The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56036

Graham Harriman, MA, LPC¹, Marcela Dixon, CHW², and Sergiy Barsukov, BA, CHW². (1) Primary Care, Multnomah County Health Department, 426 SW Stark St, 8th FL, Portland, OR 97213, (503)988-3674, graham.a.harriman@co.multnomah.or.us, (2) Multnomah County Health Department, Multnomah County Health Department, 426 SW Stark, 8th FL, Portland, OR 97204

Within the Multnomah County Health Department primary care clinics in Portland, OR, there are a disproportionally low number of Latino and Russian-speaking clients with psychiatric diagnoses relative to the overall clinic population. Research suggests that lifetime rates of mental illness do not differ significantly between whites and Latinos, and while less is known about Russian-speaking populations, the unique circumstances of former Soviet refugees in Portland creates a particularly stressful acculturation experience and puts them at risk for psychological stress and mental illness. This discrepancy indicates the need to improve identification of psychiatric conditions within the health clinic system. A two-year SAMHSA (Substance Abuse and Mental Health Services Administration) Mental Health Disparities Project has increased identification and treatment of mental health needs of Russian and Latino clients through Community Health Worker (CHW) case management, psychotherapy, and increasing cultural competence of clinic staff.

The project builds upon a depression collaborative whereby depression is treated along with other chronic health conditions to improve clients’ general health outcomes. In this model of service delivery CHWs work closely with other primary care staff to meet the individual needs of clients. Because CHWs share the same language and culture of their clients, they are better able to address barriers to mental health and medical care. Two bicultural/ bilingual mental health therapists, contracted through local community-based organizations also provide psychotherapy in clients’ own language allowing for a deeper understanding of psychiatric needs. Collaborating with these organizations has increased community capacity to address mental health needs.

Learning Objectives:

• 1. To show the increased cultural competency in the healthcare setting through the SAMHSA Mental Health Disparities Project
• 2. To explain the bridge created in this project between communities and the health care system by employing Community Health Workers
• 3. To illustrate the increase in treatment capacity in Primary Care Clinics and culturally specific community based organizations
• 4. To explain the incorporation of mental health intervention into a more general model of chronic illness care

Keywords: Mental Health Services, Community-Based Health Promotion

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 381.0 kb)