Adverse childhood experiences (ACEs) have been linked to mental health illnesses such as anxiety and depression. In Hispanic culture, mental illness is largely stigmatized which greatly affects individuals from seeking the help they need. This further perpetuates mental illnesses due to ACEs. Miami-Dade County has a large Hispanic population that experiences high levels of poverty. Miami Dade has high rates of violence, domestic and gun violence which are factors that contribute to ACEs. To target the stigmas around mental health and decrease mental illness due to ACEs, this program will aid Hispanic adolescents by providing a mental health intervention through education and support that includes their families to break the cycle of internalized generational trauma. This program will include educating parents on outdated beliefs about mental health as well as ACEs, providing counseling, and decreasing mental illness in adolescents, thereby improving their quality of life.
As opposed to using a disease-centric which focuses on a single predominant disease (Tinetti, 2016), a public health framework will be used to address a wider range of factors that impact health. These factors include issues such as education, poverty, and transportation (Philanthropy Network Greater Philadelphia, 2016) all of which are vital to this program. Given that this project takes into account the individual’s ethnicity, income level, cultural views, stigmas, biases, the public health framework takes into account this interdisciplinary aspect of health and acknowledges that this project address a multi-level issue (Philanthropy Network Greater Philadelphia, 2016). This program will use primary prevention where the parents will have the access to education about mental health (Philanthropy Network Greater Philadelphia, 2016) and ACEs and by partnering with medical health centers, those who can’t afford medical care will not be turned down. Secondary prevention will also be used in the form of ACE screenings and tertiary prevention will be provided by giving the adolescents access to mental health services by licensed providers (Philanthropy Network Greater Philadelphia, 2016).
The social-ecological model implemented is McLeroy’s Model since it focuses on individual and social environmental factors as targets for health interventions (McLeroy, 1988). At the individual level, the program is working to change parental attitudes and behaviors that lead to the stigmatization of mental health and increase the knowledge on ACEs. For adolescents, at the individual level self-efficacy and increased positive attitudes are the target to help adopt healthy coping mechanisms and build skills to address poor mental health. A person’s traits and identities influence personal behaviors (Borgen Project, 2017). The importance of focusing on this level is to target knowledge and personal beliefs to increase positive attitudes, behaviors, and self-efficacy by having a full understanding of mental health. A large portion of this program focuses on the interpersonal level where the relationship between the parent and adolescent is targeted to promote healthy communication and understanding of mental health. By providing parents with monthly meetings with other parents who share the same goals, their social networks will increase thereby encouraging them to change their attitudes and behaviors. The interpersonal level is vital to include given relationships and social networks have a powerful influence on a person’s perspective (Borgen Project, 2017) and Hispanic culture is known to place a strong emphasis on family ties as a source of identity (Carteret, 2011). At the community level, it will be added that the program is working on dismantling the social norm in Hispanic communities of thinking of mental health as taboo.
Trauma-informed principles will be built into the program from the very beginning during the training of the staff. ACEs will be thoroughly covered during the training to ensure that the program members understand the severity of ACEs and to uphold the program's goals of transmitting this information to the parents. Guides and resources, such as the ACEs Connection online community, will be provided so that staff can continually remain informed and up to date (Philanthropy Network Greater Philadelphia, 2016). Throughout the training process, staff will always be asked periodically for their needs in learning or if there need to be more in-depth conversations about certain topics that come with the trauma-informed approach.
SAMHSA’s principles of trauma-informed organizations will be the core of our program. The organization will promote both physical and psychological safety to both the staff and participants (Philanthropy Network Greater Philadelphia, 2016). The motives, goals, objectives, and decisions of the organization will by transparent to build trust among all those involved and each person in the program will feel supported (Philanthropy Network Greater Philadelphia, 2016). Given that the program is working with sensitive topics such as mental health, familial relationships, and adolescent well-being, it is important that all participants feel empowered and heard. This empowerment and voice will come from the recognized strengths of the participants as well as validating each and every unique experience as the participants are working on their selves and where parents are working towards understanding their child’s experiences to break away from traumatic cycles (Philanthropy Network Greater Philadelphia, 2016). Finally, as staff is recruited, immediately the idea of a zero-tolerance for discrimination of any kind, such as racial, ethnic, sexual orientation, and gender identity, will be disclosed as a priority. This works toward removing stereotypes and biases that may re-traumatize individuals (Philanthropy Network Greater Philadelphia, 2016).
Borgen Project. (2017, August 5). Social-ecological model offers new approach to public health. The Borgen Project. https://borgenproject.org/soci...ical-model/#:~:text= Individual%3A%20An%20individual's%20various%20traits,attributes% 20noted%20at%20this%20interval
Carteret, M. (2011, March 15). Cultural values of Latino patients and families. Dimensions of Culture. https://www.dimensionsofcultur...al-values-of-latino- patients-and families/#:~:text=Latinos%20tend%20to%20be% 20highly,to%20family% 20and%20clos e%20friends.
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health education quarterly, 15(4), 351–377. https://doi.org/10.1177/109019818801500401
Philanthropy Network Greater Philadelphia. (2016). Trauma-Informed Philanthropy: A Funder’s Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley.
Tinetti, M. E., Naik, A. D., & Dodson, J. A. (2016). Moving From Disease-Centered to Patient Goals-Directed Care for Patients With Multiple Chronic Conditions: Patient Value-Based Care. JAMA cardiology, 1(1), 9–10. https://doi.org/10.1001/jamacardio.2015.0248