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Ethnicity and Mental Health: Transformative Community Approaches

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 22210

Special Issue Editors


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Guest Editor
CESPYD. Center of Community Research and Action, University of Seville, Seville, Spain
Interests: psychological wellbeing; at-risk migrants; ethnic minorities; Roma; PAR; empowerment; health justice; community advocacy

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Guest Editor
Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
Interests: health and participation disparities; immigrant population; CBPR/PAR; cultural competence; capacity building; empowerment

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Guest Editor
Public Health Program, Open Society Foundations, Berlin, Germany
Interests: health inequality; social determinants of health; environmental and social justice; sociology of human rights

Special Issue Information

Dear Colleagues,

The Global Mental Health Agenda has underscored the critical role that ethnicity and social conditions play in people’s mental health. A recent report of the UN Special Rapporteur outlines that good mental health and wellbeing must be defined by the social, psychosocial, political, economic, and physical environment that enable individuals and populations to live a life of dignity, with full enjoyment of their rights and in the equitable pursuit of their potential. Ethnicity is strongly linked to our cultural differentiation; the meanings and narratives that we share with others, and the common social and cultural codes that foster social interactions and self-identification. The growing ethnic diversity in our societies and global migration patterns have implications for people’s right to full participation in society and to enjoy mental health and wellbeing according to the ethnic patterns of populations.

Today, many ethnic minority individuals are exposed to coercive prejudices and stereotypes and social and economic conditions that threaten their wellbeing and mental health. Many are displaced persons who are victims of (a) wars, oppression and widespread violence, and natural disasters in their countries of origin; (b) traumatic experiences, loss of home and loved ones, and extreme violence during transit to safe places; and (c) victims of prejudice and discrimination in places of settlement or their own countries of residence. Further, autochthonous ethnic minorities (e.g., Roma) and indigenous minorities (e.g., Native-Americans, aborigines) are at extreme risk of vulnerability. Extreme vulnerable social, economic, and environmental conditions, which affect mental health, are suffered by ethnic minorities who are displaced and trapped in their homeland without resources and opportunities to pursue and enjoy a good and dignified life. Particularly vulnerable are those who suffer added risks due to the intersection of other psychosocial determinants of vulnerability such as children and the elderly, women and poor families, LGBTQIA+, stigmatized groups (e.g., sex workers, trafficked women), and people with disabilities.

However, ethnic and oppressed minorities, like any human group, have an immense capacity to resist and overcome oppressive and unfair living conditions, developing a critical vision of justice, building niches, and developing practices to protect, resist, and overcome the conditions of inequality according to their values, traditions, culture, social networks, and other ethnic strengths. Community-based approaches to research in which different disciplines work collaboratively within communities, hand in hand with community stakeholders, can provide safe spaces from which to promote mental health justice. This will contribute significantly to the development of the understanding of the mental health of ethnic minorities.

This Special Issue seeks to create a critical space to explore ethnic discrimination and racism as a crosscutting issue with mental health and wellbeing, to understand the causes of health, wellbeing and participation disparities, and to emphasize transformative and liberating approaches based on the strengths of communities, promoting their empowerment while ensuring their recognition and influence in social and political spaces. Papers that address mental health and wellbeing outcomes for ethnic minorities from nonmedical perspectives and the impact of sociopolitical determinants through an intersectional lens and recognize discrimination and racism at multiple levels as determinants are welcome. We encourage the submission of empirical studies, community-based participatory action research experiences, international papers comparing the mental health outcomes and wellbeing of ethnic minorities, papers that focus on hard-to-reach ethnic minority populations (e.g., Roma, the poor, indigenous communities, refugees, displaced communities), successful case studies of actions or interventions, and conceptual papers that help to unpack mental health disparities or ethical discussions in conducting of research on mental health with ethnic minority populations.

