Project 1: Mescalero

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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.