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Culture Can Affect Access To Alcohol, Drug Abuse Treatment For Rural Youth
Cultural
stereotypes about Hispanics could impede Latino youth from seeking help for
drug and alcohol abuse. In turn, substance abuse treatment providers must
better understand how their own attitudes toward culture can affect the
provision of sufficient behavioral health services, according to a new
study. To do this, providers must first assess their own notions of culture
and address any hidden biases.
The study obtained first hand information from practitioners to propose
the development of culturally relevant, quality care for rural adolescent
populations that have limited access to behavioral health care. Researchers
with the PIRE Behavioral Health Research Center of the Southwest and the
University of Montana found four commonly held cultural stereotypes that
health care providers' believed inhibited Hispanic youth from seeking help
for substance abuse - family, religion and spirituality, gender roles and
socioeconomic factors.
"By just focusing on those factors, even the best-intentioned
prevention and treatment models will result in a simplistic response to the
complex social, political and economic realities that create health
disparities among ethnic minority populations," said Dr. Cathleen Willging,
Ph.D., primary investigator on the study. "This often results in many
communities viewing mainstream health and human service institutions with
suspicion. Although social stigmas associated with behavioral health
problems no doubt influence how some Hispanic families seek help, it is
important to note the role that a history of discrimination and racism
plays in such a process."
Researchers interviewed 42 behavioral-health providers over a three-
month period in 2005. Study participants included drug and alcohol
counselors, mental health therapists, nurses and physicians, and prevention
specialists in four counties in rural, southern New Mexico. This area
includes some of the highest rates of unemployment and highest percentage
of people living in poverty in the country.
Researchers found practitioners believed that Hispanic families were
circumspect about seeking behavioral health services because of distrust of
Anglo providers, to avoid stigma of mental illness and substance abuse and
the need to demonstrate self-reliance. Providers most notably considered
Hispanic cultural heritage and values as obstacles to general well being.
This perception, researchers report, indicates that the behavioral health
providers tend to focus on culture as a site for change, thereby
deemphasizing the important role of socioeconomic status in determining the
social context of illness, help seeking and recovery.
From this study, changes to substance abuse treatment services can be
made to better provide care for rural adolescents and their families.
Researchers recommend a series of modifications to the training of
behavioral health care providers. Culturally competent care includes not
only providing appropriate Spanish-language services, but also education
and employment opportunities for youth and families -- even those lacking
legal residency. Furthermore, state and local governments should consider
mechanisms that encourage the training, hiring and licensing of local
behavioral health professionals who represent the cultural background of
the communities in which they serve.
"Training can demonstrate how different experiences, knowledge and
values cannot just be acknowledged but must be integrated and appreciated,"
said Dr. Gilbert A. Quintero, another researcher on the study. "Such
training should first encourage providers to think reflexively about their
own value systems and the status and privilege that they bring to clinical
encounters with patients of varying cultural, ethnic and class
backgrounds."
Dr. Willging is a medical anthropologist at PIRE's Behavioral Health
Research Center of the Southwest in Albuquerque. Along with Dr. Quintero of
University of Montana and Dr. Elizabeth Lilliott also of PIRE, Dr. Willging
authored the study that appears in the November edition of the journal
Qualitative Health Research. The study was funded by grants from the
National Institute on Drug Abuse and the National Institute of Mental
Health.
Pacific Institute for Research and Evaluation
http://www.pire.org
Cultura pot afecta accesul la alcool, de tratament pentru abuzul de droguri ruralã pentru Tineret - Culture Can Affect Access To Alcohol, Drug Abuse Treatment For Rural Youth - articole medicale engleza - startsanatate