Résumé
Resumen
El aumento de la población Latina rural en EEUU representa un reto para la provisión de servicios de salud mental adecuados. Barreras de acceso como el aislamiento geográfico, limitaciones en el transporte público, escasez de proveedores/as de servicios y su limitada competencia cultural son particularmente marcadas. La psicología comunitaria puede hacer contribuciones significativas para resolver este grave problema de salud pública. En este artículo, nos basamos en nuestra experiencia investigativa y de extensión con inmigrantes Latinos y Latinas en áreas rurales de la región centro-occidental de los EEUU para ilustrar percepciones sobre su situación de salud mental y su necesidad de servicios. También hacemos recomendaciones acerca de los cambios necesarios para aumentar la capacidad técnica de provisión de servicios en salud mental que respondan a las necesidades de esta población. Esto incluye el desarrollo de nuevos programas para responder a las prioridades comunitarias, el entrenamiento de promotores de salud o enlaces comunitarios para facilitar el acceso y la navegación en el sistema de salud, y realizar abogacía.
Palabras clave: Inmigrantes Latinos y Latinas, condiciones y servicios de salud mental, región central de los Estados Unidos, psicología comunitaria
Abstract
Rapid Latino and Latina population growth in rural U.S. has challenged the provision of adequate mental health services. In these areas, access barriers—geographic isolation, the lack of public transportation systems, the shortage of health care providers and their limited cultural competence—are particularly serious. Community psychology can make significant contributions to address this major public health issue. In this article, we draw on our research and outreach experience with Latino and Latina immigrants in the rural Midwest to illustrate this population’s perceived mental health status and service needs. We also provide some possible strategies for bridging gaps and make recommendations regarding much needed changes to augment the technical capacity to serve Latinos and Latinas’ mental health needs in rural areas. These include developing new programs around community priorities, training promotores/as or community liaisons to facilitate access to and navigation into the health care system, and engaging in advocacy.
Keywords: Latino and Latina immigrants, mental health status and service needs, U.S. rural Midwest, community psychology
Références
Arcury, T. A., & Quandt, S. A. (2007). Delivery of health services to migrants and seasonal farmworkers. Annual Review of Public Health, 28, 345–363.
Atdjian, S., & Vega, W. A. (2005). Disparities in mental health treatment in U.S. racial and ethnic minority groups: Implications for psychiatrists. Psychiatric Services 56, 1600–1602.
Betancourt, H., & Fuentes, J. L. (2001). Culture and Latino issues in health psychology. In S. S. Kazarian & D. R. Evans (Eds.), Handbook of cultural health psychology (pp. 306–323). San Diego, CA: Academic Press.
Bushy, A. (1993). Rural women: Lifestyles and health status. Nursing Clinics of North America, 28(1), 187-197.
Butera, G., McMullen, L., & Phillips, R. (2000). Energy express: Connecting communities and intervention on behalf of schoolchildren in West Virginia. Journal of Research in Rural Education, 16(1), 30–39.
Cantrell, C., Valley-Gray, S., & Cash, R. E. (2012). Suicide in rural areas: Risk factors and prevention. In K. Bryant Smalley, J.C. Warren, & J. P. Rainer (Eds.) Rural Mental Health: Issues, Policies, and Best Practices. New York, NY: Springer.
Casey, M. M., Blewett, L. A., & Call K. T. (2004). Providing health care to Latino immigrants: Community-based efforts in the rural Midwest. American Journal of Public Health, 94(10), 1709-1711.
Cellucci, T., & Vik, P. (2001). Training for substance abuse treatment among psychologists in a rural state. Professional Psychology: Research and Practice, 32(3), 248-252.
Cristancho, S., Peters, K., & Garcés, M. (2014). Health information preferences among Hispanic/Latino immigrants in the U.S. rural Midwest. Global Health Promotion, 21(1), 40-49.
Cristancho, S., Garcés, D. M., Peters, K., & Mueller, B. (2008). Listening to rural Hispanic immigrants in the Midwest: A community-based participatory assessment of major barriers to health care access and use. Qualitative Health Research, 18(5), 633–646.
Dalton, J., Elias, M., & Wandersman, A., (2001). Community psychology: Linking individuals and communities. New York, NY: Wadsworth Publishing.
Domínguez, S., & Maya-Jariego, I. (2008). Acculturation of host individuals: Immigrants and personal networks. American Journal of Community Psychology, 42(3-4), 309-327.
Fals-Borda, O. (1987). The application of participatory action-research in Latin America. International Sociology, 2(4), 329–347.
Fry, R. (2008). Latino settlement in the new century. Retrieved June 1, 2010, from Pew Hispanic Center at http://pewhispanic.org/files/reports/96.pdf
Gamm, L. D., Hutchinson, L. L., Dabney, B. J., & Dorsey, A. M. (2003). Rural health people 2010: A companion document to Healthy People 2010 (Vols. 1–3). College Station, TX: The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest, Rural Health Research Center.
Guerra, N. G., & Knox, L. (2008). How culture impacts the dissemination and implementation of innovation: A case study of the Families and Schools Together Program (FAST) for preventing violence with immigrant Latino youth. American Journal of Community Psychology, 41(3-4), 304-313.
Habermas, J. (1984). The theory of communicative action: Vol 1.Reason and the rationalization of society. Boston, MA: Beacon Press.
Human, J., & Wasem, C. (1991). Rural mental health in America. American Psychologist, 46(3), 232-239.
Institute of Medicine. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.
Israel, B. A., Eng, E., Schulz, A. J., & Parker, E. A. (2005). Methods in community-based participatory research for health. San Francisco, CA: Jossey-Bass.
