Creating Culturally Competent and Responsive Mental Health Services: A Case Study Among the Amish Population of Geauga County, Ohio

  • Sarah C. Miller-FellowsEmail author
  • Jim Adams
  • Jill E. Korbin
  • Lawrence P. Greksa


Providing effective mental health services requires knowledge about and cultural competence across a wide array of beliefs and practices. This study provides an example of a successful project to improve public mental health service delivery in an Amish community. County boards of mental health in a rural area of Northeast Ohio contacted researchers in 1998 to provide assistance in reaching the Amish community because of a concern that mental health services were not being utilized by the Amish population. Following meetings with community leaders, changes were made to improve the relationships of service providers and public funding agencies with the local Amish community, disseminate information about mental health concerns and services, and improve accessibility to mental health services. In 2013, a follow-up analysis of records found a 320% increase in public mental health service utilization by the Amish community within the first five years after these changes were made.


Compliance with Ethical Standards

Conflict of Interest

The authors have no conflicts of interest to disclose.


  1. 1.
    Betancourt JR, Green AR, Carrillo JE, et al. Defining Cultural Competence: A Practical Framework for Addressing Racial/Ethnic Disparities in Health and Health Care. Public Health Reports. 2003;118(4):293–302.CrossRefGoogle Scholar
  2. 2.
    Holden K, McGregor B, Thandi P, et al. Toward Culturally-Centered Integrative Care for Addressing Mental Health Disparities among Ethnic Minorities. Psychological Services. 2014;11(4):357–368.CrossRefGoogle Scholar
  3. 3.
    Fiscella K, Franks P, Gold MR, et al. Inequality in Quality: Addressing Socioeconomic, Racial, and Ethnic Disparities in Health Care. The Journal of the American Medical Association. 2000;283(19):2579–2584.CrossRefGoogle Scholar
  4. 4.
    Ford-Paz RE, Reinhard C, Kuebbeler A, et al. Culturally-Tailored Depression/Suicide Prevention in Latino Youth: Community Perspectives. The Journal of Behavioral Health Services & Research. 2015;42(4):519–533.CrossRefGoogle Scholar
  5. 5.
    Croff RL, Rieckmann TR, Spence JD. Provider and State Perspectives on Implementing Cultural-Based Models of Care for American Indian and Alaska Native Patients with Substance Use Disorders. The Journal of Behavioral Health Services & Research. 2014;41(1):64–79.CrossRefGoogle Scholar
  6. 6.
    Friesen BJ, Cross TL, Jivanjee P, et al. Meeting the Transition Needs of Urban American Indian/Alaska Native Youth through Culturally Based Services. The Journal of Behavioral Health Services & Research. 2015;42(2):191–205.CrossRefGoogle Scholar
  7. 7.
    Statistics. Amish Population by State/Province, 2015. Young Center for Anabaptist & Pietist Studies, Elizabethtown College. Available online at Accessed on March 24, 2018.
  8. 8.
    Statistics. Twelve Largest Amish Settlements in 2013. Young Center for Anabaptist & Pietist Studies, Elizabethtown College. Available online at Accessed on March 24, 2018.
  9. 9.
    Raber AB. The New American Almanac. Baltic, OH: Raber’s Book Store, 2016.Google Scholar
  10. 10.
    Cates JA. Serving the Amish: A Cultural Guide for Professionals. Baltimore, MD: Johns Hopkins University Press, 2014.Google Scholar
  11. 11.
    Knabb JJ, Vogt RG. Assessing Old Order Amish Outpatients with the MCMI-III. Journal of Personality Assessment. 2011;93(3):290–299.CrossRefGoogle Scholar
  12. 12.
    Cates JA. Facing Away: Mental Health Treatment with the Old Order Amish. American Journal of Psychotherapy. 2005;59(4):371.CrossRefGoogle Scholar
  13. 13.
    Kraybill DB, Johnson-Weiner KM, Nolt SM. The Amish. Baltimore, MD: Johns Hopkins University Press, 2013.Google Scholar
  14. 14.
    Nolt SM. Moving Beyond Stark Options: Old Order Mennonite and Amish Approaches to Mental Health. Journal of Mennonite Studies. 2011;29:133.Google Scholar
  15. 15.
    Cates JA, Graham LL. Psychological Assessment of the Old Order Amish: Unraveling the Enigma. Professional Psychology: Research and Practice. 2002;33(2):155–161.CrossRefGoogle Scholar
  16. 16.
    Coblentz EB. Epidemiology of Mental Disorders and Help-Seeking Behavior among the Amish: A Dissertation. Akron, OH: University of Akron, 1991.Google Scholar
  17. 17.
    Campanella K, Korbin JE, Acheson L. Pregnancy and Childbirth among the Amish. Social Science & Medicine. 1993;36(3):333–342.CrossRefGoogle Scholar
  18. 18.
    Hostetler JA. Amish Society, Fourth Edition. Baltimore, MD: Johns Hopkins University Press, 1993.Google Scholar
  19. 19.
    Kraybill DB. The Riddle of Amish Culture, Revised. Baltimore, MD: Johns Hopkins University Press, 2001.Google Scholar

Copyright information

© National Council for Behavioral Health 2018

Authors and Affiliations

  1. 1.Department of AnthropologyCase Western Reserve UniversityClevelandUSA
  2. 2.Geauga County Board of Mental Health and Recovery ServicesChardonUSA

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