COMMUNITY-BASED MENTAL HEALTH RESEARCH TO PROMOTE SOCIAL JUSTICE & CHILDREN’S HEALTH November 20, 2008 Jessica Goodkind, PhD University of New Mexico Department of Pediatrics Division of Prevention and Population Sciences “Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death.” – WHO Commission on Social Determinants of Health, 2008 Focus on trauma/stress continuum and social inequities Locate problems beyond the level of the individual Diversity as a strength, not deviance Empirical base for social action Creation of alternative settings & social roles People as experts on their well- being and healing Build on individual, family & community strengths Facilitate critical awareness and collective action Develop local resources and infrastructure Advocate for more just policies and laws

Refugee Well-being Project Psychological (e.g., past trauma) Material (e.g., poverty) Physical (e.g., lingering physical ailments) Social (e.g., loss of meaningful roles) Educational (e.g., limited English proficiency) Cultural (e.g., disconnection from traditional cultural practices) 6 Month Program for Refugees & Undergraduates  Learning Circles cultural exchange one-on-one learning  Advocacy to mobilize community resources Contribution of post-migration stressors to psychological distress of refugees Limitations of individual models of care

THRIVE/Nihii’iina Project Two components: 1.Adaptation, implementation, & evaluation of cognitive-behavioral intervention for trauma in schools 2.Development, implementation & evaluation of community-based mental health intervention to address multiple layers of trauma Traditional cultural practices and teachings Culturally appropriate parenting strategies Problem-solving and social support-building skills Equine and other experiential activities Heal current trauma & prevent future violence/trauma for Native American youth and their families Evidence-base: individual, family & community impact Curriculum manual & film

Project TRUST AI/AN youth have the highest rate of suicide among 15 to 24 year-olds in the U.S. Elucidate & eliminate causes of BH disparities Improve behavioral health care for AI/AN youth Method Statewide Partnership Literature Review Community Advisory Meetings (N = 71) Provider Surveys (N = 25) Consultation with Traditional Practitioners Results 32 specific policy, provider & research recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and seek transformation at multiple levels Implementation of recommendations Truth about historical trauma and current inequities that impact the mental health & well-being of Native American youth & their families Responsiveness to issues and needs identified by Native American youth & their families Understanding of the effectiveness of traditional indigenous healing practices & cultural teachings Self-determination of youth & families to guide their behavioral health services Transformation of individuals, families, communities, systems of care & social structures

Social Stressors and Asthma in Children Impact of stress on physical health and chronic disease Hispanic Women’s Social Stressor Scale (Goodkind, Gonzales, Malcoe & Espinosa, 2008) Immigration Stress Socioeconomic Stress Racism-related Stress Familial Stress Parental Stress Employment Stress Studying relationships between mothers’ social stressors and their children’s asthma