Date of Final Oral Examination (Defense)

12-2009

Type of Culminating Activity

Thesis

Degree Title

Master of Health Science, General Research

Department

Community and Environmental Health

Major Advisor

Elizabeth Hannah, Ph.D.

Abstract

Currently, Idaho’s mental health resources for Hispanics are not designed to meet their mental health needs. According to Jose Valle, the Chief of Children’s Mental Health at the Idaho Department of Health and Welfare Region III, there are no available data regarding prevalence rates for mental disorders among Hispanics in Idaho (personal communication, September 18, 2007), and little is known about what interventions work best among Hispanics (Gonzalez, 2006). As a first step in addressing the mental health needs of Hispanics in Idaho, information on the capacity of local providers to deliver culturally appropriate care is needed. The Idaho Partnership for Hispanic Mental Health (IPHMH) Planning Project was created to improve access to culturally and linguistically relevant mental health care for Hispanics in southwest Idaho. Researching mental health needs and identifying gaps in resources will help develop appropriate interventions for consumers and providers.

Findings from an informal interview with several local providers suggested that Hispanics in need of mental health care in southwest Idaho do not have sufficient resources. To improve access to culturally relevant mental health care, further exploration into the knowledge, attitudes, and skills of local providers is essential. The purpose of this thesis project was to answer the following questions:

1) What are the demographic attributes and Hispanic client profile of mental health providers in southwest Idaho?

2) What knowledge, attitudes and behaviors are associated with culturally competent mental healthcare among mental health providers serving Hispanics in southwest Idaho?

3) What are the perceived barriers and training needs related to providing and receiving culturally competent care?

To answer these questions, a survey was designed and mailed to a stratified randomized sample of 1,000 primary care and mental heath providers licensed in Ada and Canyon Counties. Crosstabs and frequencies were calculated to explore characteristics of providers who serve Hispanics. Chi-Square, Analysis of Variance (ANOVA), and t-tests were performed to examine relationships among provider variables and constructs of cultural competence.

Due to a relatively low response rate, the findings may not have been generalizable to the provider population in Ada and Canyon Counties. The providers who responded were predominantly, non-Hispanic white, worked as specialists in the mental health field, and worked in urban settings in Ada County. Substance abuse, anxiety disorders, depression, and adjustment disorders were the most common diagnoses of Hispanics receiving care.

Providers scored the Hispanic Cultural Awareness Scale (HCAS) and the Confidence Rating Scale (CRS). These scales were created to measure cultural knowledge and perceived ability to delivery culturally competent care. The providers scored higher on the Informal Interpreter Utilization Scale (IIUS) which measured the frequencies that providers used non-professional interpreters.

This study provided an important starting point to researching and addressing the provision of mental health care to Hispanics in southwest Idaho. Prior to this study, there was little information available on the providers that were available to Hispanics in need of care. The findings from this study indicated that although providers may lack some culturally specific knowledge, they are aware of the importance of culture and how its elements influence mental health.

Triangulating the findings from this study with those of the Hispanic interviews and the mental health provider key informant interviews will provide a foundation for the improvement of access and quality of care to Hispanics in need of mental health care. Programs will be researched and designed based on the findings of the Idaho Partnership for Hispanic Health’s (IPHMH) community mental health needs assessment that will focus on provider training and culturally relevant mental health outreach.

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