Consent for Research Involving Spanish- and English-Speaking Latinx Adults With Schizophrenia.

BACKGROUND: Latinxs are vastly underrepresented in mental health research; one of many contributing factors may be complexities in the research consent process, including language preferences. We examined determinants of comprehension of research consent procedures and tested the effects of a preconsent research schema condition among 180 adults with schizophrenia (60 Latinx-English and 60 Latinx-Spanish preference, and 60 non-Latinx White). STUDY DESIGN: Participants were randomly assigned (equal allocation) to an educational session regarding clinical research concepts and processes (schema condition) or to an attention control. Following a subsequent simulated consent procedure for a hypothetical drug trail, comprehension of consent disclosures was measured with 2 standard measures. STUDY RESULTS: One-way ANOVAs showed significant medium effect size differences between ethnicity/language groups on both measures of comprehension (η2s = 0.066-0.070). The Latinx-Spanish group showed lower comprehension than non-Latinx White participants; differences between the 2 Latinx groups did not reach statistical significance. Group differences were not statistically significant after adjusting for differences in education, or on scores from structured measures of acculturation, health literacy, or research literacy. Two-way ANOVAs showed no significant main effects for consent procedure on either comprehension measure (Ps > .369; partial η2s < 0.006) and no significant group-by-consent interactions (Ps > .554; partial η2s < 0.008). CONCLUSIONS: Although the preconsent procedure was not effective, the results suggest health and research literacy may be targets for reducing disparities in consent comprehension. The onus is on researchers to improve communication of consent information as an important step to addressing health care disparities.

Stigma and the Intersection of Ethnicity, Gender, Romantic Relationships, and Serious Mental Illness: Perspectives from Latinxs with Schizophrenia and Their Family Members.

Romantic relationships are a fundamental part of the human experience and contribute to quality of life and recovery of people with serious mental illness (SMI). However, few psychosocial interventions exist to address this issue among people with schizophrenia, and no existing intervention focuses on Latinxs. The intersectionality of being Latinx and having schizophrenia can create a unique experience regarding stigma, romantic relationships, and gender. Guided by intersectionality theory, this study used qualitative content analysis and an intersectionality template analysis to examine data from interviews with 22 participants-11 people with diagnosed schizophrenia and their identified primary family member. Overall, findings illustrate perspectives about romantic relationships in a sample of Latinxs with schizophrenia and highlight the stigma that people with schizophrenia and their families can experience. Five key themes emerged from the data: obstacles to romantic relationships, advantages of romantic relationships, disadvantages of romantic relationships, gender-role issues and satisfaction with life, and hope for the future. Participants reported that stigma related to schizophrenia and the lack of employment were the main obstacles to establishing and maintaining romantic relationships. These findings provide an insider perspective on romantic relationships in a sample of Latinxs with schizophrenia and elucidate the importance of using an intersectionality lens to guide culturally responsive approaches.

Substance Use in Relation to Mental Illness: A Study of Mexican-Origin Latinos with Schizophrenia and Their Family Members.

Little is known about family context and substance use behaviors among Latinos with schizophrenia. Learning about patient and family caregiver perceptions of use is critical to our understanding of how best to support these vulnerable patients and family caregivers. This study explored perceptions of substance use in relation to mental illness among Latinos primarily of Mexican origin with schizophrenia and their family caregivers. Semistructured interviews were conducted with 34 participants (20 family caregivers; 14 patients) with direct and indirect substance use experience, in their preferred language. Data were analyzed using thematic analysis, which consisted of comparing codes across and within patient and family caregiver transcripts. Findings revealed that substance use affected well-being, particularly patient recovery and caregiver burden. Strategies to address well-being included limiting substance use, being vigilant about patient use, and communicating the negative impact of use. The environmental impact and stigma of substance use were major contextual challenges. Patients addressed these by limiting their socialization. Family social context was important to how substance use was perceived and managed by patients and caregivers. As such, treatment models should consider a holistic perspective that incorporates family context when addressing substance use among Latinos with schizophrenia.

A Sociodemographic Profile of Asian Americans Served in Community Mental Health Centers for a Diagnosis of Schizophrenia Spectrum Disorder.

Little is known about Asian Americans treated for serious psychiatric disorders in the public mental health system. We characterized 75 Asian Americans seen at community mental health centers for a diagnosis of schizophrenia spectrum disorder to anticipate likely clients and gain insights into their service needs. Participants completed in-person interviews and self-report questionnaires on their demographic and social characteristics. The ethnically diverse sample featured mostly foreign-born individuals with long-standing schizophrenia. Findings highlighted participants' differential experience of social adversities and stressful events, but also revealed salient cultural resources that shielded some from the social sequelae of schizophrenia. Recovery-oriented mental health programs staffed by culturally and linguistically compatible providers remain key to engaging this marginalized population in service. Findings also uphold a holistic management of schizophrenia spectrum disorder among racial and ethnic minorities, taking into account the complex social needs of afflicted individuals.

Hope and Schizophrenia in the Latino Family Context.

This study explored hope among Latinos with schizophrenia and their family caregivers to gain a greater understanding of how it is experienced in the family context. Data were collected from 34 participants (14 individuals with schizophrenia; 20 family caregivers). Semistructured in-depth interviews were analyzed using thematic analysis, comparing codes across and within consumer and family caregiver transcripts. Findings revealed that hope was conceptualized as a multidimensional construct and was a vital resource for participants. Specifically, there was an emphasis on contextual factors that included religion and spirituality and interpersonal relationships. Findings underscore the need to expand our understanding of how hope is perceived and developed among Latinos and other underserved groups. This could lead to better recognition of this salient resource to incorporate its varied dimensions into treatment models that address the needs of consumers and family caregivers.

Psychosocial Approaches for Sexual Health and Intimate Relationships Among Patients With Serious Mental Illness.

INTRODUCTION: The sexual health and behavior and the intimate relationships of patients diagnosed with a serious mental illness (SMI) have been described as ongoing and often ignored concerns in mental health treatment. Evidence-based psychosocial interventions have emerged as effective complimentary approaches to address symptoms of SMI in conjunction with psychopharmacology, yet rarely do they address sexual concerns in a targeted manner. AIM: This systematic review explores the scope and efficacy of psychosocial interventions designed to address sexual health and behavior and intimate relationship concerns in patients with SMI. METHODS: The search was conducted in four targeted databases and identified 967 articles with four of those meeting inclusion criteria for this review. MAIN OUTCOME MEASURES: The data extracted included setting, study sample, study design, outcome measures, data analysis, and results. The measures utilized in the studies assess mental and sexual health-related outcomes. RESULTS: All four studies reported an improvement in sexual and mental health outcomes. CONCLUSION: Given the lack of psychosocial approaches and culturally sensitive adaptations, this review highlights a gap in literature that should be addressed, particularly emphasizing their combined treatment with psychotropic medication and efficacy testing with diverse populations.