL program.



You can review some material by clicking the links and you may obtain the complete packet or material by completing the utilization request and returning it to

VA Refugee Mental Health Utilization Request Form 

VA Refugee Mental Health Instructor Dos and Don’ts

Virginia Feeling Good Refugee Mental Health ESL Module Lesson Plan

Virginia Feeling Good Refugee Mental Health ESL Powerpoint Slides

Virginia Feeling Good Refugee Mental Health Student Handouts

Virginia Feeling Good Refugee Mental Health Training Video

Virginia Feeling Good Refugee Mental Health Video Guide


Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Limited health literacy affects people of all ages, races, incomes, and education levels, but the impact of limited health literacy disproportionately affects lower socioeconomic and minority groups.

It affects people’s ability to search for and use health information, adopt healthy behaviors, and act on important public health alerts.

Limited health literacy is also associated with worse health outcomes and higher costs (USDHHS).


There is increasing motivation among behavioral health and developmental disability service providers to understand culture and ethnicity factors in order to provide appropriate services. This increased motivation for improving quality of services to ethnic and culturally diverse populations is attributable to the growing political and social presence of diverse cultural groups in the larger society, a growing knowledge of how culture impacts behaviors and engagement, and expectation of licensing and accreditation entities. Tools are also being developed to assist clinicians explore culture and adapt practices for improved outcomes.


Cultural competence in the area of developmental and intellectual disabilities is a new field of study and practice. There is a growing body of work but it is not very comprehensive. Below is a list of useful toolkits and guidelines to explore this work. Autism in Black National Black Disability Coalition CLC Resources at the Interdisciplinary Technical Assistance Center on Autis…

Cultural Competence in DD/ID Services (Last Updated: Jun 19, 2015)

Autism in Black

National Black Disability Coalition

CLC Resources at the Interdisciplinary Technical Assistance Center on Autism and Developmental Disabilities 

Cultural Brokering & Community Inclusion

Engaging Latinos & African Americans in Family Support Programs

Frontline Newsletter – Services Individuals with ID

Health and Health Care Disparities Among People with Disabilities

National Council on Disability – Cultural Diversity Policy Area

UCEDD CLC Resource Center

VCU Early Intervention CLC Landing PadWorking with Diverse Communities*

Working with African American Communities

African American Mental Health Fact Sheet

African American Health 

An Early History – African American Mental Health

Working with Arab American Communities

Arab-Americans and the Social Worker: Cultural Competence

Communities Join Together To Promote Behavioral Health

Facts about Arabs and the Arab World 

Guide to Arab Culture: Health Care Delivery to the Arab American Community

Predictors of Arab American Adolescent Tobacco Use

Working with Asian-Pacific Islander Communities

Learning Disabilities Researcher Brings Attention to Overlooked Asian American Students

Asian-American Cultural Identity and Attitudes Toward Mental Health Services

Asian American Middle-Aged Adults’ Attitudes and Mental Health After the Death of a Parent

Asian Americans Tend to Shun Mental Health Care

Asian American Mental Health

Asian American Outreach Guide

Integrated Care for Asian American and Pacific Islander communities

Working with the Older Adults

Older Adult Mental Health Consumer Information

Cultural competences in the multicultural aging populations

Hispanic Older Adults

Working with Gay, Lesbian, Bisexual and Transgender Communities

See our page on LGBTQ mental health and wellness

Cultural Competence on Lesbian, Gay, Bisexual or Transgender (LGBT)

Fenway Guide to Lesbian, Gay, Bisexual & Transgender Health

Health Issues for LGBT Populations

Providing Services and Supports for Youth who are Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex or Two-Spirit

Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

Working with LGBTQ Youth

Working with Immigrant, and Refugee Communities

A First Person Refugee Account

Community Strategies for war trauma

Stressors and Barriers to MH Care for First Gen Immigrants

Backgrounder on Congolese Women

When Immigration is Trauma

Working with Latino Communities

Enhancing Mental Health Service Delivery to Hispanics: An Online Toolkit for Eliminating Disparities

Healthy Minds

Latinos values and family transitions: Practical considerations for counseling

Lifting Latinos Up- Moving Beyond Trauma

Psychological Distress Among Latino Family Caregivers of Adults With Schizophrenia

Suicide is Forever in Spanish

Guide to psychological assessments with Latinos

Latino outreach guide

Spanish wraparound guide

Fotonovela intervention ideasWorking with the Military Community

Bereavement and Grief: Information for Military Families and Communities

Counseling Veterans

Coming Home: Adjustments For Military Families

Psychological Health of Military Families

SAMHSA Veterans Resources 

Working with Native American Communities

Native American Healthcare

Native American Mental Health

Mental Health Disparities in American Indians

Working with Religious Communities

Being Muslim in America

Pastoral Education Guide: Responding to the Mental Health Needs of Multicultural Faith Communities