Prof. Manuel Garcia-Ramirez
Prof. Yolanda Suarez-Balcazar
Dr. Marek Szilvasi
Guest Editors

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Keywords

  • mental health
  • ethnicity
  • intersectionality
  • nonmedical perspective
  • community
  • minorities
  • social and environmental determinants of health

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Published Papers (6 papers)

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Research

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16 pages, 620 KiB  
Article
Impact of COVID-19 on the Mental Health and Well-Being of Latinx Caregivers of Children with Intellectual and Developmental Disabilities
by Yolanda Suarez-Balcazar, Mansha Mirza, Vanessa L. Errisuriz, Weiwen Zeng, Jasmine P. Brown, Sandra Vanegas, Nazanin Heydarian, Deborah Parra-Medina, Paula Morales, Hilda Torres and Sandy Magaña
Int. J. Environ. Res. Public Health 2021, 18(15), 7971; https://doi.org/10.3390/ijerph18157971 - 28 Jul 2021
Cited by 17 | Viewed by 4890
Abstract
The COVID-19 pandemic has impacted the entire world in unprecedented ways. However, populations that have had a history of marginalization have experienced a more profound impact. One such group is Latinx families of children with intellectual and developmental disabilities (IDD) in the Unites [...] Read more.
The COVID-19 pandemic has impacted the entire world in unprecedented ways. However, populations that have had a history of marginalization have experienced a more profound impact. One such group is Latinx families of children with intellectual and developmental disabilities (IDD) in the Unites States. In this study, we used a mixed methods approach to explore the impact of the pandemic on the mental health and well-being of Latinx caregivers of children with IDD. Specifically, we (1) identified which social determinants of health are correlated with maternal caregivers perceived general health, mental health, and well-being; (2) explored the impact of the pandemic on families’ overall eating and physical activity routines; and (3) identified emergent themes from caregivers’ experiences during the pandemic. Thirty-seven Latinx caregivers participated in three interviews in which several validated instruments were administered. The results indicated that perceived social support, annual family income, food security, and receipt of financial benefits were correlated with fewer depressive symptoms. Annual family income was also significantly correlated with perceived general health. Most caregivers reported that the pandemic had placed a strain on their economic situation; increased their isolation; and disrupted their child’s therapeutic supports, online education, eating routines, and engagement in physical activity. Meanwhile, some caregivers reported positive changes as a result of the pandemic. Implications for future research and practice are discussed. Full article
(This article belongs to the Special Issue Ethnicity and Mental Health: Transformative Community Approaches)
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12 pages, 519 KiB  
Article
Effectiveness of Community Occupational Therapy Intervention in, with and from the Community in People with Disabilities in Azrou (Morocco)
by Jerónimo J. González-Bernal, Leire Eiguren-Munitis, Josefa González-Santos, Mirian Santamaría-Peláez, Raúl Soto-Cámara and Paula Rodríguez-Fernández
Int. J. Environ. Res. Public Health 2021, 18(11), 5602; https://doi.org/10.3390/ijerph18115602 - 24 May 2021
Cited by 2 | Viewed by 3223
Abstract
In Morocco, the social and environmental context influences the volition and development of meaningful activities, creating physical, personal and social barriers to the occupational performance of people with disabilities. This study develops a community Occupational Therapy program in order to verify its effectiveness [...] Read more.
In Morocco, the social and environmental context influences the volition and development of meaningful activities, creating physical, personal and social barriers to the occupational performance of people with disabilities. This study develops a community Occupational Therapy program in order to verify its effectiveness in the volition, quality of life and perceived self-stigma of people with disabilities in the Moroccan city of Azrou, and to reduce the stigma of the community towards people with disabilities in the city. Data were collected from people with disabilities who participated in the program (N = 52), using the Volitional Questionnaire (VQ), The World Health Organization Quality of Life scale (WHOQOL-BREF), the Stigma Awareness Questionnaire (SCQ) and an ad hoc interview. In addition, community stigma was assessed by the Attribution Questionnaire (AQ-27) in citizens without disabilities (N = 42). Results confirmed that this intervention favors the inclusion of people with disabilities in their closest environment, improving volition and quality of life and reducing self-stigma. Furthermore, the community’s stigma towards people with disabilities was also significantly reduced after the intervention. Full article
(This article belongs to the Special Issue Ethnicity and Mental Health: Transformative Community Approaches)
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13 pages, 357 KiB  
Article
Examining Associations between Community Health Worker-Rated Health and Mental Health among Latino Adults with Chronic Disease
by Kiera Coulter, Maia Ingram, Abby M. Lohr, Melanie L. Bell and Scott Carvajal
Int. J. Environ. Res. Public Health 2021, 18(1), 100; https://doi.org/10.3390/ijerph18010100 - 25 Dec 2020
Cited by 4 | Viewed by 2779
Abstract
Latinos with chronic disease often experience comorbid depression, but confront barriers to mental health treatment. Community health workers (CHWs) develop trusting relationships with the communities they serve, and may be uniquely positioned to identify Latinos with mental health care needs. Research has not [...] Read more.
