Queens, New York, has cultural diversity unlike anywhere else in the US. Families are from more than 100 countries and collectively speak almost 170 languages (NYS Office of the State Comptroller, 2006). Twenty percent of the 2.2 million Queens’ residents are children (U. S. Census Bureau, 2010). Twenty-three percent of these children are living in single-parent households and 13% are living below the poverty line. Of children living in poverty, 39% are Latino and 25% are African American/ Caribbean. Over half of residents speak a language other than English; 23% of homes are Spanish speaking.
Children from economically-disadvantaged families of racial and ethnic diversity are the most likely to be exposed to violence and the associated negative mental health consequences, but are the least likely to get access to any mental health care, let alone evidence-based practices (Alvidrez, 1999; DHHS, 2001). Although CHP has worked diligently to close the gaps in mental health disparities, statistics show that only a tiny percentage of traumatized Latino, African-American, and Caribbean families receive adequate mental health care. Further, the 2010 U.S. census reported that the population of individuals identifying as Hispanic or Latino rose 43% compared to just 10 years ago. This number indicates a population shift and a subsequent need for specialized, culturally-informed and adapted services for Hispanics/Latinos.
Surveying Queens’ community leaders, we have learned that service access is limited by three factors: (1) concrete barriers, such as transportation, lack of services in primary language, and need for childcare; (2) conceptual barriers, such as stigma and being unsure of the purpose of therapy; and (3) culturally-specific barriers, such as familismo (i.e., belief in putting family’s needs before one’s own). Effective recruitment of multicultural families requires: use of bicultural/bilingual clinicians; community-based outreach campaigns; and collaborations with community-based organizations (Snowden, Masland, Ma, & Ciemens, 2006). Thus, CHP has begun to move beyond the walls of our clinic by creating Project CONNECT.
Project CONNECT (Community Networks Negotiating Evaluations and Counseling for Trauma) was developed to bridge science and practice in the field of children’s mental health. Seeking to alleviate barriers to access, we build on established relationships with local multicultural communities to bring the free evidence-based treatment we provide at our clinic into community settings universally viewed as “safe,” such as libraries. Outreach is key to building these community partnerships, so CHP’s team conducts workshops on topics related to childhood violence; attend family centered events and fairs; distribute posters and brochures; and provide information about our work at various community events and settings. In 2013 alone, staff participated in more than 100 events at schools, churches, and libraries.
Once we identify families who are interested, we conduct a mental health evaluation to ensure that our services will match families’ needs; if not, we provide an appropriate referral. Over 9 months, Project CONNECT families receive weekly individual and family therapy, specifically, Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT), co-developed by Dr. Brown. The therapy is specialized—developed for children who have witnessed or been exposed to violence. Since we believe caregivers are the key to the success of their children, therapy sessions involve both children and their caregivers. All therapy is adapted to be culturally sensitive and language accessible for non-English-speaking families. AF-CBT has been adapted for African American, Caribbean, and Latino families by the Project CONNECT team.
We have chosen to serve the Queens community because it has a high index of violence and is critically underserved in terms of mental health. We have selected Western Queens (Long Island City, Woodside, Corona, and Astoria) to serve the Latino community and Central Queens (Jamaica/South Hollis) to serve the African American and Caribbean communities. Children ages 5-17 from these areas who have experienced violence (e.g., excessive corporal punishment by a caregiver, or sexual or physical assault by a peer, acquaintance, or stranger) are invited to participate.
Our work aims to alleviate the effects that violence has on community members, such as PTSD and depression, and to prevent violence from reoccurring within homes and at schools. This innovative approach represents a shift in mental health delivery and is expected to increase rates of identification, referral, assessment and treatment of youth exposure to violence. CHP is able to provide these services and evaluate results, with the goal of disseminating best practices nationwide.
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