Transcript The Co-infection of HIV/AIDS and Hepatitis B and C: The

Reducing Disparities among
Youth in Transition to
Adulthood
Georgetown Technical Assistance Center
Peter Gamache, Ph.D. candidate
MBA/MPH
Introduction
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Learning community
Peer resource network
Source of Support
Peter Gamache, Ph.D. candidate, MBA, MLA, MPH, RN
Cell # 813-817-5100 | Email: [email protected]
Website: petergamache.com
Gaps Within & Across Systems
. . .for addressing, monitoring, and evaluating unequal access,
availability, and utilization.
Child System
Adult system
Special education
Child welfare
Criminal justice
Juvenile Justice
Adult mental health
Child mental health
Housing
Vocational rehabilitation
18 – 21
years
Birth
Substance abuse
Death
Intersections and Multiplier Effects
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According to the NIMH (2006), 1 out of 10 children
age 18 and younger suffer from a mental disorder.
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Children in particular are at greater risk of having
mental health problems when socio-political factors,
environmental factors, or distressing events occur in
their lives or surroundings (Friedman, Callejas, Nesman, Mowery, &
Gamache, 2006)
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According to SAMHSA, these factors include
harmful stress, discrimination, poverty, trauma, and
exposure to violence or physical abuse (DHHS, 2003).
Intersections and Multiplier Effects
Insurance
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Hispanic children: 21.1% uninsured
Black children: 13%
Asian children: 9.4%
Non-Hispanic White children: 7.6%
All children: 11.6 percent uninsured (Urban Institute, 2004).
Mental Health Access
 The percentage of African Americans
receiving needed mental health care is only
half that of non-Hispanic Whites
(Surgeon General Report, 1999).
Intersections and Multiplier Effects
Employment
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Black unemployment was 14.8 percent in 2009,
compared to 8.5 percent for Whites. Hispanic
unemployment was 12.1 percent (Urban League, 2010).
Unemployed males, ages 16-29 = 19.5% African
American, 7.9% White; 8% Hispanic; 7.8% Asian
(Kaiser Family Foundation, 2006).
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Reasons: Mental health disparities contributing to
gaining/maintaining employment.
Postsecondary Education
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White youth are nearly twice as likely as Hispanic
youth beginning at community colleges to finish a
bachelor’s degree; 81 percent of Whites complete a
bachelor’s degree compared to 57 percent of
Latinos (Fry, 2004).
Intersections and Multiplier Effects
Criminal Involvement
 African-American youth are six times
more likely than White youth to be
incarcerated. Latino youth are three times
more likely (Annie E. Casey Foundation).
Alcohol/Substance Abuse
 % of high school students who drank for
the first time before age 13 = 18.1%
White, 24.9% Black, 27.1% Hispanic
(CDC Youth Risk Behavior Surveillance, 2010).
Transition to Independence Process
(TIP) System
Examples
Employment
 Engages in employment exploration & experience.
Education
 Explores career options (e.g., interviewing people in careers,
library explorations and web searches on careers, visiting
community trade schools & colleges).
Living Situation
 Improves stability in housing location (e.g., planned moves vs.
evictions and fleeing to avoid rent).
Personal Effectiveness & Wellbeing
 Accesses/uses preventative and necessary medical/dental services.
Community-life Functioning
 Attends or volunteers with community organizations, activities,
support groups, spiritual supports.
Assets-based Approach
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Biological Needs
Psychological Needs
Social Needs
Physical
Mental
Emotional
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Human Capital
Social Capital
Cultural Capital
Transition to Independence Process
(TIP) System
Example:
Employment
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Human Capital
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Social Capital
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Technical skills development
Volunteering
Job shadowing
Practicum
Apprenticeships
Professional networking
Cultural Capital
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Current events
Destinations
Next Steps
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If disparities are to be reduced, service providers
must acknowledge experiences of racism and
discrimination within health and mental health
systems at the interpersonal and intrapersonal
levels, and such incidents require targeted attention
at the organizational and systems levels.
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Discrimination and racism should be considered in
all program planning and research efforts.
References
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Annie E. Casey Foundation. Retrieved from
http://www.aecf.org/upload/publicationfiles/fact_sheet5.pdf
Centers for Disease Control and Prevention. (2010, June). Youth risk behavior
surveillance system. Retrieved from
http://www.cdc.gov/HealthyYouth/yrbs/index.htm
Clark, H. B., & Unruh, D. K. (2009). Transition of youth & young adults with
emotional or behavioral difficulties: An evidence-supported handbook.
Baltimore, MD: Paul H. Brookes Publishing.
Department of Health and Human Services (2003). Glossary of terms: Child
and adolescent mental health. Retrieved from http://www.mentalhealth.
samhsa.gov/publications/allpubs/CA-0005/default.asp
Friedman, L., Callejas, L., Nesman, T., Mowery, D., & Gamache, P. (2006).
Research with African American populations. Retrieved from
http://rtckids.fmhi.usf.edu/rtcpubs/CulturalCompetence/services/CultCom
pServices.pdf
References
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Fry, R. (2004). Latino youth finishing college: The role of selective pathways.
Washington, DC: Pew Charitable Trusts. Retrieved from
http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/News/Press_R
eleases/Hispanics_in_America/pew_hispanic_college062304.pdf
Kaiser Family Foundation. (2006). Race, ethnicity, & health care. Retrieved
from http://www.kff.org/minorityhealth/upload/7541.pdf
National Institute of Mental Health (2006). Child and adolescent mental
health. Retrieved from
http://www.nimh.nih.gov/healthinformation/childmenu.cfm
Surgeon General Report. (1999). African Americans. Use of mental health
services. Retrieved from http://mentalhealth.samhsa.gov/cre/fact1.asp
Urban Institute. (2010). Children without health insurance. Retrieved from
http://www.urban.org/pressroom/childrenwithout.cfm
Urban League. (2010). State of Black America report. New York: Author.
Retrieved from http://www.nul.org/estore/content/2010-state-blackamerica-report