Culturally Competent Systems of Care for Children’s Mental Health: Advances and Challenges

Child and Adolescent Psychiatry, East Tennessee State University, 204 McWherter Hall, Box 70567, Johnson City, TN 37614, USA.
Community Mental Health Journal (Impact Factor: 1.03). 11/2005; 41(5):539-55. DOI: 10.1007/s10597-005-6360-4
Source: PubMed


There has been a remarkable growth in cultural diversity in the United States over the past 20 years. The population of minority groups has increased at a much faster rate than the European-background population in America, and faster even among children and youth. At the same time, minority youth face increasing disparities in their mental health and in access to mental health services. These are related to the multiple challenges they already face in socioeconomic status, but are aggravated by the lack of culturally competent services that can address their specific mental health needs within the context of their culture, family, and community. This paper reviews the current knowledge about the mental health of culturally diverse youth in the United States, and provides guidance on approaches to address the disparities they face.

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Available from: Eugenio Rothe, Aug 22, 2014
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    • "Several epidemiologic studies have shown that only one in five children with emotional and behavioral disorders receive mental health services [1-3]. Low-income and ethnically diverse children lag well behind their middle class, Caucasian counterparts in rate of service utilization [3,4]. Access barriers, such as lack of specialized services in low-income communities, high cost,and poor service quality, and stigma have been found to affect service utilization by ethnically diverse children [5-9]. "
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    • "Greater perception of social support was related to fewer withdrawn/depressed and anxious/depressed symptoms in tenth grade. Overall, these findings are consistent with the research conducted with non-immigrant populations that has demonstrated the importance of social support in adolescent socio-emotional functioning (Cauce, Mason, Gonzales, Hiraga, & Liu, 1994; Clark-Lempers, Lempers, & Ho, 1991; Pumariega, Rogers, & Rothe, 2005). Further, anxious/depressed symptoms decreased even when acculturative stress is included in the model. "
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    ABSTRACT: This longitudinal study of 286, urban residing, first- and second-generation immigrant adolescents examined the degree to which acculturative stress is related to the developmental trajectories of mental health problems and the role of social support in this process. Participants were recruited when they entered 10th grade and two additional waves of data were gathered at 12-month intervals. Using individual growth curve modeling, the results show significant decline in internalizing mental health problems during the high school years. At the same time, greater exposure to acculturative stress predicted significantly more withdrawn/depressed, somatic, and anxious/depressed symptoms. Additionally, social support moderated the relation between acculturative stress and anxious/depressed symptoms. Gender and generation status differences were found only at baseline (10th grade).
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    • "One study found that despite efforts by parents, schools, and teachers to help immigrant children adjust, uprooting a child from his or her natural surroundings to a country where the people, culture, religion, and language are different from what the child knows can be confusing, potentially traumatic, and may impact the mental health of the child. In addition, delegitimization of immigrant families' social and cultural identity by the dominant society and widespread institutions such as schools could erode the families' protective potential and adaptive abilities (Beiser, Feng, Hyman, & Tousignant, 2002; Pumariega, Rogers, & Rothe, 2005). Stress-related environmental and cultural changes create emotional conflict, which can lead to a host of mental health problems including schizophrenia (Beiser, Feng, Hyman, & Tousignant, 2002). "
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    ABSTRACT: Impact of immigration on the development of adolescent schizophrenia. The review of literature used Academic Search Premier, CINHAL, PsychINFO, PubMed, and MEDLINE databases to examine reasons given to immigration as a risk factor to adolescent schizophrenia. There is not a single factor or a group of related factors that could explain why the incidence of schizophrenia among immigrants is higher compared with natives of the host county. Further inquiry into this phenomenon is needed to understand factors that increase the risk of schizophrenia among immigrant children and to help plan and implement strategies for prevention.
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