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Ruiz-Cosignani D, Chen Y, Cheung G, Lawrence M, Lyndon MP, Ma'u E, Ramalho R. Adaptation models, barriers, and facilitators for cultural safety in telepsychiatry: A systematic scoping review. J Telemed Telecare 2024; 30:466-474. [PMID: 34989643 DOI: 10.1177/1357633x211069664] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction: Indigenous peoples, and racial and ethnic minorities around the world experience significant mental health inequities. Telepsychiatry can contribute to addressing these inequities among these populations. However, it is first crucial to ensure the cultural safety of this tool as a critical step toward health equity. This review aimed to collate evidence regarding cultural adaptations, barriers, opportunities, and facilitators for telepsychiatry services supporting minority groups. Method: Using the PRISMA extension for scoping reviews (PRISMA-ScR) guideline, we conducted a systematic scoping review and thematic analysis. Six databases were searched using the PICO framework, i.e., population, intervention, comparison, and outcomes.. Additional literature was identified through reference lists screening. We developed a table for data extraction, and the extracted data were further analyzed following Braun and Clarke's approach for thematic analysis. Results: A total of 1514 citations were screened with a final total of 58 articles included in the review. The themes related to telepsychiatry cultural adaptations emphasize the crucial role of community involvement and quality service delivery. Identified barriers were associated with service and infrastructure, and service users' socioeconomic and cultural contexts. Opportunities and facilitators for telepsychiatry were enhanced access and rapport, and multi-organizational collaborations and partnerships. Discussion: This review identified factors that can guide the adaptation of telepsychiatry evidence-based interventions to meet the needs of Indigenous peoples and racial and ethnic minorities. Telepsychiatry programs must be specifically designed for the population they seek to serve, and this review offers emerging insights into critical factors to consider in their development.
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Affiliation(s)
- Daniela Ruiz-Cosignani
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Yan Chen
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Mark Lawrence
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Mataroria P Lyndon
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Etuini Ma'u
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Rodrigo Ramalho
- Department of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
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Burke HH, Murray A. Systemic Racism's Impact on Minority Children and Youth With Psychosis: Enacting Antiracist Strategies in Psychosis Care. J Am Acad Child Adolesc Psychiatry 2023; 62:1080-1082. [PMID: 37080452 DOI: 10.1016/j.jaac.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/02/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
Psychotic disorders represent a treatable but debilitating subset of mental illnesses. Children and adolescents who are given a diagnosis of psychosis are at risk for serious sequelae that may affect cognitive and social function. Alarmingly, evidence has shown that racial differences exist in the diagnosis and progression of pathology. This article presents a conceptualization of the challenges that minority pediatric patients diagnosed with a psychotic disorder often confront, and explores practical means to antiracist care.
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Affiliation(s)
- Hugh H Burke
- University of Minnesota (Twin Cities) Medical School, Minneapolis, Minnesota.
