La Maestra enhanced psychosocial program: An educational, preventive, early intervention and treatment mental health model addressing the mental health needs of immigrants and refugees of Central San Diego

The presentation will provide a description of La Maestra Enhanced Psychosocial Program, an educational, preventive, early intervention and treatment mental health model addressing the mental health needs of immigrants and refugees of Central San Diego. This model was implemented with a two years grant from California Endowment.

La Maestra Community Health Centers serves a racially and ethnically diverse population of 30 nationalities, with poor or nonexistent access to any behavioral health care. Approximately 95 % of the Latino pregnant female participating in the Family Wellness – Enhanced CPSP Psychosocial program reported that this was their first experience with a mental health provider. Approximately 80 % of participants have an average of 2-6 years of education and met criteria for a diagnosis of Acculturation (V.62.4) Approximately, 96 % of program participants reported problems with nausea and vomiting and approximately 82 % reported improvement after learning to observe and document their water and food intake (8 glasses of water and 6 meals daily). Participants learned to identify the impact that emotional stress and self-care patterns have in the discomfort they experience during pregnancy and postpartum.

Project participants averaged 3-6 sessions during pregnancy and postpartum. During the grant, approximately 643 families had their first experience with a mental health provider and the goal were to improve self-care during pregnancy and postpartum, accept and cope with unplanned pregnancies, address parenting issues, resolve relational problems with their spouses or partners especially due to jealousy, acculturation stress, financial hardship, etc.). Approximately, 80% of pregnant Latinas reported social isolation and/or limited support system; therefore, program participation, including attendance to individual sessions and support groups demonstrate improvement in self-efficacy and self-esteem.

The clinical statistics during the grant period indicate that approximately 60 % of project participants reported childhood maltreatment, including sexual and physical abuse, and histories of family problems due to domestic violence and alcoholism. Approximately 50% of the pregnant Latinas accessing service reported untreated depression, anxiety and posttraumatic stress disorder. Approximately 70% of the pregnant Latinas accessing the CPSP enhanced psychosocial service reported improvement in their mental status after the second or third session. The reduction of postpartum depression is estimated in 75% of the participants initially identified as high risk during the initial assessment. During the project approximately 98 women meet criteria for a diagnosis of Postpartum Depression and they continue receiving treatment. Approximately 60 % of project participants meet the criteria for Axis I diagnosis (293.83 ) Mood Disorder due to a Medical Condition (pregnancy) with Depressive Features (depressed mood, anxiety, crying spells, insomnia, lack of energy, irritability and loss of interest and pleasure are the most common symptoms reported). Consequently, approximately 65 % of pregnant Latinas at time of the initial mental health need assessment met criteria for medical necessity. Approximately, 85 % of Latinas participants had natural birth. Participants reduced approximately 65 % the number of unnecessary emergency hospital visits for pregnancy-related issues, such as spotting or false labor. Patients learned to identify the precipitating stressful situation that precipitated their health problems and emergency visits to the hospital. The support groups emphasize the importance of prenatal care classes and patients who were not participating were encouraged to take advantage of the service and were referred.