Mescalero Tribal Preventive and Earty Mental Health Intervention Project

美国印第安人和阿拉斯加原住民青年之间的行为健康差距很大，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(CBPR)项目的目标是开发和试点公共卫生预防干预模式的测试要素，该模式是为新墨西哥州马斯莱罗阿帕奇部落保留地的青少年量身定做的，适合文化和社会。我们建议与Mscalero心理健康预防和干预工作组合作：(1)确定MEB最需要解决的严重问题(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 物质滥用问题；(2)扩大现有梅斯杰罗预防方案的重点，以关注更多的严重MEB；(3)审查和调整抑郁症、自杀风险、创伤后应激障碍和早期精神病症状的筛查量表，以确保它们在文化和社会上适合梅斯杰罗保护区的年轻人；(4)同样地审查和调整当代和历史创伤引起的症状和期望的生活功能结果的措施；(5)审查和调整多家庭小组(MFG)预防治疗模式，以确保其对梅斯雷罗保护区的年轻人的文化和社会适宜性；(6)在梅斯雷罗阿帕奇学校卫生中心(SBHC)对由此产生的公共卫生模式(外联、识别、转诊、筛查和干预)的可行性进行为期一年的试点；和(6)对该模式进行为期三年的评估，包括：对其接触、登记和治疗目标人群、获得社区的可接受性、随着时间的推移保持对计划模式的忠诚度、其可持续性和输出的潜力进行过程评估；以及，最重要的是检查结果 在学生对治疗的满意度、MEB症状水平、生活质量受损和临床改善评估方面，以发展对该模型缩小行为健康差异的潜力的一些感觉。

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.