SACRAMENTO — A draft report by the UC Davis Center for Reducing Health Disparities that is meant to serve as a guide for California counties in carrying out the prevention and early intervention component of the landmark 2005 Mental Health Services Act (MHSA) was among the issues addressed by experts and state officials during a special meeting at the state Capitol earlier this week.
The 22-page report, entitled "Building Partnerships: Key Considerations When Engaging Underserved Communities Under the MHSA," was one of the topics focusing on health disparities in California. Lawmakers for the Black, Latino and Asian-Pacific Islander caucuses of the state Legislature, along with the Sacramento branch of the National Association for the Advancement of Colored People, hosted a town hall meeting October 30 to discuss problems in health care and its impact on communities of color and low- income populations.
"A critical aspect of our report is that we need to learn directly from members of underserved communities about what their needs, concerns and assets are instead of assuming that we already know the answers," said Sergio Aguilar-Gaxiola, director of the UC Davis Center for Reducing Health Disparities and principal investigator of the study.
Aguilar-Gaxiola, a professor of internal medicine at UC Davis and an expert on mental health in ethnic populations, said the report provides a series of key considerations that may help counties reach out and engage ethnic groups that historically have been inadequately served by public mental health systems.
The UC Davis report is the result of a nine-month, $500,000 project led by Aguilar-Gaxiola and funded by state's Department of Mental Health. It focused on collecting comments and insights from underserved communities, primarily Asian/Pacific Islanders, Native Americans, African Americans and Latinos in 10 counties around California, including Sacramento.
Aguilar-Gaxiola said the purpose was not to simply spell out what has already been well-documented: that low-income and minority populations experience health disparities across a broad spectrum of illnesses due to access to and quality of care. Rather, the intent was to develop the strategies to engage hard-to-reach, underserved populations.
“The best way to identify effective outreach and engagement strategies is to learn directly from members of target communities,” said Aguilar-Gaxiola.
As part of the project, 30 focus groups were held around the state to identify mental health concerns and needs, and develop recommendations for prevention and early-intervention programs. Researchers also conducted dozens of one-on-one interviews with community advocates who work at the state and local levels and have established trust and credibility within particular communities.
Aguilar-Gaxiola said his team learned a variety of things that should be of interest to policy makers. Advocates noted the significant problems people can have in simply accessing health care. Lack of knowledge about where to obtain mental health care, as well as shortages in transportation options and culturally and linguistically appropriate services, were frequently cited as critical elements by local advocates.
"We need to pay attention to histories of marginalization and mistrust,” said Aguilar-Gaxiola. “We have an opportunity to build on community strength and local knowledge and encourage cooperation. We have to identify opportunities for co-learning, make important strides toward sustainability and enhance capacity building, while protecting the well-being, interests and rights of communities, particularly those with vulnerable populations such as underserved communities."
Finally, Aguilar-Gaxiola pointed out that underserved communities do have great strengths. Strong family ties can serve as protective factors in offering important emotional and instrumental support during times of stress. Policymakers should be aware of the beneficial impacts of such protective factors and take care that they remain in place, he emphasized.
Aguilar-Gaxiola said he was pleased with the positive response his report's preliminary recommendations generated from both lawmakers and representatives from community-based organizations who attended the October 30 event. He noted that many of the themes emerging from the “Building Partnerships: Engaging Underserved Communities Under the MHSA” project were welcomed by meeting participants, suggesting the report's findings will help enhance mental health outreach and policies at the state level.
The UC Davis Center for Reducing Health Disparities, in alliance with the UC Davis Clinical and Translational Science Center (CTSC), provides leadership and support within and beyond UC Davis Health System to promote the health and well-being of ethnically diverse populations. Major areas of focus include raising awareness of the unique cultural and linguistic attributes of minority populations, developing culturally and linguistically sensitive communications, and working with policymakers, administrators, practitioners, consumers and families to reduce health disparities. The Center's "Building Partnerships: Engaging Underserved Communities Under the MHSA" project is a good example of translating research into practical information that will likely benefit policy makers and mental health administrators as they strive to engage underserved communities and jointly develop practical solutions to reducing health disparities. Such efforts are aligned with the CTSC's Community Engagement goal of moving research findings into community practices.