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Peter Gamache, Ph.D. Peter Gamache, Ph.D. candidatecandidate
MBA/MPH MBA/MPH
Reducing Disparities among Reducing Disparities among Youth in Transition to Youth in Transition to
Adulthood Adulthood Georgetown Technical Assistance CenterGeorgetown Technical Assistance Center
IntroductionIntroduction
Learning Learning communitycommunity
Peer resource Peer resource networknetwork
Source of SupportSource of Support
Peter Gamache, Ph.D. candidate, MBA, MLA, MPH, RNPeter Gamache, Ph.D. candidate, MBA, MLA, MPH, RNCell # 813-817-5100 | Email: [email protected] Cell # 813-817-5100 | Email: [email protected] Website: petergamache.comWebsite: petergamache.com
Gaps Within & Across Systems. . .for addressing, monitoring, and evaluating unequal access, availability, and utilization.
Child System
Special education
Child welfare
Juvenile Justice
Child mental health
Adult system
Criminal justice
Adult mental health
Housing
Vocational rehabilitation
Substance abuse
18 – 21
years
Birth Death
Intersections and Multiplier Effects
According to the NIMH (2006), 1 out of 10 children age 18 and younger suffer from a mental disorder.
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).
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 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).
Employment 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).
Reasons: Mental health disparities contributing to gaining/maintaining employment.
Postsecondary Education 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).
Intersections and Multiplier Effects
Transition to Independence Process (TIP) System
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.
Examples
Assets-based ApproachAssets-based Approach Biological NeedsBiological Needs Psychological NeedsPsychological Needs Social NeedsSocial Needs
Human CapitalHuman Capital Social CapitalSocial Capital Cultural CapitalCultural Capital
Physical Mental
Emotional
Transition to Independence Process (TIP) System
Employment Human Capital
Technical skills development Volunteering Job shadowing Practicum Apprenticeships
Social Capital Professional networking
Cultural Capital Current events Destinations
Example:
Next Steps
• 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.
• Discrimination and racism should be considered in all program planning and research efforts.
References• 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/CultCompServices.pdf
References• 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_Releases/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-black-america-report