Community Mental Health Intervention for Latino Mental Health Disparities

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Drexel University

Disqualifiers: Substance use disorder, Mania, Psychosis, Schizophrenia, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

Latinos in the U.S. experience significant disparities in access to mental health services due to lack of health insurance, language barriers, low availability of bilingual providers, mental health stigma, and fear of deportation. There is an urgent need to identify low-cost, culturally appropriate interventions to reduce mental health disparities among this population. This project will address that need by implementing and testing CRISOL Mente, a multi-level, culturally-congruent community intervention to improve the mental health of the Latino population in Philadelphia.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment CRISOL Mente for Latino mental health disparities?

The research highlights the importance of culturally adapted, community-based interventions for improving mental health care access and outcomes among Latinos, suggesting that treatments like CRISOL Mente, which involve community and faith-based partnerships, could effectively address mental health disparities by reducing stigma and increasing mental health literacy. ^{1 2 3 4 5}

Is the Community Mental Health Intervention for Latino Mental Health Disparities safe for humans?

The studies reviewed do not provide specific safety data for the Community Mental Health Intervention for Latino Mental Health Disparities, but they do suggest that community-based mental health programs for Latinos, like the ones described, are generally well-received and focus on reducing stress and depressive symptoms without reported safety concerns. ^{1 4 5 6 7}

How is the CRISOL Mente treatment different from other treatments for Latino mental health disparities?

CRISOL Mente is unique because it is a multilevel community intervention specifically designed to address mental health disparities in Latino communities by integrating cultural and community-based approaches, unlike standard treatments that may not consider these cultural factors. ^{2 4 6 7 8}

Research Team

Eligibility Criteria

CRISOL Mente is for Latinos aged 18-65 living in specific counties around Philadelphia who self-identify as Latino and have moderate to severe anxiety, depression, or PTSD. It's not for those with high-risk mental health issues, current therapy participants, or pregnant individuals.

Inclusion Criteria

Self-identification as a member of the Latino community

I am between 18 and 65 years old.

I am fluent in either English or Spanish.

Exclusion Criteria

Pregnancy

People with high-risk mental health symptoms: active suicidality, substance use disorder, mania, psychosis, and schizophrenia

I have been in mental health therapy within the last 3 months.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Latino lay health workers (LHW) conduct community outreach, screening, referral, and provide basic mental health treatment over 6 months

6 months

Frequent contact with LHWs

Follow-up

Participants are monitored for improvement in mental health symptomatology, including depressive, anxiety, and PTSD symptoms

6 months

Baseline and 6-month surveys

Treatment Details

Interventions

• CRISOL Mente (Behavioural Intervention)

Trial Overview The trial tests CRISOL Mente, a community-based program aiming to improve access to mental health services among Latinos through outreach programs and culturally-tailored care strategies.

Participant Groups

Group I: LHW stepped care and task shifting Experimental Treatment 3 Interventions

LHW conduct activities of prior arms but in addition, they may provide specific components of mental health care (task-shifting), providing components of basic evidence-based treatments to patients with non-complex needs, and addressing other syndemic health and social conditions.

Group II: LHW as outreach agents/navigators Experimental Treatment 1 Intervention

Conduct outreach activities with people in the community who are hard to reach and with limited access to health care, conduct screening for symptoms of mental illnesses, encourage and refer individuals at-risk, suspected of having, or affected by mental health issues for further triage.

Group III: LHW as navigators and auxiliary to care Experimental Treatment 2 Interventions

LHW continue conducting outreach and referral activities but in addition, LHW are more involved in their care. They arrange consultations, introduce the patient to the clinical team via a "warm hand-off" and assist in scheduling a follow -up visit, reviews the care plan with the patient and help reduce patient and system barriers impeding psychological well-being, support patients in achieving management goals; help patients address barriers through education, referral, and navigation to ancillary community services. They have frequent contact with the patient.

Who Is Running the Clinical Trial?

Drexel University

Lead Sponsor

Trials

160

Recruited

48,600+

Nancy D. Spector

Drexel University

Chief Medical Officer

MD from Drexel University

Denis O'Brien

Drexel University

Chief Executive Officer since 2020

MBA from Drexel University

The Philadelphia AIDS Consortium

Collaborator

Trials

1

Recruited

600+

Esperanza Health Center

Collaborator

Trials

1

Recruited

600+

Findings from Research

Latinos with serious mental illness have significant healthcare needs, with counseling and therapy services being the most important, as identified by a study involving 122 participants who rated various health needs on a 7-point scale.

