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

项目摘要 拉丁美洲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。在加州， 在外国出生的拉丁美洲人中，未经治疗的精神疾病的比例（67%）比美国人更严重。出生 拉丁裔（46%）。此外，英语水平有限的拉丁美洲人不太可能认识到需要 治疗，推迟治疗更长的时间，并获得更少的心理健康服务相比， 精通英语的拉丁美洲人污名化、有限的心理健康知识和文化因素已被确定为 拉丁裔心理健康治疗差异的主要贡献者。尽管拉丁裔可能不愿意寻求 心理健康专业人员，他们往往依赖于宗教集会和精神形式的应对时， 面临心理健康问题。然而，宗教团体报告说， 与精神卫生部门合作，包括缺乏精神卫生培训、人员配备和资源。 可以利用宗教团体和社区组织之间的战略伙伴关系 针对拉丁美洲人之间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已经制定了一系列量身定制的计划， 不同的需求和受精神疾病影响的社区，包括独特的方案， 旨在解决文化多样性和基于信仰的社区的问题。我们提出了一个集群随机 利用NAMI的资源，对一种多成分、以教会为基础的干预措施进行对照试验， 减少耻辱感、提高心理健康素养和改善获得心理健康服务的机会的计划 在洛杉矶和滨江县的拉丁裔中。 我们的具体目标是： 1)评估为拉丁美洲人量身定制的多成分、以教会为基础的干预措施是否增加了 为精神疾病患者提供所需的精神健康治疗和支持。 2)检查精神卫生服务的使用和支持提供是否与目标相关， 变革机制，如污名化和心理健康扫盲。 3)探讨不同移民身份的干预措施的有效性差异（例如，美国与 非美国出生;英语熟练与英语有限熟练;在美国的年数）。 自从一份具有里程碑意义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异，但这些差异似乎正在恶化。合作 建立心理健康意识和倡导组织，使这种模式高度可持续 并可能对估计有1.473亿美国人的宗教信仰产生重大影响。 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.