Latinos with chronic disease often experience comorbid depression, but confront barriers to mental health treatment. Community health workers (CHWs) develop trusting relationships with the communities they serve, and may be uniquely positioned to identify Latinos with mental health care needs. Research has not examined whether their rating of clients’ health is indicative of their mental health. This mixed-methods study examines CHWs’ appraisals of Latino adults’ health and their relation to mental health outcomes, and explores factors informing CHWs’ rating of health status. The current study utilized baseline data from the Linking Individual Needs to Community and Clinical Services (LINKS) study. We assessed associations between CHW-rated health (CHWRH), or rating of health status as poor–excellent, and mental health outcomes with multilevel linear regression modelling. We qualitatively analyzed CHWs’ written perceptions of participants’ health status to understand what influenced their health rating. The quantitative results showed that CWHRH was significantly related to depressive symptoms and emotional problems severity. The qualitative results showed that CHWs took a holistic and ecological approach in rating health. The findings suggest that CHWRH could be indicative of mental health among Latino adults. Further studies investigating CHWRH as an independent indicator of mental health are warranted. Full article
(This article belongs to the Special Issue Ethnicity and Mental Health: Transformative Community Approaches)
15 pages, 1229 KiB  
Article
Exploring Similarities and Differences of Non-European Migrants among Forensic Patients with Schizophrenia
by David A. Huber, Steffen Lau, Martina Sonnweber, Moritz P. Günther and Johannes Kirchebner
Int. J. Environ. Res. Public Health 2020, 17(21), 7922; https://doi.org/10.3390/ijerph17217922 - 28 Oct 2020
Cited by 10 | Viewed by 2752
Abstract
Migrants diagnosed with schizophrenia are overrepresented in forensic-psychiatric clinics. A comprehensive characterization of this offender subgroup remains to be conducted. The present exploratory study aims at closing this research gap. In a sample of 370 inpatients with schizophrenia spectrum disorders who were detained [...] Read more.
Migrants diagnosed with schizophrenia are overrepresented in forensic-psychiatric clinics. A comprehensive characterization of this offender subgroup remains to be conducted. The present exploratory study aims at closing this research gap. In a sample of 370 inpatients with schizophrenia spectrum disorders who were detained in a Swiss forensic-psychiatric clinic, 653 different variables were analyzed to identify possible differences between native Europeans and non-European migrants. The exploratory data analysis was conducted by means of supervised machine learning. In order to minimize the multiple testing problem, the detected group differences were cross-validated by applying six different machine learning algorithms on the data set. Subsequently, the variables identified as most influential were used for machine learning algorithm building and evaluation. The combination of two childhood-related factors and three therapy-related factors allowed to differentiate native Europeans and non-European migrants with an accuracy of 74.5% and a predictive power of AUC = 0.75 (area under the curve). The AUC could not be enhanced by any of the investigated criminal history factors or psychiatric history factors. Overall, it was found that the migrant subgroup was quite similar to the rest of offender patients with schizophrenia, which may help to reduce the stigmatization of migrants in forensic-psychiatric clinics. Some of the predictor variables identified may serve as starting points for studies aimed at developing crime prevention approaches in the community setting and risk management strategies tailored to subgroups of offenders with schizophrenia. Full article
(This article belongs to the Special Issue Ethnicity and Mental Health: Transformative Community Approaches)
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14 pages, 311 KiB  
Article
Waterloo Better Beginnings as a Transformative Prevention Project: Impacts on Children, Parents, and the Community
by Geoffrey Nelson, Julian Hasford, Carlos Luis Zatarain, Alexis Gilmer, S. Kathleen Worton, Marwa Eid, Salma Bangash and Jeremy Horne
Int. J. Environ. Res. Public Health 2020, 17(10), 3442; https://doi.org/10.3390/ijerph17103442 - 15 May 2020
Viewed by 3165
Abstract
Better Beginnings Waterloo (BBW) is an ecological, community-driven, prevention program for children aged 4–8 and their families. BBW was implemented in two low-income communities with high percentages of visible minorities. Data on Grade 1–2 children and their parents (the baseline comparison group) were [...] Read more.
Better Beginnings Waterloo (BBW) is an ecological, community-driven, prevention program for children aged 4–8 and their families. BBW was implemented in two low-income communities with high percentages of visible minorities. Data on Grade 1–2 children and their parents (the baseline comparison group) were gathered through parent interviews (n = 34) and teacher reports (n = 68) in 2015, prior to BBW programs, and in the period 2018–2019, the same data were collected through parent interviews (n = 47) and teacher reports (n = 46) for children and parents participating in programs (the BBW group). As well, qualitative, open-ended individual interviews with parents (n = 47) and two focus groups were conducted in the period 2018–2019. Children in the BBW cohort were rated by their teachers as having a significantly lower level of emotional and behavioural problems than those in the baseline sample; parents in the BBW cohort had significantly higher levels of social support than parents in the baseline cohort; BBW parents rated their communities significantly more positively than parents at baseline. The qualitative data confirmed these findings. The quantitative and qualitative short-term findings from the BBW research showed similar positive impacts to previous research on program effectiveness, thus demonstrating that the Better Beginnings model can be successfully transferred to new communities. Full article
(This article belongs to the Special Issue Ethnicity and Mental Health: Transformative Community Approaches)