| | - Aimee Murray
- University of Minnesota (Twin Cities) Medical School, Minneapolis, Minnesota
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Barrita A, Strong MN, Ferraris J, Wong-Padoongpatt G. Drugs and racial microaggressions: A mediation analysis of racism, mental health, and coping strategies. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:209078. [PMID: 37245853 DOI: 10.1016/j.josat.2023.209078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/17/2022] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Racial microaggressions are daily slights and denigrations perpetrated toward people of color (PoC). These forms of everyday racism are significant stressors for PoC and can insult, invalidate, and assault racial identities. Past findings on discrimination indicate a strong link between engagement in maladaptive behaviors (e.g., substance use and behavioral addictions) and perceived racism. Although the topic of racism is receiving more traction, a dearth of knowledge still persists on racial microaggressions and how these daily interactions can elicit negative coping behaviors, particularly substance use. The current study examined the relationship among microaggressions, substance use, and psychological distress symptoms. Specifically, we aimed to explore if PoC cope with racial microaggressions by using substances. METHODS We surveyed 557 PoC within the United States using an online platform. Participants answered questions related to their experiences with racial microaggressions, drug and alcohol use as coping strategies for discrimination, and self-reported mental health. Experiences with racial microaggressions was the main predictor variable and the drug and alcohol use as coping strategy was the main outcome variable. The study tested psychological distress as the main mediator for the relationship between racial microaggressions and drug and alcohol use. RESULTS Findings indicated that microaggressions were a significant predictor of psychological distress symptoms, B = 0.272, SE = 0.046, p < .001, and psychological distress was a significant predictor of coping strategies that involved substance and alcohol use, B = 0.102, SE = 0.021, p < .001. Racial microaggressions were no longer a significant predictor of coping strategies that involved substance and alcohol use after controlling for psychological distress, B = 0.027, SE = 0.024, p = .260. In an exploratory approach, our model was further explained by assessing alcohol refusal self-efficacy, which results suggest be a second mediator in the relation between racial microaggressions and substance use. CONCLUSION Overall, results suggest that racial discrimination exposes PoC to higher risks for both poorer mental health and the misuse of substances and alcohol. Practitioners treating PoC with substance abuse disorders might also need to assess the psychological impact of experiences with racial microaggressions.
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Affiliation(s)
- Aldo Barrita
- Department of Psychology, University of Nevada, Las Vegas, United States of America.
| | - Michelle N Strong
- Department of Psychology, University of Nevada, Las Vegas, United States of America
| | - Janelle Ferraris
- Department of Psychology, University of Nevada, Las Vegas, United States of America
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Williams SZ, Lewis CF, Muennig P, Martino D, Pahl K. Self-reported anxiety and depression problems and suicide ideation among black and latinx adults and the moderating role of social support. J Community Health 2022; 47:914-923. [PMID: 35921053 DOI: 10.1007/s10900-022-01127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 01/09/2023]
Abstract
Suicide is a critical public health problem. Over the past decade, suicide rates have increased among Black and Latinx adults in the U.S. Though depression is the most prevalent psychiatric contributor to suicide risk, Black and Latinx Americans uniquely experience distress and stress (e.g., structural adversity) that can independently operate to worsen suicide risk. This makes it important to investigate non-clinical, subjective assessment of mental health as a predictor of suicide ideation. We also investigate whether social support can buffer the deleterious impact of poor mental health on suicide ideation.We analyzed data from 1,503 Black and Latinx participants of the Washington Heights Community Survey, a 2015 survey of residents of a NYC neighborhood. Multivariable logistic regression was conducted to examine the effect of subjectively experienced problems with anxiety and depression on suicide ideation independent of depression diagnosis, and the role of social support as a moderator.Estimated prevalence of past two-week suicide ideation was 5.8%. Regression estimates showed significantly increased odds of suicide ideation among participants reporting moderate (OR = 8.54,95% CI = 2.44-29.93) and severe (OR = 16.84,95% CI = 2.88-98.46) versus no problems with anxiety and depression, after adjustment for depression diagnosis. Informational support, i.e., having someone to provide good advice in a crisis, reduced the negative impact of moderate levels of anxiety and depression problems on suicide ideation.Findings suggest that among Black and Latinx Americans, subjective feelings of anxiety and depression account for a significant portion of the suicide ideation risk related to poor mental health. Further, social support, particularly informational support, may provide protection against suicide ideation.
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Affiliation(s)
- Sharifa Z Williams
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA. .,Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA.
