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Salud Mental: Discussing Youth and the Public System

The U.S. leads in mental health issues but lags in treatment and services, particularly for children in foster care and the Juvenile System. In the U.S. nearly 500,000 children are in foster care at any given time and close to 85% of these children have a mental health illness. Latinos exemplify the number of children who enter Child Protection Services annually. For example, foster care has nearly doubled from 8% in 1990 to 15% in 2002 for Latinos, with over representation in child victim reports.

While Americans have a crucial healthcare reform proposal moving through Congress, stakeholders took center stage on September 15 to discuss the magnitude of mental health in the Latino community and assure that mental health is also on the forefront of the agenda.

Congresswoman Grace Flores Napolitano (CA-38) moderated the mental health summit. She recently introduced a bill that would provide mental health services to select schools. She was joined by Dr. Anita Chandra, behavioral scientist and child and adolescent health expert from the RAND Corporation, Jackie Contreras, child psychologists and managing director for strategic consulting at Casey Family Programs, Kathi Grasso, senior juvenile justice policy and legal advisor at the Office of Juvenile Justice and Delinquency Prevention, Dr. Panayiota Coureli, psychologists and director of the foster Grandparent Program in the California Division of Juvenile Justice, and the Honorable Patricia A. Macias, presiding Judge of the 388th Family District Court in Texas and former president of the National Council of Juvenile and Family Court Judges.

"Children in foster care or juvenile systems experience maltreatment or neglect, and this contributes to the mental health trajectory," said Dr. Jackie Contreras. The risk for emotional and behavioral problems may further exacerbate mental health issues. An issue identified by all panelists was the difficulties experienced by families as their children transition from childhood to youth and adulthood. For example, the relationship between mental health and academic performance has been studied among Latino youth, and research suggests that anxiety disorders, depression, and stress related problems result in low academic achievement and engagement.

Latinos are also the least likely to access mental health services compared to their ethnic/racial counterparts. Nearly 32% of children who suffer from mental health problems receive no mental health services. "We are also seeing more low income families coming into care," said Dr. Contreras from El Paso, TX. This may account for the lack of mental health professionals who are unfamiliar with the unique needs of the Latino community, and cultural and linguistic competence.

Other barriers to access mental health services include socioeconomic status, isolation, and language and cultural barriers. These also negatively influence the quality of life of Latinos. Dr. Courelli from California expressed that children in juvenile systems are at higher risk from falling deeper into the system because of the limited coordination between mental health settings, foster care, and the juvenile system.

Of greater concern to the Latino community is poor data collection. Currently, there is no data on immigration status and ethnicity break-down. This is detrimental to the success of programs tailored specifically for Latino children and youth.

Kathi Crasso with the Office of Juvenile Justice and Delinquency Prevention expressed that a greater focus on evidence-based programs and schools are critical in providing services where the youth are. In response to the presentation, audience members suggested that "access is not sufficient and we must look at services that provide quality care." Approaches at the local, state and federal level can reduce mental health disparities. As a model of care, Dr. Coureli has implemented the "Successfully Dressed" program in CA, which aims to alter the perceptions of incarcerated youth transitioning to parole by exposing them to grooming, hygiene, and professional style of dress.

Congresswoman Napolitano finished the summit with a call to action. She challenged the participants and Latino community to make mental health a priority, so that children and youth can also lead productive, healthy lives.