Delivering Church-based Interventions to Reduce Stigma and Mental Health Treatment Disparities among Latinos.

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Project Summary Latinos are disproportionately affected by persistent, high levels of untreated mental illness. In California, rates of untreated mental illness are even more severe among foreign-born Latinos (67%) than U.S.-born Latinos (46%). Moreover, Latinos with limited English proficiency are less likely to recognize a need for treatment, put off treatment for longer periods of time, and access fewer mental health services compared to English-proficient Latinos. Stigma, limited mental health literacy, and cultural factors have been identified as major contributors to Latino mental health treatment disparities. Although Latinos may be reluctant to seek out mental health professionals, they often rely on religious congregations and spiritual forms of coping when confronted with mental health problems. However, religious congregations report major obstacles to collaborating with the mental health sector including the lack of mental health training, staffing, and resources. Strategic partnerships between religious congregations and community-based organizations can be leveraged to target sources of mental health treatment disparities among Latinos. The National Alliance on Mental Illness (NAMI), the nation's largest grassroots mental health organization has developed a host of programs tailored to the different needs and segments of the community affected by mental illness, including programs uniquely designed to address culturally diverse and faith-based communities. We propose a cluster randomized controlled trial of a multi-component, church-based, intervention that leverages NAMI's resources and programs to decrease stigma, increase mental health literacy, and improve access to mental health services among Latinos in Los Angeles and Riverside Counties. Our specific aims are to: 1) Assess whether a multi-component, church-based intervention tailored for Latinos increases needed mental health treatment use and support provision to individuals with a mental illness. 2) Examine whether mental health service use and support provision are related to targeted mechanisms of change such as stigma and mental health literacy. 3) Explore differences in the effectiveness of the intervention by immigration status (e.g., U.S. vs. non-U.S. born; English proficient vs. limited English proficient; years in the U.S.). Nearly two decades have passed since a landmark Surgeon General's report highlighted the significant mental health treatment disparities among Latinos, yet these disparities appear to be worsening. Partnering with an established mental health awareness and advocacy organization makes this model highly sustainable and could yield significant impact for the estimated 147.3 million Americans who are members of a religious congregation.