Reducing mental health disparities by increasing the personal relevance of interventions.

Abstract

One of the most persistent health disparities is the underutilization of mental health services by people of color. Neither evidence-based treatments (universal focus), nor culturally-adapted treatments (group focus), have reduced these disparities. We propose the Personal Relevance of Psychotherapy (PROP) model that integrates universal, group, and individual dimensions to determine the personal relevance of interventions. A cultural example of personal relevance among people of East Asian ancestry involves "face" (i.e., one's prestige and position in society) which may moderate treatment outcomes. Pragmatic intervention approaches focused on helping individuals cope with specific external problems, as compared to managing a "personal" disease, can effectively "restore" face. Thus, social problem-solving interventions may be more personally relevant to many people of East Asian ancestry than approaches that are internallyfocused. In addition, we posit that social neuroscience can offer unique opportunities above and beyond self-report measures when assessing the impact of PROP and the personal relevance of interventions for diverse populations. Our preliminary evidence upon testing this hypothesis indicated that among Asian Americans, exposure to problem-solving therapy content elicited significantly greater neural activity in brain areas associated with personal relevance as compared to exposure to cognitive-behavioral therapy content. Identifying personally-relevant interventions has the potential to reduce mental health disparities by increasing engagement with mental health services for diverse groups. The increased client engagement produced by personally-relevant interventions also has the potential to make mental health services more effective for diverse groups.

Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems

“…As such, treatment services or interventions should not exist in a vacuum. Our findings do not negate the importance of providers and criminal-legal personnel incorporating knowledge on group-specific dimensions for suicide risk into programming for adults with criminal-legal involvement to yield more inclusive approaches to treatment services and interventions [ 87 – 89 ]. Understanding both cultural variations and shared factors in risk management of suicide may enhance therapeutic relationships and inform risk evaluations for high-needs populations [ 90 , 91 ].…”

Strategies for Incorporating Culture into Psychosocial Interventions for Youth of Color

“…A steadily growing number of psychosocial interventions feature selective and directed cultural tailoring (Fung et al, 2016;Ginsburg & Drake, 2002;Huey & Rank, 1984;Lau et al, 2011;Matos et al, 2009;Pina et al, 2012, Rosselló & Bernal, 1999Santisteban et al, 2011;Silverman et al, 1999;Young et al, 2010); however, many of these interventions are designed prior to implementation. As such, these interventions can address group-specific concerns, but they may not be designed to handle client-specific concerns or intragroup differences that may require the intervention to be adapted in real-time (Chorpita & Daleiden, 2014;Nagayama Hall et al, 2021). A promising future research direction may, therefore, be to study and build decision support tools for helping mental health providers make real-time decisions about when and how to culturally tailor psychotherapy.…”

Epigenetic and Genetic Factors Associated With Opioid Use Disorder: Are These Relevant to African American Populations

“…The potential ramifications of these changes in the course of the COVID-19 infection has also been discussed ( Blackwood and Cadet, 2021a ). Some of these complications may be related to the lack of access of African American individual patients to psychiatric care that has been shown to be an area of major racial inequities ( Hall et al, 2021 ; Stahler et al, 2021 ). This discussion suggests the need to increase available resources to increase access to treatment programs by African Americans who seem to be suffering from the brunt of the disasters associated with the opioid epidemic in the United States.…”