ABSTRACT
Asian and Pacific Islander Americans (APIAs) are a diverse group, representing many cultures of origin, a range of immigration experiences, and varying access to economic and other resources. Despite stereotypes such as the "model minority" and cultural values that stigmatize mental illness and complicate mental health help-seeking, APIAs' psychiatric rehabilitation and recovery needs are significant. These needs are inadequately treated within existing systems of care. Passage of California's Mental Health Services Act (MHSA) in 2004 created the opportunity for Sacramento County to fund a full-service mental health clinic designed to meet the needs of the APIA community. The process by which this clinic, the Transcultural Wellness Center, was conceptualized, advocated for, and launched is described. This clinic is considered a best practice model within the MHSA system redesign effort.
Subject(s)
Asian , Community Mental Health Centers/organization & administration , Community Mental Health Services/organization & administration , Health Care Reform/methods , Mental Disorders/rehabilitation , Native Hawaiian or Other Pacific Islander , Asian/psychology , California , Community Mental Health Services/legislation & jurisprudence , Cultural Characteristics , Health Planning , Humans , Local Government , Mental Disorders/ethnology , Native Hawaiian or Other Pacific Islander/psychology , Organizational Case Studies , Organizational InnovationABSTRACT
Emotion self-regulation is an important developmental task in the preschool period that is related to children's emotional and behavioral adjustment in early childhood. Emotion self-regulation and its relation to later adjustment has not been studied in children born with orofacial clefts, despite their risk for externalizing and internalizing behavior problems. Eighty-three 5-year-old children with cleft lip and palate, isolated cleft palate, or no cleft condition were videotaped during a laboratory disappointment situation. Results showed that children in the cleft group expressed less disappointment than children in the comparison group. Longitudinal analyses revealed that parenting stress measured when the children were 2 years of age predicted Expressed Disappointment at age 5 years, which, in turn, predicted severity of behavior problems at age 7 years. Although tentative, results indicate that control over mild negative affect may be a protective factor for children with clefts, buffering the effects of early stress on the development of later behavioral and emotional problems. Thus, interventions that reduce parenting stress and enhance children's emotion regulation strategies may decrease the risk for later psychological problems in this population.
