News & Announcements

National Latinx Leaders Address the Community’s HIV Crisis

Posted: September 17, 2018

Alarmed by increasing HIV rates among Latinx men who have sex with men and transgender Latina women of all ages, the National Hispanic Medical Association hosted a meeting in Atlanta for community leaders to address the situation. Specifically, they assessed, discussed and identified action steps to be taken to help reverse the trend.

According to a press release from the Latino Commission on AIDS, the meeting enumerated several action steps to address the unique challenges facing the Latinx community. “Participants recognized the devastation of HIV,” the press release states, “the barriers to prevention and care services, the impact of stigma, immigration, culture, race and the social determinants of health that impact Hispanic/Latinx in the United States, Puerto Rico and the U.S. Virgin Islands.”

The next steps and goals are currently being drafted, and participants will review them at upcoming meetings before they are publicized.

The meeting was not the first effort of national Latinx groups to address the HIV problem. In March 2018, a group of 147 organizations and 176 individual leaders sent a letter to Eugene McCray, MD, director of the Division of HIV/AIDS Prevention, part of the Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

The letter detailed the crisis in the Latinx community before spelling out a call to action.

Read more on POZ.com.



Talking about Depression Can Be Hard for Asian Americans, but Services Can Help

Posted: September 13, 2018

The feelings of loneliness and isolation began for Glor Parong at 15 years old. She was dealing with the pressures of being the first-born child in a Filipino household, where she was expected to be a role model and caretaker for her younger siblings. Then there were her parents, who she said were going through financial difficulties and frequently arguing.

But Parong was taught not to disclose any of her problems to anyone outside of her family, she said. As a result, she carried the weight of those emotions alone. “I didn't say anything verbally, but deep down I wanted my mom's and my dad's attention. I wanted them to love me and to say it's OK,” she said.

After three suicide attempts, Parong, now 46, said she eventually sought help to come to terms with a fact that hadn’t been easy for her to accept: She was depressed. Seeing a psychiatrist was key to understanding depression, she added, which she continues to live with today.

Parong copes, among other things, by incorporating creative activities like dance into her life. She currently works at the Asian Pacific Counseling & Treatment Centers (APCTC), a mental health center in Los Angeles that was developed to meet the needs of the Asian Pacific population.

Depression and Suicide in the Asian American Community

The suicide rate among Asian Americans and Pacific Islanders in 2016 was approximately half of the general population, according to Centers for Disease Control and Prevention (CDC) data. Suicide ranks as the ninth leading cause of death among Asian Americans and Pacific Islanders and the 10th leading cause of all deaths in the U.S.

But for Asian Americans and Pacific Islanders between the ages of 15 and 19, suicide was the leading cause of death in 2016, according to CDC data, accounting for 31.8 percent of all deaths.

The pressure to succeed academically, financially, and career-wise is considered a common cause for depression among Asian Americans, Silvia Yan, program director of adult services and training director at APCTC, said.

But that pressure isn't the culprit for depression across all subgroups in the population.

In the Korean-American community, for instance, depression due to isolation is pervasive among seniors, according to Connie Chung Joe, executive director of Korean American Family Services (KFAM) in Los Angeles. “We know that the more isolated you get increases your risk factors for suicide,” Joe said. “To reduce those factors, you need ... people you can talk to and go to for help; Having places to go to whether it’s to go exercise or do hobbies. For Korean seniors, that gets very, very limited because there's not very many that are specific for the Korean community, and they also don’t know how to access them."

Southeast Asian refugees are another group that has battled depression and trauma as a result of their history with violence, according to Lan Nguyen-Chawkins, a psychologicst at APCTC. She noted that Cambodian Americans carry the experience of torture and working in labor camps, while Vietnamese Americans and Laotian Americans endured refugee camps after fleeing warfare in their countries. “What they experienced was a massive problem with trust in human beings,” she said. “It’s like, 'Well, why do I need you? I survived under a hundred dead bodies. I don’t need you.'”

Because refugees survived the war without talking, some may not see a need to talk about what they've gone through or their feelings about it, Nguyen-Chawkins said. And by the time many of them seek help, their depression is at chronic levels.

Disparity in Available Services

As the Asian-American population — the fastest growing ethnic group in the country — continues to rise, it faces the challenge of accessing the culturally sensitive mental health services it needs.

One of the barriers Korean seniors face, according to Joe, is that nearly all are limited English proficient and low-income, and rely on publicly funded health services that aren't always culturally or linguistically tailored to them.

Groups like APCTC are among those that offer culturally sensitive mental health services. The nonprofit provides services in languages clients are most comfortable with and places greater emphasis on the family as opposed to the individual than mainstream providers. Yan said the center invites family members to participate in the process, from the initial evaluation to the development of treatment plans.