| | - Crystal Fuller Lewis
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA.,Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Peter Muennig
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Daniele Martino
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA
| | - Kerstin Pahl
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA.,Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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Eliacin J, Matthias MS, Burgess DJ, Patterson S, Damush T, Pratt-Chapman M, McGovern M, Chinman M, Talib T, O'Connor C, Rollins A. Pre-implementation Evaluation of PARTNER-MH: A Mental Healthcare Disparity Intervention for Minority Veterans in the VHA. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 48:46-60. [PMID: 32399857 DOI: 10.1007/s10488-020-01048-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To design PARTNER-MH, a peer-led, patient navigation program for implementation in Veterans Health Administration (VHA) mental health care settings, we conducted a pre-implementation evaluation during intervention development to assess stakeholders' views of the intervention and to explore implementation factors critical to its future adoption. This is a convergent mixed-methods study that involved qualitative semi-structured interviews and survey data. Data collection was guided by the Consolidated Framework for Implementation Research (CFIR). We interviewed and administered the surveys to 23 peers and 10 supervisors from 12 midwestern VHA facilities. We used deductive and inductive approaches to analyze the qualitative data. We also conducted descriptive analysis and Fisher Exact Test to compare peers and supervisors' survey responses. We triangulated findings to refine the intervention. Overall, participants viewed PARTNER-MH favorably. However, they saw the intervention's focus on minority Veterans and social determinants of health framework as potential barriers, believing this could negatively affect the packaging of the intervention, complicate its delivery process, and impact its adoption. They also viewed clinic structures, available resources, and learning climate as potential barriers. Peers and supervisors' selections and discussions of CFIR items were similar. Our findings informed PARTNER-MH development and helped identify factors that could impact its implementation. This project is responsive to the increasing recognition of the need to incorporate implementation science in healthcare disparities research. Understanding the resistance to the intervention's focus on minority Veterans and the potential barriers presented by contextual factors positions us to adjust the intervention prior to testing, in an effort to maximize implementation success.
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Affiliation(s)
- Johanne Eliacin
- VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA.
- Psychology Department, ACT Center of Indiana, IUPUI, Indianapolis, USA.
- Regenstrief Institute, Inc, Indianapolis, IN, USA.
| | - Marianne S Matthias
- VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA
- Regenstrief Institute, Inc, Indianapolis, IN, USA
- Department of Communication Studies, IUPUI, Indianapolis, USA
| | - Diana J Burgess
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA
| | - Scott Patterson
- Department of Psychiatry, Richard L. Roudebush VAMC, Indianapolis, IN, USA
| | - Teresa Damush
- VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA
- Regenstrief Institute, Inc, Indianapolis, IN, USA
- General Internal Medicine, Indiana University School of Medicine, Indianapolis, USA
| | - Mandi Pratt-Chapman
- Institute for Patient-Centered Initiatives & Health Equity, George Washington University Cancer Center, Washington, DC, USA
| | - Mark McGovern
- Psychiatry & Behavioral Sciences; Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Matthew Chinman
- Veterans Integrated Service Network 4 Mental Illness Research, Education and Clinical Center and the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | | | - Caitlin O'Connor
- VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA
| | - Angela Rollins
- VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA
- Psychology Department, ACT Center of Indiana, IUPUI, Indianapolis, USA
- Regenstrief Institute, Inc, Indianapolis, IN, USA
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Breslau J, Stein BD, Burns RM, Collins RL, Han B, Yu H, Mojtabai R. Examining contradictory evidence on racial/ethnic differences in perceived need for behavioral health treatment. Int J Methods Psychiatr Res 2018; 27:e1743. [PMID: 30207004 PMCID: PMC6279592 DOI: 10.1002/mpr.1743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/08/2018] [Accepted: 08/10/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The study aims to investigate apparently contradictory evidence regarding racial/ethnic differences in perceived need for behavioral health treatment in two prominent surveys of the U.S. population, the National Comorbidity Survey Replication (NCS-R) and the National Survey of Drug Use and Health (NSDUH). METHODS The two surveys were compared with respect to two components of perceived need: service use and perceived need among the untreated. Logistic regression models were estimated to adjust comparisons for demographic characteristics. Comparisons were conducted in samples representing the entire population, without selection on a mental health assessment, and for samples meeting criteria for lifetime major depression. RESULTS The surveys are concordant with respect to racial/ethnic differences in service use and discordant with respect to perceived need among the untreated. For instance, among untreated individuals, the odds of perceiving a need for treatment are significantly higher in Blacks than Whites in the NCS-R (OR = 1.8, 95% CI [1.1, 2.9]) but do not differ between these groups in the NSDUH (OR = 0.9, 95% CI [0.7, 1.2]). Temporal trends do not appear to explain this discordance. CONCLUSION Assessments of racial/ethnic differences in perceived need among untreated individuals are affected by methodological differences across surveys. Resolving contradictory evidence is critical to efforts to reduce racial/ethnic disparities.
