Mescalero Tribal Preventive and Earty Mental Health Intervention Project

美国印第安人和阿拉斯加土著青年之间的行为健康差异很大，特别是在抑郁、自杀和创伤后应激障碍方面。这一拟议的基于社区的参与性研究项目的目标是开发和试点一种公共卫生预防干预模式的要素，这种模式是为新墨西哥州梅斯卡莱罗阿帕奇部落保留地的青少年量身定制的，在文化和社会上都是合适的。我们建议与梅斯卡莱罗精神健康预防和干预工作组合作(1)确定最需要解决的严重MEB问题（包括暂时的抑郁、自杀风险、创伤后应激障碍、精神病的早期症状和共存症状）

Behavioral health disparities among American Indian and Alaska Native youth are dramatic, particularly in terms of depression, suicide and post-traumatic stress disorder. The goal of this proposed community based participatory research (CBPR) project is to develop and pilot test elements of a public health prevention intervention model that is tailored to be culturally and socially appropriate for adolescents on the Mescalero Apache Tribal Reservation in New Mexico. We propose to partner with a Mescalero Mental Health Prevention and Intervention Task Force to (1) identify what serious MEB problems most need to be addressed (including, provisionally, depression, suicide risk, post-traumatic stress disorder, early symptoms of psychosis and coexisting substance abuse problems ; (2) broaden the focus of existing Mescalero prevention programs to focus on a larger array of serious MEB's; (3) review and adapt screening scales for depression, suicide risk, PTSD, and early symptoms of psychosis to insure their cultural and social appropriateness for youth on the Mescalero reservation; (4) similarly review and adapt measures of symptoms resulting from contemporary and historical trauma and of desirable life function outcomes; (5) review and adapt a multifamily group (MFG) prevention treatment model to ensure its cultural and social appropriateness for youth on the Mescalero reservation; (6) conduct a one-year pilot of the feasibility of the resulting public health model (outreach, identification, referral, screening and intervention) in the Mescalero Apache School Based Health Center (SBHC); and (6) conduct a three year evaluation of the model including; a process evaluation of its ability to reach, enroll and treat the target population, obtain acceptability in the community, maintain fidelity over time to the program model, its potential for sustainability and export; and, most importantly examine outcomes in terms of student satisfaction with treatment, MEB symptom levels, quality of life impairment and clinical assessment of improvement to develop some sense of the model's potential for reducing disparities in behavioral health.