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Randomized Controlled Trial
. 2010 Aug;7(4):368-79.
doi: 10.1177/1740774510369847. Epub 2010 Jun 22.

A clinical trial of peer-based culturally responsive person-centered care for psychosis for African Americans and Latinos

Janis Tondora  1 , Maria O'Connell, Rebecca Miller, Tom Dinzeo, Chyrell Bellamy, Raquel Andres-Hyman, Larry Davidson
Affiliations
Randomized Controlled Trial

A clinical trial of peer-based culturally responsive person-centered care for psychosis for African Americans and Latinos

Janis Tondora et al. Clin Trials. 2010 Aug.

Abstract

Background: Providing culturally competent and person-centered care is at the forefront of changing practices in behavioral health. Significant health disparities remain between people of color and whites in terms of care received in the mental health system. Peer services, or support provided by others who have experience in the behavioral health system, is a promising new avenue for helping those with behavioral health concerns move forward in their lives.

Purpose: We describe a model of peer-based culturally competent person-centered care and treatment planning, informed by longstanding research on recovery from serious mental illness used in a randomized clinical trial conducted at two community mental health centers.

Methods: Participants all were Latino or African American with a current or past diagnosis within the psychotic disorders spectrum as this population is often underserved with limited access to culturally responsive, person-centered services. Study interventions were carried out in both an English-speaking and a Spanish-speaking outpatient program at each study center. Interventions included connecting individuals to their communities of choice and providing assistance in preparing for treatment planning meetings, all delivered by peer-service providers. Three points of evaluation, at baseline, 6 and 18 months, explored the impact of the interventions on areas such as community engagement, satisfaction with treatment, symptom distress, ethnic identity, personal empowerment, and quality of life.

Conclusions: Lessons learned from implementation include making cultural modifications, the need for a longer engagement period with participants, and the tension between maintaining strict interventions while addressing the individual needs of participants in line with person-centered principles. The study is one of the first to rigorously test peer-supported interventions in implementing person-centered care within the context of public mental health systems.

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Figures

Figure 1
Figure 1
Illustration of arms in person-centered care for psychosis among low-income, urban adults of color interventions
Figure 2
Figure 2
Design and timeline for the study
See this image and copyright information in PMC

References

    1. U.S. Department of Health and Human Services. Mental Health: Culture, Race, and Ethnicity – A Supplement to Mental Health: A Report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD, 2001.
    1. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, Rockville, MD, 1999.
    1. A practical guide for implementing the recommended national standards for culturally and linguistically appropriate services in healthcare. [homepage on the Internet]. 2001. Available at: http://www.omhrc.gov/clas/guide3a.asp (accessed on 7 September 2009).
    1. Tondora J, Pocklington S, Gregory Gorges A, et al. Implementation of person-centered care and planning: how philosophy can inform practice. Unpublished paper, Substance Abuse and Mental Health Services Administration, Rockville, MD, 2005.
    1. Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21st Century. Institute of Medicine, National Academy Press, Washington, D.C., 2001.

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