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Affiliation(s)
- Joshua Breslau
- RAND Health Division, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Bradley D Stein
- RAND Health Division, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Rachel M Burns
- RAND Health Division, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Rebecca L Collins
- RAND Health Division, RAND Corporation, Santa Monica, California, USA
| | - Bing Han
- RAND Health Division, RAND Corporation, Santa Monica, California, USA
| | - Hao Yu
- RAND Health Division, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Maura J, Weisman de Mamani A. Mental Health Disparities, Treatment Engagement, and Attrition Among Racial/Ethnic Minorities with Severe Mental Illness: A Review. J Clin Psychol Med Settings 2018; 24:187-210. [PMID: 28900779 DOI: 10.1007/s10880-017-9510-2] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mounting evidence indicates that there are mental health disparities in the United States that disadvantage racial/ethnic minorities in medical and mental health settings. Less is known, however, about how these findings apply to a particularly vulnerable population, individuals with severe mental illness (SMI). The aim of this paper is to (1) provide a critical review of the literature on racial/ethnic disparities in mental health care among individuals with SMI; (2) identify factors which may contribute to the observed disparities; and (3) generate recommendations on how best to address these disparities. Specifically, this article provides an in-depth review of sociocultural factors that may contribute to differences in treatment engagement and rates of attrition from treatment among racial/ethnic minorities with SMI who present at medical and mental health facilities. This review is followed by a discussion of specific strategies that may promote engagement in mental health services and therefore reduce racial/ethnic disparities in SMI.
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Affiliation(s)
- Jessica Maura
- Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd, Coral Gables, FL, 33146, USA.
| | - Amy Weisman de Mamani
- Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd, Coral Gables, FL, 33146, USA
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Wyatt LC, Ung T, Park R, Kwon SC, Trinh-Shevrin C. Risk Factors of Suicide and Depression among Asian American, Native Hawaiian, and Pacific Islander Youth: A Systematic Literature Review. J Health Care Poor Underserved 2016; 26:191-237. [PMID: 25981098 DOI: 10.1353/hpu.2015.0059] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Suicide has become an increasing public health challenge, with growing incidence among Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) youth. Using an ecological framework, the purpose of this systematic review was to explicate risk and protective factors for depression or suicide among AA and NHPI youth from available peer reviewed research. The ecological framework provides a useful blueprint for translating social determinants of health to explain the experience of depression and suicidal behaviors among AA and NHPI youth. Sixty-six studies were extracted from PsychInfo, Ovid Med-line, EMBASE, CINAHL, and Web of Science. Policy and practice recommendations are offered in light of relevant themes that emerged. Further research and data disaggregation is needed to develop and strengthen population health strategies, interventions, and policies that address the underlying social conditions and cultural contexts of mental health disparities associated with depression and suicide among AA and NHPI youth.