There are notable differences in healthcare priorities between U.S.-born Latinos and those born abroad, with over 25% of importance ratings differing significantly, highlighting the need for tailored approaches in integrated care for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prioritizing the healthcare needs of Latinos with mental illness. Corrigan, PW., Torres, A., Lara, JL., et al.[2023]

Recent research highlights ongoing disparities in mental health care for Latinos, emphasizing the need for targeted interventions to address these gaps, as identified in five significant studies published since 2001.

To effectively reduce these disparities, future research should focus on implementing interventions across multiple pathways to care, such as illness recognition and family support, particularly for conditions like schizophrenia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

From documenting to eliminating disparities in mental health care for Latinos. López, SR., Barrio, C., Kopelowicz, A., et al.[2021]

A study involving 257 low-income Latino patients showed that both telephone and face-to-face cognitive behavioral therapy interventions significantly reduced depression severity compared to usual care, with moderate effect sizes of 0.56 and 0.64, respectively.

The telephone-based intervention had a higher treatment initiation rate (89.7%) compared to face-to-face sessions (78.8%), indicating that telephone care may enhance access to mental health services for Latino patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of the Engagement and Counseling for Latinos (ECLA) intervention in low-income Latinos. Alegría, M., Ludman, E., Kafali, EN., et al.[2021]

Latino communities in the U.S. face significant mental health treatment disparities due to factors like stigma and limited mental health literacy, but they often turn to religious congregations for support.

A new study involving 1400 participants from 14 parishes will evaluate a parish-based intervention by NAMI and the Diocese of San Bernardino aimed at reducing stigma and improving mental health literacy, potentially enhancing access to mental health services for Latino parishioners.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A parish-based multilevel cluster randomized controlled trial to reduce stigma and mental health treatment disparities among Latino communities. Wong, EC., Torres, VN., Martinez, MO., et al.[2023]

Over one third of residents in a US-Mexico border colonia have been diagnosed with a mental health condition, and more than half report experiencing significant stress and worry, indicating a critical need for mental health support in these communities.

Despite high levels of uninsured individuals, 77% of those diagnosed with mental health issues sought help primarily through primary care providers, highlighting the reliance on general healthcare services for mental health care in low-income populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental Health Disparities Among Low-Income US Hispanic Residents of a US-Mexico Border Colonia. Marquez-Velarde, G., Grineski, S., Staudt, K.[2021]

The ALMA intervention significantly reduced depressive symptoms among Latina immigrants, with participants showing lower levels of depression post-intervention and at a two-month follow-up compared to a comparison group.

The online delivery of the ALMA intervention was particularly effective, leading to greater reductions in both depressive and anxiety symptoms compared to the comparison group, highlighting the adaptability and effectiveness of community-based mental health programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting mental health in Latina immigrant women: Results from the Amigas Latinas Motivando el Alma intervention trial. Ornelas, IJ., Rao, D., Price, C., et al.[2023]

The Mentes Positivas en Acción (MPA) program, an 8-week community-based intervention for low-income Spanish-speaking Latinos, significantly reduced stress and depressive symptoms compared to a control group, demonstrating its efficacy in this population.

Participants in the treatment group showed a notable improvement in stress (PSS scores decreased by 0.80) and depressive symptoms (PHQ-9 scores decreased by 5.7), while the control group showed no significant changes until after receiving the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mentes Positivas en Acción: A Randomized Feasibility Study of a Promotor-Delivered Cognitive Behavioral Stress Management Program for Low-Income Spanish-Speaking Latinos. Sternberg, RM., Stewart, AL., Nápoles, AM.[2021]

The collaboration between academic and community organizations focuses on understanding the attitudes and knowledge regarding mental health care resources within the Latino community.

This initiative aims to create effective interventions and educational outreach models, fostering ongoing partnerships to improve mental health care access and awareness in this community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reflections on effective nursing partnerships addressing mental health in the Latino community. Garcia, C.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Prioritizing the healthcare needs of Latinos with mental illness. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

From documenting to eliminating disparities in mental health care for Latinos. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of the Engagement and Counseling for Latinos (ECLA) intervention in low-income Latinos. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

A parish-based multilevel cluster randomized controlled trial to reduce stigma and mental health treatment disparities among Latino communities. [2023]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Mental Health Disparities Among Low-Income US Hispanic Residents of a US-Mexico Border Colonia. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Promoting mental health in Latina immigrant women: Results from the Amigas Latinas Motivando el Alma intervention trial. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Mentes Positivas en Acción: A Randomized Feasibility Study of a Promotor-Delivered Cognitive Behavioral Stress Management Program for Low-Income Spanish-Speaking Latinos. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Reflections on effective nursing partnerships addressing mental health in the Latino community. [2021]