Pastoral Education Workbook: Responding to the Mental Health Needs of Multicultural Faith CommunitiesNational Standards for Culturally and Linguistically Appropriate Services

Title VI of the Civil Rights Act of 1964

Virginia laws that specifically require the use of language services

Webinar: Beyond the Right Thing to Do: The Legal Case for CLAS Implementation


Individual and organizational assessments are a cornerstone of the ability to build a culturally competence organization. In general, the continuous quality improvement process for any organization an assessment phase, a planning phase, an implementation phase, and an evaluation phase (Briefer French et al., 2008).

Organizations should make this decision with a strategic mindset and consider a number of factors including whether they have the right resources to create an accurate tool, whether they can identify a tool that fits their organizational structure, whether they are looking to do an assessment for the entire organization or just on division or one level, or any variety of other factors that could impact the outcome of the assessment. 

Listed below are a number of assessment tools from a broad spectrum of experts and organizations.

CCSAQ Assessment Tool Portland State University

Guide to conducting a self assessment D Andrulis

National Center for Cultural Competence Organizational and Individual Assessment Tools

National Mental Health Association Community Needs Assessment

NY Center of Excellence CLC Assessment Tools

Peer Program CLC Assessment ToolDBHDS State Board Policy 1023

DBHDS Departmental Instruction 209

Research: Journal of Health Care Law and Policy Volume 10 | Issue 2 Article 6 Legislation as Intervention: A Survey of Cultural Competence Policy in Health Care


CARF – The mission of CARF is to promote quality, value, and optimal outcomes of services through a consultative accreditation process that centers on enhancing the lives of persons served. 

Magella Behavioral Health – Magellan Provider Handbook, Section 4 – The Quality Partnership

Magellan Provider Handbook

Magellan Cultural Competency Resource Kit


Organizations are required to take reasonable steps to ensure meaningful access to their programs and activities by LEP persons. 

The Guidance explains that the obligation to provide meaningful access is fact-dependent and starts with an individualized assessment that balances four factors:

Number or Proportion of LEP Individuals

Frequency of Contact With the Program

Nature and Importance of the Program

Resources Available

Department of Medicaid Services

The updated Provider Manual for Community Mental Health Rehabilitation Services from Virginia Department of Medical Assistance includes a chapter on cultural and linguistic competence expectations for providers of services. 

Resilience/Recovery and Cultural/Linguistic CompetenceCommunity Engagement

Genuine community engagement is a cornerstone of cultural and linguistic competence and effective and efficient outcomes for service delivery. If you do not have input or support from all members of the community, you cannot develop programs, services, and supports that meet the needs of all members of that community.

Read more in the Principles of Community Engagement from US DHHS.


Effective communication is critical for diagnosis, treatment, and delivery of services. Research shows the direct connection between quality of care, positive outcomes, customer satisfaction, and the provision of effective language services for individuals with communication or language needs. 

Qualified Bilingual Staff Program*Translated Documents/Key Forms (in Spanish)*


Authorization of Use – Disclosure of Health Related Information – Spanish

Complaint Resolution Form – Spanish – Western State Hospital

Uniform Authorization to Use and Exchange Information – Spanish


DBHDS Notice of Advanced Directives (DI202) – Spanish

DBHDS Addendum of Notice of Advance Directives (DI202) – Spanish

DBHDS Notice of Patient Rights – Spanish


Notice of the Right to Appeal – SpanishOrganizational Resources*

Identifying resources for clinicians and service providers, developing tools, templates, and guidance documents for managers and leadership can help busy organizations understand complex information and implement measures that make an immediate difference. 


Building Cultural Competence in your Organization

Data & Demographics2016 Cultural Competence White PaperImplicit Social Attitudes Test (Harvard)Overcoming Language Barriers*

Actions Speak Louder than Words 

You Just Don’t Understand!Working with Interpreters*

Practice-Based Guidance for Working with Interpreters in Clinical Settings

Use trained interpreters, not bilingual staff or community members -Untrained interpreters allow for inaccurate or summarized communication, they can try to normalize comments or behaviors and are less likely to keep sessions confidential.

Allow the interpreter to explain their protocols to you and the individual- Interpreters are trained to use different methods based on the circumstances. The interpreter should explain these protocols to ensure clear communication.

Stress stigma associated with mental health that can influence interpreters- Professional and untrained interpreters may not understand the complexity of mental health and can bring their own bias to a session. For interventions to be effective, this needs to be addressed.

