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

项目摘要 拉美裔人不成比例地受到持续的、高水平的未经治疗的精神疾病的影响。在加利福尼亚州， 在外国出生的拉丁裔中，未接受治疗的精神疾病的比率(67%)甚至比在美国出生的更严重 拉丁裔(46%)。此外，英语水平有限的拉美裔人不太可能认识到 治疗，推迟治疗的时间更长，获得的精神卫生服务更少 精通英语的拉丁裔。耻辱、有限的心理健康素养和文化因素已被确定为 拉丁精神健康治疗差异的主要因素。尽管拉美人可能不愿去寻找 作为心理健康专业人士，他们经常依赖宗教集会和精神形式来应对 面临心理健康问题。然而，宗教集会报告说，主要障碍是 与精神卫生部门合作，包括缺乏精神卫生培训、人员配置和资源。 可以利用宗教会众和社区组织之间的战略伙伴关系 针对拉美裔心理健康治疗差异的来源。全国精神疾病联盟 全国最大的基层精神卫生组织(NAMI)开发了一系列量身定做的项目 针对受精神疾病影响的社区的不同需求和部分，包括独特的方案 旨在解决文化多样性和以信仰为基础的社区。我们提出了一种随机化的簇 一项多成分、以教会为基础的干预措施的对照试验，该试验利用NAMI的资源和 减少污名、提高心理健康素养和改善获得心理健康服务的方案 在洛杉矶和河滨县的拉丁裔中。 我们的具体目标是： 1)评估为拉丁裔量身定做的多成分、基于教会的干预措施是否增加 为精神病患者提供所需的心理健康治疗、使用和支持。 2)检查精神卫生服务的使用和支持提供是否与目标相关 改变的机制，如污名和心理健康知识普及。 3)根据移民身份探讨干预措施的有效性差异(例如，美国与 非美国出生；精通英语与有限英语水平；在美国生活多年)。 近20年来，一位里程碑式的卫生部长报告强调了 拉丁美洲人之间的心理健康治疗差距很大，但这些差距似乎正在恶化。合作伙伴关系 建立了心理健康意识和倡导组织，使这一模式具有高度的可持续性 并可能对大约1.473亿信奉宗教的美国人产生重大影响 会众。

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.