From Documenting to Eliminating Disparities in Mental Health Care for Latinos

Department of Psychology, University of Southern California.
American Psychologist (Impact Factor: 6.87). 10/2012; 67(7):511-23. DOI: 10.1037/a0029737
Source: PubMed


The U.S. Surgeon General's report Mental Health: Culture, Race and Ethnicity-A Supplement to Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services, 2001) identified significant disparities in mental health care for Latinos and recommended directions for future research and mental health services. We update that report by reviewing five groundbreaking research projects on the mental health of Latinos that were published since 2001. National studies of adults and children, longitudinal designs, and analyses of Latino subgroups characterize these investigations. Despite the increasing sophistication of disparities research, these landmark studies, as well as the research in the supplemental report, can be characterized as documenting disparities in care. We argue that the next wave of research should give greater attention to reducing and eliminating disparities. Accordingly, we apply Rogler and Cortes's (1993) framework of pathways to care to the study of Latinos with schizophrenia. Specifically, we draw on research regarding the recognition of illness, social networks (families) and their association with the course of illness, and interventions. We illustrate examples at each pathway that have the potential to reduce disparities. We argue that implementing interventions synchronously across multiple pathways has considerable potential to reduce and eventually eliminate disparities in mental health care. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

46 Reads
  • Source
    • "Related to the measure of intrinsic moti - vation , further validation of the expanded definition is needed . We also need studies with racially and ethnically diverse sam - ples to examine the contribution of sociocultural and contextual factors to recovery from schizophrenia ( Brekke & Barrio , 1997 ; Lopez , Barrio , Kopelowicz , & Vega , 2012 ) . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: We assessed the prevalence of recovery from schizophrenia during the first year of community-based psychosocial rehabilitation and whether psychosocial attributes predicted the achievement of recovery beyond demographic and clinical characteristics. Method: We used data from 246 individuals with schizophrenia spectrum disorder collected at baseline and 6 and 12 months after admission to psychosocial rehabilitation. Results: The proportion of participants who showed recovery for either 6-month period and for 1-year period during the follow-up period was 19.86% and 7.53%, respectively. Although predictors of recovery for 1-year period could not be reliably estimated due to its low prevalence, higher levels of intrinsic motivation and more positive family relationships at baseline predicted recovery for either 6-month period after controlling for initial functioning capacity. Conclusion: In the context of psychosocial rehabilitation, individuals with schizophrenia have highly heterogeneous trajectories. Psychosocial attributes at the start of treatment are important contributors to successful recovery.
    Full-text · Article · Jun 2015 · Research on Social Work Practice
  • Source
    • "They represent a group with a prevalence of mental illness estimated at 36%, the highest among the Latino communities (Alegría et al., 2008; Alegría et al., 2007). Also, significant inequities have been found among the Latino communities (López et al., 2012a), especially among Puerto Ricans who have one of the lower rates of treatment seeking (Alegría et al., 2001; Keyes et al., 2012). Literature has shown that it is critical to understand how socio-cultural factors such as stigmatization shape opinions, beliefs, and attitudes about mental illnesses (Link, 2013; Olafsdottir & Pescosolido, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The experiences of stigmatization among people living with specific Serious Mental Illnesses (SMI), such as Borderline Personality Disorder (BPD) has not been addressed by the scientific literature. In this study we wanted to explore how people living with BPD experience stigmatization. We examine the experiences of 8 people (7 women and 1 man) living and receiving treatment for BPD in Puerto Rico. We used an exploratory qualitative design with semi-structured interviews. To interpret our data, we conducted a thematic analysis. We discuss three categories that focus on one identified theme: the interpersonal dimension of the stigmatization process. These categories are (a) society’s views of people living with BPD, (b) family relationships, and (c) partner relationships. Our findings show that people with BPD experience a high attributed personal responsibility, discrimination, social exclusion, and lack of social support. In addition, our findings suggest that the stigmatization of BPD might be more complex than other mental illnesses as it shares characteristics of both SMI and less severe forms of mental illness. We also discuss the importance for practitioners to address stigmatization in therapy and the importance for research to address other aspects of the stigmatization process such as its structural dimension.
    Full-text · Article · Apr 2014 · Qualitative Report
  • Source
    • "According to the US Census Bureau (Ennis et al. 2011) Latinos make up 50.5 million individuals living in the US (about 16 %), a 43 % increase since 2000. Yet, despite the growing size of this population, mental health research on Latinos remains largely sparse (e.g., Alegría et al. 2012; Lopéz et al. 2012), including research regarding suicidal risk (e.g., suicidal thoughts, suicide behaviors) in Latinos (Fortuna et al. 2007). Based on a report by Heron (2012), suicide represents the third leading cause of death in young Latinos (ages 15–24) after accidents and assaults, accounting for over 11 % of total deaths. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In the present study, we examined hope and positive problem orientation as additive predictors of suicidal risk, namely, hopelessness and suicide behavior, in a sample of 155 (37 males and 118 females) Latinos. Consistent with expectations, we found hope and positive problem orientation to be associated with lower suicidal risk. In addition, results of conducting hierarchical regression analyses indicated that hope accounted for significant variance in both indices of suicidal risk. Moreover, the inclusion of positive problem orientation as a predictor was found to account for additional unique variance in both indices of suicidal risk, beyond what was accounted for by hope. Finally, results of conducting additional analyses indicated a significant Hope × Positive Problem Orientation interaction effect in accounting for suicidal risk. Some implications of the present findings are discussed.
    Full-text · Article · Jan 2014 · Cognitive Therapy and Research
Show more