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16 pages, 1485 KiB  
Study Protocol
RoMoMatteR: Empowering Roma Girls’ Mattering through Reproductive Justice
by Manuel Garcia-Ramirez, Belen Soto-Ponce, María J. Albar-Marín, Daniel La Parra-Casado, Dena Popova and Raluca Tomsa
Int. J. Environ. Res. Public Health 2020, 17(22), 8498; https://doi.org/10.3390/ijerph17228498 - 17 Nov 2020
Cited by 9 | Viewed by 4034
Abstract
Aim: To present a protocol study directed at tackling gender discrimination against Roma girls by empowering their mattering so they can envision their own futures and choose motherhood only if—and when—they are ready. Background: Motherhood among Roma girls (RGM) in Europe [...] Read more.
Aim: To present a protocol study directed at tackling gender discrimination against Roma girls by empowering their mattering so they can envision their own futures and choose motherhood only if—and when—they are ready. Background: Motherhood among Roma girls (RGM) in Europe impoverishes their lives, puts them at risk of poor physical and mental health and precipitates school dropouts. Overwhelming evidence affirms that the conditions of poverty and the social exclusionary processes they suffer have a very important explanatory weight in their sexual and reproductive decisions. Methods: Through a Community-based Participatory Action Research design, 20–25 Roma girls will be recruited in each one of the four impoverished communities in Bulgaria, Romania and Spain. Data collection and analysis: Desk review about scientific evidences and policies will be carried out to frame the problem. Narratives of Roma women as well as baseline and end line interviews of girl participants will be collected through both qualitative and quantitative techniques. Quantitative data will be gathered through reliable scales of mattering, socio–political agency, satisfaction with life and self. A narrative analysis of the qualitative information generated in the interviews will be carried out. Expected results: (1) uncover contextual and psychosocial patterns of girl-motherhood among Roma women; (2) build critical thinking among Roma girls to actively participate in all decisions affecting them and advocate for their own gender rights within their communities; and (3) empower Roma girls and their significant adults to critically evaluate their own initiatives and provide feedback to their relevant stakeholders. Conclusions: Roma girls will improve their educational aspirations and achievements and their social status while respecting and enhancing Roma values. Full article
(This article belongs to the Special Issue Ethnicity and Mental Health: Transformative Community Approaches)
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