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Jenkins MM, Youngstrom EA. A randomized controlled trial of cognitive debiasing improves assessment and treatment selection for pediatric bipolar disorder. J Consult Clin Psychol 2016; 84:323-33. [PMID: 26727411 DOI: 10.1037/ccp0000070] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined the efficacy of a new cognitive debiasing intervention in reducing decision-making errors in the assessment of pediatric bipolar disorder (PBD). METHOD The study was a randomized controlled trial using case vignette methodology. Participants were 137 mental health professionals working in different regions of the United States (M = 8.6 ± 7.5 years of experience). Participants were randomly assigned to a (a) brief overview of PBD (control condition), or (b) the same brief overview plus a cognitive debiasing intervention (treatment condition) that educated participants about common cognitive pitfalls (e.g., base-rate neglect, search satisficing) and taught corrective strategies (e.g., mnemonics, Bayesian tools). Both groups evaluated 4 identical case vignettes. Primary outcome measures were clinicians' diagnoses and treatment decisions. The vignette characters' race or ethnicity was experimentally manipulated. RESULTS Participants in the treatment group showed better overall judgment accuracy, p < .001, and committed significantly fewer decision-making errors, p < .001. Inaccurate and somewhat accurate diagnostic decisions were significantly associated with different treatment and clinical recommendations, particularly in cases where participants missed comorbid conditions, failed to detect the possibility of hypomania or mania in depressed youths, and misdiagnosed classic manic symptoms. In contrast, effects of patient race were negligible. CONCLUSIONS The cognitive debiasing intervention outperformed the control condition. Examining specific heuristics in cases of PBD may identify especially problematic mismatches between typical habits of thought and characteristics of the disorder. The debiasing intervention was brief and delivered via the Web; it has the potential to generalize and extend to other diagnoses as well as to various practice and training settings.
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Black Church Leaders’ Attitudes About Mental Health Services: Role of Racial Discrimination. CONTEMPORARY FAMILY THERAPY 2015. [DOI: 10.1007/s10591-015-9363-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
AIM To determine whether disparities exist in mental health care provision to immigrants and Italian citizens with severe mental illness in Bologna, Italy. METHODS Records of prevalent cases on 31/12/2010 with severe mental illness and ≥1 contact with Community Mental Health Centers in 2011 were extracted from the mental health information system. Logistic and Poisson regressions were carried out to estimate the probability of receiving rehabilitation, residential or inpatient care, the intensity of outpatient treatments and the duration of hospitalisations and residential care for immigrant patients compared to Italians, adjusting for demographic and clinical covariates. RESULTS The study population included 8602 Italian and 388 immigrant patients. Immigrants were significantly younger, more likely to be married and living with people other than their original family and had a shorter duration of contact with mental health services. The percentages of patients receiving psychosocial rehabilitation, admitted to hospital wards or to residential facilities were similar between Italians and immigrants. The number of interventions was higher for Italians. Admissions to acute wards or residential facilities were significantly longer for Italians. Moreover, immigrants received significantly more group rehabilitation interventions, while more social support individual interventions were provided to Italians. CONCLUSIONS The probability of receiving any mental health intervention is similar between immigrants and Italians, but the number of interventions and the duration of admissions are lower for immigrants. Data from mental health information system should be integrated with qualitative data on unmet needs from the immigrants' perspective to inform mental health care programmes and policies.
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Pendergast LL, Youngstrom EA, Brown C, Jensen D, Abramson LY, Alloy LB. Structural invariance of General Behavior Inventory (GBI) scores in Black and White young adults. Psychol Assess 2015; 27:21-30. [PMID: 25222430 PMCID: PMC4355320 DOI: 10.1037/pas0000020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the United States, Black and White individuals show discrepant rates of diagnosis of bipolar disorder versus schizophrenia and antisocial personality disorder, as well as disparate access to and utilization of treatment for these disorders (e.g., Alegria, Chatterji, et al., 2008; Chrishon, Anderson, Arora, & Bailey, 2012). Such diagnostic discrepancies might stem from racially related cognitive biases in clinical judgment or from racial biases in measurements of bipolar disorder. The General Behavior Inventory (GBI) is among the most well-validated and widely used measures of bipolar mood symptoms, but the psychometric properties of the GBI have been examined primarily in predominantly White samples. In this study, we used multigroup confirmatory factor analyses (CFA) to examine the invariance of GBI scores across racial groups with a nonclinical sample. Fit was acceptable for tests of configural invariance, equal factor loadings, and equal intercepts, but not invariance of residuals. Findings indicate that GBI scores provide functionally invariant measurement of mood symptoms in both Black and White samples. The use of GBI scores may contribute consistent information to clinical assessments and could potentially reduce diagnostic discrepancies and associated differences in access to and utilization of mental health services.
