A CULTURALLY SENSITIVE PROGRAM FOR LATINOS TO REDUCE BARRIERS TO MENTAL HEALTH TREATMENT SERVICES: A GRANT PROPOSAL

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1 A CULTURALLY SENSITIVE PROGRAM FOR LATINOS TO REDUCE BARRIERS TO MENTAL HEALTH TREATMENT SERVICES: A GRANT PROPOSAL Noriela Flores California State University, Long Beach May 2017

2 Introduction The Hispanic population in the United States is currently over 50.5 million, comprising 16% of the entire population (U.S. Census Bureau, 2010) Latinos also have a higher rate of depression in comparison to Whites (Alegria et al., 2008) Latinos receive disproportionately fewer mental health services than their White counterparts (Alegria et al., 2008) Many Latinos residing in the United States face several acculturation-related barriers to receiving mental health services (Keyes, 2012; Ojeda, 2006; Perrino, 2009; Ramos, 2014) There are interventions that can help reduce barriers Latinos face when accessing mental health treatment. Overreaching Goals Due to the growing Latino population and the barriers often faced when seeking mental health services, the proposed culturally sensitive mental health program Pequeño Proyecto Para Ti will help reduce the barriers Latinos face when accessing mental health services

3 Social Work Relevance As stated in the Ethical Principles of the National Association of Social Workers Code of Ethics (2008), social workers should understand culture and its function in society; in addition, social workers should have knowledge of their clients cultures and be competent in the provision of services that are sensitive to client s cultures Latinos lacking access or adequate mental health services that are culturally sensitive is of big concern in social work, because Latinos are in need of accessing resources and programs available to them

4 Cross-cultural Relevance When the use of standardized instruments from a dominant culture are used with minority cultural ethnic groups, the instruments being used may lack cultural relevance and equivalence (Alegria et al.,2008) Adding a cultural perspective might not be easy, but it is significant to incorporate Latinos cultural perspectives in order for this population to seek effective mental health treatment that is relatable to them It has been suggested that language and cultural factors can explain the disparity among Latinos use of mental health services, indicating that a need for services that explicitly emphasizes in factors that are unique to the Latino community can improve treatment utilization (Keyes et al., 2012).

5 Methods Target Population: The target population for this grant project will be Latinos who are already receiving services at La Familia, as well as other Latinos residing in Santa Ana Strategies Used to Identify Funding Source: Attention was placed on funders with open and available grants that would meet the needs of the intended program and the projected budget, keywords Latino, Mental health, Barriers, Depression, Conditions, Treatment, and Culture were searched for research and funding purposes Funding Source Selected The National Institute of Mental Health (NIMH) places highest priority on approaches that can impact practice and public health. NIMH was selected for this project

6 Methods The Hamilton Depression Rating Scale (HAMD) is an instrument used to detect depression, and it has proven successful in assessing Latinos (Aponte-Rivera et al., 2014). This instrument will be used to determine which individuals will meet the requirements to participate in this program The 12- week treatment will consist of 1-hour weekly sessions in person or over the phone with a therapist who is culturally competent and speaks their language, using cognitive behavioral therapy interventions and teaching positive coping skills. This program will require funding for the amount of $187,565 to serve approximately 200 Latinos experiencing depression over a 1-year period.

7 Grant Proposal Therapy will consist of evidence-based treatment: Cognitive Behavioral Therapy for up to 12 weeks. Research suggests that CBT is effective in reducing depressive symptoms within Latinos (Voss, 2008) The HAMD will be used prior to starting program, again after 1-2 months of treatment, and after completion a posttest will be used to measure outcomes of treatment Participants will also be able to access case management services by a case manager to get direct assistance All program interventions will be available in Spanish and English, and all information and services provided will be culturally sensitive to meet the needs of Latinos through language and printed materials The program will use different pre and posttests in order to evaluate effectiveness of the program

8 Grant Proposal Goals and Objectives Goal 1: To increase participants mental health literacy as it relates to symptoms and treatment options Objective #1: Participants will participate in two 2-hour workshops on mental health literacy. Each participant will complete a pre and posttest in order to measure knowledge prior and after attending these workshops. All the services will be available in English and Spanish. After completing both workshops participants will increase their mental health literacy by 80% or higher Goal 2: To reduce participant s depressive symptoms Objective #1: At the conclusion of the 12-week individual CBT treatment, participants will have decreased their depressive symptoms by 90% or higher as measured by scores on the Hamilton Depression Rating Scale at baseline and after completion of the program Goal 3: Participants will be connected to at least two agencies through the case management services available in the program to encourage them to utilize services available and helpful to them. Objective #1: Participants and nonparticipants will have received at least two referrals to services in their community. It is estimated that 70% of participants referred to services in their community will utilize these services and will benefit from them.

9 Lessons Learned Through cultural sensitivity and altering services to meet their needs, Latinos are more likely to access the services they need There is not enough research on male Latinos an the need for research to focus on their specific needs is very important due to Latino males having the lowest utilization of mental health services Social workers can provide psycho-education to Latinos to improve their mental health literacy, as this has proven helpful in increasing awareness and reducing mental health stigma (Lopez et al., 2012) It is important for social workers to be involved in macro practice and create programs that are beneficial to the community Social work practice can help provide evidence-based interventions such as CBT, as it has demonstrated effectiveness in treating depression within the Latino population (Voss, 2008)

10 References Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C., Takeuchi, D., Meng, X.-L. (2008).Disparity in Depression Treatment among Racial and Ethnic Minority Populations in the United States. Psychiatric Services (Washington, D.C.), 59(11), Aponte-Rivera, V., Dunlop, B. W., Ramirez, C., Kelley, M. E., Schneider, R., Blastos, B., &... Craighead, W. E. (2014). Enhancing Hispanic Participation in Mental Health Clinical Research: Development of a Spanish-Speaking Depression Research Site. Depression & Anxiety ( ), 31(3), doi: /da Keyes, K., Martins, S., Hatzenbuehler, M., Blanco, C., Bates, L., & Hasin, D. (2012). Mental health service utilization for psychiatric disorders among Latinos living in the United States: the role of ethnic subgroup, ethnic identity, and language/social preferences. Social Psychiatry & Psychiatric Epidemiology, 47(3), doi: /s Lopez, S.R., Barrio, C., Kopelowicz, A., & Vega, W.A. (2012). From Documenting to Eliminating Disparities in Mental Health Care for Latinos. American Psychologist, 67(7), doi: /a National Association of Social Workers (2008). Code of Ethics of the National Association of Social Workers. Retrieved from Ojeda, V. D., & McGuire, T. G. (2006). Gender and Racial/Ethnic Differences in Use of Outpatient Mental Health and Substance Use Services by Depressed Adults. Psychiatric Quarterly, 77(3), doi: /s Perrino, T., Brown, S.C., Mason, C.A., & Szapocznik, J. (2009). Depressive Symptoms Among Urban Hispanic Older Adults in Miami: Prevalence and Sociodemographic Correlates. Clin Gerontol January 1; 32(1): doi: / Ramos, Z., & Alegría, M. (2014). Cultural Adaptation and Health Literacy Refinement of a Brief Depression Intervention for Latinos in a Low-Resource Setting. Cultural Diversity & Ethnic Minority Psychology, 20(2), doi: /a Voss Horrell, S.C. (2008). Effectiveness of Cognitive-Behavioral Therapy with Adult Ethnic Minority Clients: A Review. Professional Psychology: Research & Practice, 39(2), doi: /

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