1. Peter Gamache, Ph.D. candidate MBA/MPH Reducing Disparities among Youth in Transition to Adulthood Georgetown Technical Assistance Center

2. Introduction Learning community Learning community Peer resource network Peer resource network Source of Support Source of Support Peter Gamache, Ph.D. candidate, MBA, MLA, MPH, RN Cell # 813-817-5100 | Email: peter.gamache@gmail.com Website: petergamache.com

3. Gaps Within & Across Systems...for addressing, monitoring, and evaluating unequal access, availability, and utilization. Child System Special education Child welfare Juvenile Justice Child mental health Adult system Criminal justice Adult mental health Housing Vocational rehabilitation Substance abuse 18 – 21 years BirthDeath

4. Intersections and Multiplier Effects According to the NIMH (2006), 1 out of 10 children age 18 and younger suffer from a mental disorder. Children in particular are at greater risk of having mental health problems when socio-political factors, environmental factors, or distressing events occur in their lives or surroundings (Friedman, Callejas, Nesman, Mowery, & Gamache, 2006). According to SAMHSA, these factors include harmful stress, discrimination, poverty, trauma, and exposure to violence or physical abuse (DHHS, 2003).

5. Intersections and Multiplier Effects Insurance Hispanic children: 21.1% uninsured Black children: 13% Asian children: 9.4% Non-Hispanic White children: 7.6% All children: 11.6 percent uninsured (Urban Institute, 2004). Mental Health Access The percentage of African Americans receiving needed mental health care is only half that of non-Hispanic Whites (Surgeon General Report, 1999).

6. Employment Black unemployment was 14.8 percent in 2009, compared to 8.5 percent for Whites. Hispanic unemployment was 12.1 percent (Urban League, 2010). Unemployed males, ages 16-29 = 19.5% African American, 7.9% White; 8% Hispanic; 7.8% Asian (Kaiser Family Foundation, 2006). Reasons: Mental health disparities contributing to gaining/maintaining employment. Postsecondary Education White youth are nearly twice as likely as Hispanic youth beginning at community colleges to finish a bachelor’s degree; 81 percent of Whites complete a bachelor’s degree compared to 57 percent of Latinos (Fry, 2004). Intersections and Multiplier Effects

7. Criminal Involvement African-American youth are six times more likely than White youth to be incarcerated. Latino youth are three times more likely (Annie E. Casey Foundation). Alcohol/Substance Abuse % of high school students who drank for the first time before age 13 = 18.1% White, 24.9% Black, 27.1% Hispanic (CDC Youth Risk Behavior Surveillance, 2010). Intersections and Multiplier Effects

8. Transition to Independence Process (TIP) System Employment Engages in employment exploration & experience. Education Explores career options (e.g., interviewing people in careers, library explorations and web searches on careers, visiting community trade schools & colleges). Living Situation Improves stability in housing location (e.g., planned moves vs. evictions and fleeing to avoid rent). Personal Effectiveness & Wellbeing Accesses/uses preventative and necessary medical/dental services. Community-life Functioning Attends or volunteers with community organizations, activities, support groups, spiritual supports. Examples

9. Assets-based Approach Biological Needs Biological Needs Psychological Needs Psychological Needs Social Needs Social Needs Human Capital Human Capital Social Capital Social Capital Cultural Capital Cultural Capital Physical Mental Emotional

10. Transition to Independence Process (TIP) System Employment Human Capital Technical skills development Volunteering Job shadowing Practicum Apprenticeships Social Capital Professional networking Cultural Capital Current events Destinations Example:

11. Next Steps If disparities are to be reduced, service providers must acknowledge experiences of racism and discrimination within health and mental health systems at the interpersonal and intrapersonal levels, and such incidents require targeted attention at the organizational and systems levels. Discrimination and racism should be considered in all program planning and research efforts.

12. References Annie E. Casey Foundation. Retrieved from http://www.aecf.org/upload/publicationfiles/fact_sheet5.pdf http://www.aecf.org/upload/publicationfiles/fact_sheet5.pdf Centers for Disease Control and Prevention. (2010, June). Youth risk behavior surveillance system. Retrieved from http://www.cdc.gov/HealthyYouth/yrbs/index.htm http://www.cdc.gov/HealthyYouth/yrbs/index.htm Clark, H. B., & Unruh, D. K. (2009). Transition of youth & young adults with emotional or behavioral difficulties: An evidence-supported handbook. Baltimore, MD: Paul H. Brookes Publishing. Department of Health and Human Services (2003). Glossary of terms: Child and adolescent mental health. Retrieved from http://www.mentalhealth. samhsa.gov/publications/allpubs/CA-0005/default.asp Friedman, L., Callejas, L., Nesman, T., Mowery, D., & Gamache, P. (2006). Research with African American populations. Retrieved from http://rtckids.fmhi.usf.edu/rtcpubs/CulturalCompetence/services/CultCom pServices.pdf http://rtckids.fmhi.usf.edu/rtcpubs/CulturalCompetence/services/CultCom pServices.pdf

13. References Fry, R. (2004). Latino youth finishing college: The role of selective pathways. Washington, DC: Pew Charitable Trusts. Retrieved from http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/News/Press_R eleases/Hispanics_in_America/pew_hispanic_college062304.pdf http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/News/Press_R eleases/Hispanics_in_America/pew_hispanic_college062304.pdf Kaiser Family Foundation. (2006). Race, ethnicity, & health care. Retrieved from http://www.kff.org/minorityhealth/upload/7541.pdfhttp://www.kff.org/minorityhealth/upload/7541.pdf National Institute of Mental Health (2006). Child and adolescent mental health. Retrieved from http://www.nimh.nih.gov/healthinformation/childmenu.cfm http://www.nimh.nih.gov/healthinformation/childmenu.cfm Surgeon General Report. (1999). African Americans. Use of mental health services. Retrieved from http://mentalhealth.samhsa.gov/cre/fact1.asphttp://mentalhealth.samhsa.gov/cre/fact1.asp Urban Institute. (2010). Children without health insurance. Retrieved from http://www.urban.org/pressroom/childrenwithout.cfm http://www.urban.org/pressroom/childrenwithout.cfm Urban League. (2010). State of Black America report. New York: Author. Retrieved from http://www.nul.org/estore/content/2010-state-black- america-reporthttp://www.nul.org/estore/content/2010-state-black- america-report