Asians recently surpassed Hispanics as the largest group of new immigrants to the United States. Among Asians, Filipinos are the largest subgroup in California and the second largest subgroup in the U.S. Los Angeles County is home to the largest concentration of Filipinos in the country. Despite their size, they have been described as an “invisible minority” because they are one of the least understood and researched groups related to health status and needs. Filipinos are exposed to multiple adversities, including immigration stress, loss of social status, and lower self-esteem due to discrimination, placing young children at risk for future behavioral and mental health problems. In contrast to the “model minority myth” ascribed to Asians in general, recent studies showcase an increased need for mental health and social services among Filipinos, in part because of higher rates of problem behaviors such as substance use, high school dropout, and teen births compared to other Asian subgroups. Filipino adolescents were also found to have increased reports of depressive symptoms and alarmingly high rates of suicidal ideation (38.9%) and suicide attempts (27%). Despite these behavioral health challenges, Filipino adults and children have low rates of mental health care and preventive care utilization. Barriers to accessing mental health care include: stigma, cultural factors (hiya or shame to the family), lack of knowledge about mental health and services, and conflicting messages about mental health received by professionals and other community leaders.
Wicked Problem Description:
“Mental health crises and distress are viewed differently because of ignorance, poor knowledge, stigma and discrimination. This cannot continue to be allowed to happen, especially as we know that there can be no health without mental health.”
Professor Gabriel Ivbijaro, President of the World Federation for Mental Health
Mental health disorders among children in the U.S. are a wicked problem with an estimated cost of $247 billion per year. One out of 5 children in the U.S. have a mental, emotional, or behavioral health diagnosis, placing them at risk for poorer health and shorter lives. Evidence-based parenting interventions provided in childhood have proven to be effective in preventing the onset and escalation of child behavioral and mental health problems. Yet, few parents participate in such programs, especially hard-to-reach, underserved minority and immigrant populations like Filipinos.
Our project is designed to reflect the first two phases of a three-phase of community-partnered participatory research (CPPR) initiative. Phase 1 will involve a series of meetings to address barriers and needs in the community in order to develop a shared understanding of mental health that will inform the implementation of a culturally-congruent educational campaign to improve mental health awareness in our community. We will form a steering committee of 5-10 members to meet monthly to plan activities and identify at least 25 community members and leaders to 12 quarterly coalition meetings. We will then finalize our educational campaign strategy and plan a conference that will combine science and use the arts to engage the community in a dialogue about mental health. Phase 2 will involve training providers and parent peers to act as mental health promoters who conduct outreach using this shared understanding of mental health with a focus on engaging parents to participate in the Incredible Years® Parent Program. This curriculum will incorporate, kapwa, a core Filipino value defined as community, togetherness, or a sense of shared identity. We will offer the Incredible Years® Parent program in community-based settings across Los Angeles County over two years. We propose to approach at least 400 Filipino families about participating in these groups, and plan to enroll 180 parents.
There are two intended outcomes for this project:
- A significant reduction in mental health stigma in our target community
- A significant increase in the participation rate in the Incredible Years® Parent Program offered as a prevention service
Phase 1 will take place during Year 1 and Phase 2 will take place during Years 2-3.
Search to Involve Pilipino Americans, a community–based organization serving Filipino families is our primary community partner. We also have relationships with public and private schools, churches, mental health care providers, and community-based organizations.
During Phase 1, coalition members will take a survey indicating their level of mental health stigma, knowledge about mental health disparities among Filipino youth, mental health service systems in the community, and their feelings around their level of engagement with the group. Annually, the committee and coalition members will take this survey to measure new partnerships, knowledge gained, and level of engagement. During Phase 2, we will implement the Incredible Years® School Age Parent Program, an evidence-based preventive parenting intervention and measure parenting practices, parenting stress, child behavior (parent and teacher report), and mental health stigma before and after the intervention, as well as enrollment and participation rates.