Developing Community-Based Interventions for American Indian Mental Health

描述(由申请人提供)：我的长期职业目标是开发一个研究计划，解决被边缘化、精神创伤和服务不足的人群在精神健康服务方面的差距。我希望开展以社区为基础的服务干预研究，其结果是：(A)以证据为基础和与文化相关的干预措施；(B)以消费者为导向的干预措施，以减少心理健康护理的障碍；(C)对心理学作为一门涉及不同个人和群体的心理健康和福祉的学科作出理论和应用贡献。我之前的大部分工作都是关于难民的。在这份职业奖项申请中，我提出了一套培训目标和研究活动，为我成功地与美国印第安人群体合作做好准备。首先，我建议把重点放在纳瓦霍青年身上，并在以下方面接受培训：(1)美洲印第安人的精神健康；(2)人种学方法和方法论；(3)创伤相关疾病的特征和治疗的临床视角；(4)定量数据分析和研究设计战略；(5)社区精神健康干预研究中的伦理问题，以及与美国印第安人的研究。我将通过一个全面的培训计划(课程作业、独立研究以及与当地和国家导师的实地访问)，以及通过有指导地执行研究，包括对纳瓦霍青少年及其家庭经历的心理健康状况和压力源进行民族志评估，以及为这一群体设计和预先测试以社区为基础的参与式干预模式，来实现这些目标。新墨西哥大学是追求这些目标的绝佳环境。健康促进和疾病预防中心以及精神病学、家庭和社区医学合作项目、美洲原住民健康中心和西南行为健康中心，在参与式研究、成功开发和测试适合文化的干预措施方面有着出色的历史，并与美洲印第安人社区建立了牢固的联系。相关性：美国印第安人经历了种族灭绝和压迫的历史，这导致了代际创伤和精神健康障碍和药物滥用的不成比例的高患病率。现有的心理健康服务在文化上往往并不合适。这些因素造成了许多差异，拟议的培训和研究旨在解决这一问题。

DESCRIPTION (provided by applicant): My long term career goal is to develop a research program that addresses disparities in mental health services for marginalized, traumatized and underserved populations. I hope to conduct community-based services intervention research that results in: (a) evidence-based and culturally-relevant interventions; (b) consumer-driven interventions that reduce barriers to mental health care; and (c) theoretical and applied contributions to psychology as a discipline concerned with the mental health and well-being of diverse individuals and groups. Most of my previous work has been with refugee populations. In this career award application, I propose a set of training goals and research activities that will prepare me to work successfully with American Indian populations. Initially I propose to focus on Navajo youth and to obtain training in: (1) American Indian mental health; (2) ethnographic methods and methodology; (3) clinical perspectives on the character and treatment of trauma-related disorders; (4) quantitative data analysis and research design strategies; and (5) ethical issues in community-based mental health intervention research, and research with American Indians. I will achieve these goals through a comprehensive training plan (coursework, independent study, and site visits with local and national mentors), and through mentored execution of research that involves ethnographic assessment of the mental health conditions and stressors experienced by Navajo adolescents and their families and the design and pre-testing of a community-based participatory intervention model for this population. University of New Mexico is an excellent environment in which to pursue these goals. The Center for Health Promotion and Disease Prevention and collaborating programs in Psychiatry, Family and Community Medicine, the Center for Native American Health, and the Behavioral Health Center of the Southwest, have an outstanding history of participatory research, success in developing and testing culturally-appropriate interventions, and strong connections to American Indian communities. Relevance: American Indians have endured a history of genocide and oppression, which has resulted in intergenerational trauma and disproportionately high prevalence of mental health disorders and substance abuse. Available mental health services are often not culturally appropriate. These factors have contributed to numerous disparities, which the proposed training and research are designed to address.