Read more on NBCNews.com



Culturally Appropriate Care to Address American Indian/Alaska Native Mental Health Disparities

Posted: September 12, 2018

Non-Hispanic American Indian and Native American (AI/AN) adults and children are at greater risk than all other racial groups of experiencing poor mental health outcomes and unmet medical and mental healthcare needs. For instance, suicide rates for AI/AN adults and youth are higher than the national average

For native people, cultural differences play a crucial role in this gap as well as in the misdiagnosis. An accurate assessment is not possible without intimate knowledge of another culture; such knowledge cannot always be learned in the present educational systems, many of which do not share the same historical accounts or knowledge tribal systems have been teaching for thousands of years. 

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) states that understanding a culture means comprehending and applying that culture’s beliefs, ceremonial rituals, and customs. With the Native American culture, this would not be possible without the actual time and tutelage of an American Indian or First Nations Healer and Spiritual Person, who would be most qualified to provide the appropriate expertise. In order for native-serving providers to meet the standards set forth in the DSM-5, they must learn from outside of the Western medical education system. 

Few mental health diagnostic tools, assessments, or treatments have been studied in AI/AN communities. For instance, few mental health treatment models apply spiritual phenomena—such as spirits, ghosts, or healing—but this is an area common within Native American tribes. 

Read more on NPA-RHEC.org.



Soldiers Who Attempt Suicide Often have No History of Mental Health Issues

Posted: September 11, 2018

More than one-third of U.S. Army soldiers who attempt suicide don’t have a history of mental health problems, a recent study suggests.

Attempted suicides have become more common among enlisted soldiers since the start of the wars in Afghanistan and Iraq, researchers note in JAMA Psychiatry. While a history of mental illness has long been linked to an increased risk of suicide among military service members and civilians alike, less is known about the risk among soldiers who haven’t been diagnosed with psychiatric disorders.

For the current study, researchers examined data on 9,650 active-duty Army soldiers who attempted suicide between 2004 and 2009 as well as a control group of more than 153,000 soldiers who didn’t attempt suicide.

Overall, 3,507, or 36 percent, of the soldiers who attempted suicide had no previous diagnosis of mental illness, the study found.

“Soldiers without a mental health diagnosis may have had mental health problems but had not reported them to their medical care teams,” said lead author Dr. Robert Ursano, director of the Center for the Study of Traumatic Stress at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

“This can be because they do not think they have a problem, they are concerned about stigma associated with mental health care – which is true in both military and civilian settings – or they felt even if they reported their problems to their physicians that nothing would help,” Ursano said by email.

Some factors unique to military service did appear to influence the odds of a soldier with no prior mental illness diagnosis attempting suicide.

For example, even without a history of mental illness, soldiers in their first year of military service were six times more likely to attempt suicide than people in the Army for longer.

And soldiers without a prior mental health diagnosis who had previous deployments were 2.4 times more likely to attempt suicide than those without prior deployments.

Work stress might also play a role.

Soldiers with no history of psychiatric problems who had a promotion delayed for up to two months were twice as likely to attempt suicide as those who didn’t experience delayed promotions. And they were 60 percent more likely to attempt suicide if they were demoted in the previous year.

Previous combat injuries were also associated with a 60 percent higher risk of suicide attempts among soldiers without a history of mental illness.

The study wasn’t designed to prove whether or how a prior mental health diagnosis might directly impact the risk of suicide, and it’s impossible to know what proportion of people without a prior diagnosis might have been suffering from untreated mental illness.

Women soldiers were also 2.6 times more likely than men to attempt suicide, and soldiers treated in the past month for a physical injury were 3 times more likely than those not recently treated for an injury to make a suicide attempt.

Army suicide rates were lower in the 2000s than in the general population, Mark Reger of the Veterans Affairs Puget Sound Health Care System in Seattle and colleagues point out in an accompanying editorial. Mental health care for soldiers has also shifted from being provided primarily in mental health clinics to being offered in other settings, Reger and colleagues note.

“Since soldiers without a mental health diagnosis are unlikely to be seen in mental health clinics by definition, a focus on prevention in other settings appears warranted,” they write.

Behavioral health services are more widely available today, and mental health clinicians may deploy with units or be available within walking distance of barracks to make it easier for soldiers to access care, they write.

Read more on Reuters.com.



Protocol for Achieving Health Equity in Preventive Services, Supplemental Evidence & Data Request

Posted: September 10, 2018

The Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ) has posted the protocol for Achieving Health Equity in Preventive Services. The protocol describes the purpose and scope of the review, the key questions, and inclusion/exclusion criteria about what types of studies will be included.

In addition, if there is unpublished scientific information relevant to this topic, AHRQ encourages you to submit it via the Supplemental Evidence and Data for Systematic Reviews (SEADS) portal. The deadline for submissions is October 1. Materials submitted cannot be confidential; they may be made public. This is a voluntary request for information.

The purpose of the review is to summarize the state of the evidence on achieving health equity in preventive services by identifying the effects of impediments and barriers that can create disparities in prevention services, and the effectiveness of strategies and interventions to reduce health disparities in preventive services.

AHRQ is a government agency tasked with producing evidence to improve the quality of healthcare while working with partners to ensure that the evidence is understood and used.

Learn more and submit SEADs for systematic review at EffectiveHealthcare.AHRQ.gov.



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