New Path for Treating Latinx Immigrants with Mental Health and Substance Misuse Symptoms

February 7, 2019

A team of researchers at the Disparities Research Unit at Massachusetts General Hospital (MGH) – in collaboration with two teams in Spain and collaborators in the U.S. and Puerto Rico – has tested a novel preventive intervention designed to provide tailored treatment for Latino immigrants with both mental health and substance misuse symptoms. Their report is being published online in JAMA Network Open.

“We know that Latino patients benefit when treatments are culturally tailored, evidence based and accessible,” says Margarita Alegria, PhD, chief of the Disparities Research Unit and a professor in the Departments of Medicine and Psychiatry at Harvard Medical School. “We sought to provide a customized treatment to Latino immigrants in different contexts – in the U.S. and Spain – to see how best to serve this growing and important demographic population in our communities.”

The authors note that immigrants face enormous barriers to access appropriate behavioral health treatments. A variety of structural and institutional barriers mean that Latinos who need mental health and substance use services may be less likely to receive evidenced-based care and have worse outcomes than non-immigrant Latino adults. Therefore, the study team conducted outreach to people not seeking care, inviting them to be screened for elevated co-occurring mental health and substance use symptoms. If the screenings revealed mild to severe symptoms, they were invited to participate.

The study team developed the Integrated Intervention for Dual Problems and Early Action (IIDEA) program to provide culturally tailored care that incorporates evidence-based practices – including cognitive restructuring and mindfulness-based therapy along with substance-craving reduction and coping strategies. The intervention was offered in both the Greater Boston area and in Madrid and Barcelona, Spain, to Latino adults aged 18 to 70 who screened positive for co-occurring symptoms. IIDEA is an integrated therapy that involves 10 to 12 weekly sessions that include motivational interviewing, cultural formulation, assessment of barriers to care, psychoeducation, cognitive behavioral therapy, mindfulness exercises, communication skills and reduction of risk behaviors.