Ecological Interventions In Mental Health

The problems frequently associated with minority status and acculturation are numerous. Among some of the characteristics of minorities include, for exam-

pie, low educational status, high unemployment, high rates of poverty, high risk for some health and mental health problems, high risk for victimization, high rates of incarceration, and high risk for engaging in violence.

Psychology as a profession, according to Shore (1998), is still establishing its identity and more recently has been developing interests and greater involvement in issues of prevention of psychological disorders and the promotion of mental health. These more recent areas of focus of the profession of psychology address such concerns as social issues, ethnic minorities, and ultimately the elaboration of what is needed in a society so that all its members have the opportunity to grow mentally healthy, with appropriate services available if and when problems arise (Shore, 1998). The application of psychological science and methodology to community defines the growing field of Community Psychology. Among the legitimate professional activities of Community Psychology is advocacy, the integration of theory, research, and practice to bring about change to issues of concern for a given community. Theory plays a role in organizing and structuring knowledge. Research plays a role in offering objective data that can clarify and monitor the knowledge from which actions can be taken to ameliorate illness or to promote growth or health. Professional practices in psychology identify issues of concern with respect to access, availability, effectiveness, and acceptability of services and interventions. Practice issues in community psychology are not exclusively directed toward individuals. Community psychology interventions may be broad and may involve development of new programs or modifications to programs, organizations, educational and health systems, litigation and social policy interventions, and the like. An example of how psychological science can be applied to prevention of community-based problems is reported by Caplan, Vinokur, and Price (1997) in their review of the literature. After examining the knowledge that persons experiencing a recent job loss frequently are at greater risk for abuse, depression, alcoholism, poor physical health, violence and mental disruption, resources were directed toward these groups resulting in a clear prevention benefit. Another very direct and concrete example is provided by the advocacy efforts in San Antonio, Texas, leading to changes in local ordinances restricting minors from purchasing spray paint and thus reducing rates of toluene inhalant abuse.

In addition to concern for promotion of health and wellness, an important aspect of community psychology is concerned with directing appropriate resources to prevent or reduce mental health problems. Sue, Funino, Hu, Takeu-chi, and Zane (1991), for example, found that ethnic matching of therapist and client led to lower premature termination, greater number of sessions, and better outcomes for African Americans, American Indians, Asian Americans, Mexican Americans, and Whites.

The ecological perspective, an important part of multicultural mental health practice, examines the contexts of both growth and pathology (also see Marsella, chapter 1, this volume). In an ecological perspective, the relations of culture, economic systems, political systems, socialization practices, acculturation stresses, and social problems are related to individual functioning. The macro-level is linked to the individual via such variables as cultural identity, personality, and mental health. Community problems as well as individual mental health problems are intricately intertwined such that in order to effectively prevent or change the individual, the context may require to be changed as well. The prevention and promotion of health activities have particular relevance for children and youth. Whereas it may be too late for some persons, it may not be too late to apply these interventions for young children. Addressing the needs of children is a legitimate advocacy practice in community psychology as are interventions that strengthen the family in society. By incorporating culture and ecological models, the practice of psychology is widened or broadened, and solutions to mental health problems are equally increased in proportion.

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