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Affiliation(s)
- Laura L Pendergast
- Department of Psychological, Organizational, and Leadership Studies in Education
| | - Eric A Youngstrom
- Department of Psychological, Organizational, and Leadership Studies in Education, Temple University
| | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison
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Rosario AM, DE LA Rosa M. Santería as Informal Mental Health Support Among U.S. Latinos with Cancer. JOURNAL OF RELIGION & SPIRITUALITY IN SOCIAL WORK 2014; 33:4-18. [PMID: 29033697 PMCID: PMC5637394 DOI: 10.1080/15426432.2014.873294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This article explores and examines Santería's function as a culturally congruent informal mental health support that assists U.S. Latinos to cope with the psychosocial sequelae of living with cancer. Research has demonstrated that Santería serves as a mediating institution for many Latinos. The tradition functions as both a religion and a health care system within various Latino subgroups and has functioned as an informal mental health service in occurrences of health versus illness.
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Affiliation(s)
- Adelaida M Rosario
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida
| | - Mario DE LA Rosa
- School of Social Work, Florida International University, Miami, Florida
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Carpenter-Song E, Whitley R. Behind the scenes of a research and training collaboration: power, privilege, and the hidden transcript of race. Cult Med Psychiatry 2013; 37:288-306. [PMID: 23580139 DOI: 10.1007/s11013-013-9311-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This paper examines a federally funded research and training collaboration between an Ivy League psychiatric research center and a historically Black university and medical center. This collaboration focuses on issues of psychiatric recovery and rehabilitation among African Americans. In addition, this multidisciplinary collaboration aims to build the research capacity at both institutions and to contribute to the tradition of research in culture and mental health within the medical social sciences and cultural psychiatry. This article provides a window into the complex, often messy, dynamics of a collaboration that cross cuts institutional, disciplinary, and demographic boundaries. Taking an auto-ethnographic approach, we intend to illustrate how collaborative relationships unfold and are constructed through ongoing reciprocal flows of knowledge and experience. Central to this aim is a consideration of how issues of power, privilege, and the hidden transcript of race shape the nature of our research and training efforts.
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Affiliation(s)
- Elizabeth Carpenter-Song
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Dartmouth Psychiatric Research Center, Lebanon, NH, USA.
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Shim RS, Baltrus P, Bradford LD, Holden KB, Fresh E, Fuller LE. Characterizing depression and comorbid medical conditions in African American women in a primary care setting. J Natl Med Assoc 2013; 105:183-91. [PMID: 24079219 PMCID: PMC4039195 DOI: 10.1016/s0027-9684(15)30106-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND African American women are more likely to seek treatment for depression in primary care settings; however, few women receive guideline-concordant depression treatment in these settings. This investigation focused on the impact of depression on overall functioning in African American women in a primary care setting. METHODS Data was collected from a sample of 507 African American women in the waiting room of an urban primary care setting. The majority of women were well-educated, insured, and employed. The CESD-R was used to screen for depression, and participants completed the 36-Item Short-Form Survey to determine functional status. RESULTS Among the participants with depression, there was greater functional impairment for role-physical (z = -0.88, 95% CI = -1.13, -0.64) when compared to individuals with diabetes and hypertension. Individuals with depression also had greater role-emotional impairment (z = -1.12, 95% CI = -1.37, -0.87) than individuals with diabetes and hypertension. African American women with comorbid hypertension and depression had greater functional impairment in role-physical when compared to African American women with hypertension and no depression (t(124) = -4.22, p < 0.01). CONCLUSION African American women with depression are more likely to present with greater functional impairment in role function when compared to African American women with diabetes or hypertension. Because African American women often present to primary care settings for treatment of mental illness, primary care providers need to have a clear understanding of the population, as well as the most effective and appropriate interventions.
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Affiliation(s)
- Ruth S Shim
- National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA.
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