Improving Mental Health Services for Low-Income Latinos in Primary Care

改善为低收入拉美裔人提供的初级保健心理健康服务 迫切需要建设社区能力，为拉美裔移民提供可获得的精神卫生服务。与非拉美裔白人相比，美国的拉美裔美国人更不可能使用心理健康服务，他们也不太可能接受与指南一致的护理，差距越来越大。社区精神卫生学术伙伴关系(CAP-MH)寻求通过加强乔治敦医学院精神病学系创伤中心和社区(CTC)与蒙哥马利县初级护理联盟(PCC)之间的现有伙伴关系来解决这些关切，以支持及时发展和评估具有文化能力的、对创伤敏感的创新干预措施，以改善患者的心理健康。该项目的一个主要目标是将临床研究纳入社区诊所一级的临床护理过程。因此，通过升级精神健康部分，将改进中国人民健康委员会S电子病历，包括增加具体研究方案干预所需的定制数据元素，以及基本功能，包括改进的数据汇总功能。一旦EMR升级，将对蒙哥马利关怀行为健康计划(MCBHP)进行自然评估，比较有无该计划的诊所。本研究的目的包括：1)通过检查MCBHP相关的过程参数，包括与指南一致的护理提供的程度，来评估正在进行的MCBHP的实施程度；2)评估MCBHP对精神健康结果(抑郁、焦虑)的有效性；以及，3)在合并慢性健康状况(糖尿病、高血压、肥胖)的患者中，评估MCBHP对心理健康、健康行为和健康相关结果的有效性。背景支助工作将包括与提供者和其他工作人员的访谈和焦点小组，他们的意见将用于帮助设计电子病历和研究的灵活方面。这一伙伴关系将开始成为社区知情干预发展的实验室，以改善服务，并最终改善大量未得到充分服务的少数族裔人口的健康。 叙事(面向外行公众) 拉美裔人口很难获得对文化敏感的心理健康服务。拟议的项目将通过在马里兰州蒙哥马利县的初级保健服务提供者组织中建设社区S为拉丁裔社区开发和研究精神健康服务的能力来解决这些差异。对一个已经在社区提供精神健康服务的临床项目的研究将进行评估，临床医生和工作人员将提供意见来帮助我们设计这项研究。

IMPROVING MENTAL HEALTH SERVICES FOR LOW-INCOME LATINOS IN PRIMARY CARE Building community capacity to deliver accessible mental health services to Latino Immigrants is much needed. Latinos in the US are less likely to utilize mental health services than non-Latino Whites, and they are less likely to receive guideline-concordant care, with disparities increasing. The Community Academic Partnership for Mental Health (CAP-MH) seeks to address these concerns by strengthening an existing partnership between the Center for Trauma and the Community (CTC) in the Psychiatry Department at Georgetown Medical School, and the Primary Care Coalition (PCC) of Montgomery County, to support the timely development and evaluation of culturally competent, trauma-sensitive, and innovative interventions to improve patient mental health. A major goal of this project is to integrate clinical research into the clinical care process at the community clinic level. Thus, PCC¿s electronic medical record (EMR) will be improved by upgrading the mental health section, including the addition of custom data elements required for specific research protocol interventions, and essential functionalities, including improved data summary functions. Once the EMR has been upgraded, a naturalistic evaluation of the Montgomery Cares Behavioral Health Program (MCBHP) will be conducted, comparing clinics with and without the program. The study aims include, 1) To evaluate the extent of implementation of the ongoing MCBHP via examination of MCBHP-related process parameters, including extent of guideline-concordant care provision; 2) To evaluate the effectiveness of the MCBHP on mental health outcomes (depression, anxiety); and, 3) among the subset of patients with comorbid chronic health conditions (diabetes, hypertension, obesity), to evaluate the effectiveness of the MCBHP on mental health, health behaviors, and health-related outcomes. Background support work will include interviews and focus groups with providers and other staff, whose input will be used to help design flexible aspects of the EMR and the study. This partnership will begin to serve as a laboratory for community-informed intervention development to improve services, and ultimately the health, of a large underserved minority population. Narrative (for the lay public) Latino populations have difficulty accessing culturally sensitive mental health services. The proposed project will address these disparities by building the community¿s capacity to develop and study mental health services for the Latino community in a primary care service provider organization in Montgomery County, MD. A study of a clinical program that is already delivering mental health services in the community will be evaluated, with clinicians and staff providing input to help us design the study.