Israel, B. A., Schulz, A. J., Parker, E. A., Becker, A. B., Allen, A., & Guzmán, J. R. (2003). Critical issues in developing and following community-based participatory research principles. In M. Minkler & N. Wallerstein (Eds.), Community-based participatory research for health (pp. 56–73). San Francisco, CA: Jossey-Bass.
Kandel, W., & Cromartie, J. (2004). New patterns of Hispanic settlement in rural America (Rural Development Research Report 99). Washington, DC: Economic Research.
Klostermann, K., & Kelley, M. L. (2009). Alcoholism and intimate partner violence: Effects on children’s psychosocial adjustment. International Journal of Environmental Research & Public Health, 6(12), 3156–3168.
Leisey, M. (2009). The Journey Project: A case study in providing health information to mitigate health disparities. Journal of the Medical Library Association, 97(1), 30–33.
Lenardson, J. D., Ziller, E. C., Lambert, D., Race, M. M., & Yousefian, A. (2010). Access to Mental Health Services and Family Impact of Rural Children with Mental Health Problems. Maine Rural Health Research Center Working Paper #45 (October). University of Southern Maine.
Lenardson, J. D., Hartley, D., Gale, J. A., & Pearson, K. B. (2012). Substance use and abuse in rural America (Chapter 12). In K. Bryant Smalley, J. C. Warren, & J. P. Rainer (Eds.) Rural Mental Health: Issues, Policies, and Best Practices. New York, NY: Springer.
Lewin, K. (1946). Action research and minority problems. Journal of Social Issues, 2, 34–46.
López, S. R. (2002). Mental health care for Latinos: A research agenda to improve the accessibility and quality of mental health care for Latinos. Psychiatric Services, 53, 1569–1573.
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion and motivation. Psychological Review, 98(2), 224-253.
Montero, M. (2004). Introducción a la psicología comunitaria: Desarrollo, conceptos y procesos. Buenos Aires: Paidós.
Mueller, K., Ortega, S., Parker, K., Patil, K., & Askenazi, A. (1999). Health status and access to care among rural minorities. Journal of Health Care for the Poor & Underserved, 10, 230–249.
Murray, J. D., & Keller, P. A. (1991). Psychology and rural America: Current status and future directions. American Psychologist, 46(3), 220–231.
Negi, N. J. (2013). Battling discrimination and social isolation: Psychological distress among Latino day laborers. American Journal of Community Psychology, 51(1-2), 164-174.
Partida, Y. (2007). Addressing language barriers: Building response capacity for a changing nation. Journal of General Internal Medicine, 22(2), 347–349.
Philbrick, J. T., Connelly, J. E., & Wofford, A. B. (1996). The prevalence of mental disorders in rural office practice. Journal of General Internal Medicine, 11, 9-15.
Probst, J. C., Moore, G. C., Glover, S. H., & Samuels, M. E. (2004). Person and place: The compounding effects of race/ethnicity and rurality on health. American Journal of Public Health, 94(10), 1695–1703.
Rhodes, S. D., Foley, K. L., Zometa, C. S., & Bloom, F. R. (2007). Lay health advisor interventions among Hispanics/Latinos: A qualitative systematic review. American Journal of Preventive Medicine, 33(5), 418–427.
Ricketts, T. C. (1999). Rural health in the United States. New York, NY: Oxford University Press.
Sentell, T., Shumway, M., & Snowden, L. (2007). Access to mental health treatment by English language proficiency and race/ethnicity. Journal of General Internal Medicine 22(suppl. 2), 289–293.
Stroul, B. A., & Blau, G. M. (Eds.). (2008). System of care handbook: Transforming mental health services for children, youth, and families. Baltimore, MD: Paul H. Brookes.
Swider, S. M. (2002). Outcome effectiveness of community health workers: An integrative literature review. Journal of Public Health Nursing, 19(1), 11–20.
Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple and Family Psychology: Research and Practice, 1(2), 134-145.
Torres, L., Driscoll, M. W., & Voell, M. (2012). Discrimination, acculturation, acculturative stress, and Latino psychological distress: A moderated mediational model. Cultural Diversity and Etnic Minority Psycology, 18(1), 17-25
Triandis, H. C. (1994). Culture and social behavior. New York, NY: McGraw-Hill.
U.S. Department of Health and Human Services [DHHS]. (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
U.S. Department of Health and Human Services [DHHS]. (2001). Mental health: Culture, race, and ethnicity—A supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
U.S. Department of Health and Human Services [DHHS]. (2003). Achieving the promise: Transforming mental health care in America (Pub. No. SMA-03-3832). Rockville, MD: President’s New Freedom Commission on Mental Health.
Vega, W. A., & López, S. R. (2001). Priority issues in Latino mental health services research. Mental Health Services Research, 3, 189–200.
Wallerstein, N., & Duran, B. (2006). Using community-based participatory research to address health disparities. Health Promotion Practice, 7(3), 312-323.
Willis, E., Kabler-Babbitt, C., & Zuckerman, B. (2007). Early literacy interventions: Reach out and read. Pediatric Clinics of North America, 54(3), 625–642.
World Health Organization (2001). Strengthening mental health promotion (Fact sheet no. 220). Geneva: World Health Organization.
Zea, M. C., Asner-Self, K. K., Birman, D., & Buki, L. P. (2003). The Abbreviated Multidimentional Acculturation Scale: Empirical validation with two Latino/Latina samples. Cultural Diversity and Ethnic Minority Psychology, 9(2), 107-126.
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