243294 Overcoming Stigma About Mental Health Services: Lessons from Working with Refugee and Immigrant Families

Monday, October 31, 2011: 12:30 PM

Donna Behrens, RN, MPH, BSN , Center for Health and Health Care in Schools, The George Washington University School of Public Health and Health Services, Washington, DC
Clea McNeely, DrPH , Department of Public health, University of Tennessee, Knoxville, Knoxville, TN
Background: Stigma about mental illness is often reported as a barrier to providing school mental health services to refugee and immigrant children. Purpose: Drawing from a five-site comparative case study of school-based mental health programs, presenters will describe three successful cultural adaptations that prevent school mental health services from being stigmatized. Significance: In the US, 25% of children under 18 have at least one parent who is a refugee or immigrant. Methodology: 90 in-depth interviews were conducted at five program sites (Chicago, Los Angeles, Boston, Durham, and Fargo) of Caring Across Communities, a national demonstration project of school-based mental health services for refugees and immigrants. Interviews were conducted with mental health professionals; school teachers, administrators, and staff; immigrant and refugee parents; and staff of partner agencies in the community. Analysis was conducted using a modified constant comparison method. Findings/Results: The sites that integrated mental health services into a comprehensive social service framework without ever labeling mental health services as such successfully increased utilization of mental health services. These successful strategies fully involved parents and staff from community agencies as essential partners. In contrast, when mental health providers attached mental health terminology to children's behavior, due to either habit or necessity (e.g., informed consent), they inadvertently increased and created barriers to help-seeking. Conclusions/Recommendations: Cultural adaptations that prevent school mental health services from being stigmatized in refugee communities are feasible and increase access to care. These adaptations require increased resources.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
Identify three successful cultural adaptations that prevent school mental health services from being stigmatized Describe how mental health professionals often inadvertently increase stigma about their services

Keywords: Mental Health Services, Refugees

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: School health is my area of expertise. I was the project officer for the program that is the subject of this study and collaborated with my co-author on the evaluation. I have worked in state government crafting school-based health policies for over 10 years. I also have worked over 10 years in a leadership position, including as the executive director, with the Maryland Assembly on School Based Health Care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.