Define roles clearly- Roles must be understood and respected. The interpreter should not offer counseling and the provider should not interpret the individuals’ words.

The provider should discuss the goals for the session with the interpreter before seeing the client- Providers often have specific goals for each counseling session. The interpreter needs to be aware of these goals to work with the provider towards reaching common outcomes.

Include a little time to meet with the interpreter before and after each session to discuss concerns or answer questions- The provider and the interpreter will not always understand the other’s methods. Allow time to communicate about a session to reduce problems or confusion and be sure this isn’t done in front of the individual you are serving.

Recognize that even though someone may be bilingual they must still be trained with the skills that make them good interpreters -Just like providers are trained in a profession, bilingualism doesn’t mean someone is automatically an interpreter. Check to see if they have been trained in cultural competence and cross cultural communication and help them understand the importance of culturally and linguistically sensitive interventions.

Build a team – Providers and interpreters are both essential to good care. Emphasizing mutual respect facilitates better outcomes.

Use tools to assess communication – Even though you may not speak the language, you can use a tool to gauge whether a particular interpreter is delivering the message with some accuracy. One such tool can be found here.

Adapted from the Center for Health and Health Care in Schools, School of Public Health and Health Services, the George Washington UniversityHow working with interpreters supports HIPAA

Interpreter Waiver Template 

CLAS InterpetTool

Working with an Interpreter Language Selection in Individuals who are Bilingual*

Language, Culture, and Emotion Trauma-Informed Cross-Cultural Psychoeducation: Refugee Mental Health Training for Community Leaders (TI-CCP)*

Trauma-Informed Cross-Cultural Pyschoeducational Training (TI-CCP) was designed for mental health professionals to engage with and build capacity in refugee community leaders for community-based mental health and psychosocial support and to establish a close partnership and healing environment in the community. TI-CCP adopts two main pillars to guide the training sessions: Trauma-informed and culture-informed approaches. Refugee Health Screener (RHS 15)*

The purpose of the RHS-15 is to screen and identify refugees in need of mental health treatment, provide education about mental health issues, discuss expected stress responses, improve adjustment and provide information about or linkage with mental health resources. As of 2016, it is available in 16 languages.WEBINAR -ADMINISTERING AND IMPLEMENTING THE RHS-15 IN YOUR COMMUNITY




I Speak Posters

How to choose a language service

Identify barriers and opportunities for language services

Interpreter services planning worksheet

Interpreter waiver form example

Plain Language Toolkit

Interpreter Refusal form example

Language access services are also commonly referred to as language assistance services and linguistically appropriate services.

LAS are services that are designed to ensure effective communication between individuals who are limited English proficient, individuals who are Deaf, Late Deafened, Hard of Hearing, of DeafBlind, or individuals who may have other communication barriers and their English speaking providers.

Primary LAS include interpretation (oral) and translation (written) services. LAS can also involve provisions that enhance communication, such as assistive technology, tools for low literacy, signage and symbols for wayfinding.

Use this template to make sure your organization is considering all the aspects of language services.The OHEA serves as the Language Coordinator for the DBHDS Facility System and beyond. In this role, we work to provide quality translations of key forms and documents that are commonly used across facilities. Available documents are posted here.

Research: Journal of Health Care Law and Policy Volume 10 | Issue 2 Article 6 Legislation as Intervention: A Survey of Cultural Competence Policy in Health CareState Refugee Health and Wellness Resources*

UVA International Family Medicine Clinic 

Northern Virginia Family Services – Multicultural Human Services 

National Resources

Refugee Health Technical Assistance Center Bridging Refugee Youth and Children’s Services 


Health Roads Media

Gulf Coast Jewish Services

Office of Refugee Resettlement- Emotional Wellness

International Resources

US Committee for Refugees UNHCR – Mental Health Psycho Social Support for Persons of Concern

Navigating Virginia’s Behavioral Health System*

A guidebook for Newcomers, Refugee Leaders, Community Support Partners & Volunteers.

Question, Persuade, and Refer Training for Refugee Gatekeepers – Facilitators available for training*

In Virginia, gatekeeper training instructors have been certified by the Question Persuade Refer (QPR) Institute to deliver the Gatekeeper training to refugee stakeholders including resettlement case managers, ESL teachers, ethnic-community based organization members, and others who come into regular contact with refugee populations. 


UVA International Family Medicine Clinic 

Northern Virginia Family Services – Multicultural Human Services 

National Resources

Refugee Health Technical Assistance Center Bridging Refugee Youth and Children’s Services 


Health Roads Media

Gulf Coast Jewish Services

Office of Refugee Resettlement- Emotional Wellness

International Resources*

US Committee for Refugees UNHCR – Mental Health Psycho Social Support for Persons of Concern