Community-based Participatory Research Examining the Health Care Needs of African Americans who are Homeless with Mental Illness

Abstract

African Americans with mental illness who are homeless experience significant health risks and illnesses leading to high mortality and morbidity rates. A community-based participatory research (CBPR) team conducted a qualitative study to begin to describe these problems. Results from focus groups and key informant interviews of 42 individuals yielded 98 themes which were sorted into three categories: problems, solutions, and peer navigators. Results included a review of the problems and solutions which the community or people might adopt. An additional goal was to understand and develop impact of peer navigators for addressing health problems in this group. Results yielded a list of values in hiring peer navigators as well as skills and resources they might need to successfully do their job. Findings from the study are currently being used by the CBPR team to develop a peer navigator program for this community.

Using Peer Navigators to Address the Integrated Health Care Needs of Homeless African Americans With Serious Mental Illness

“…A CBPR team comprising eight African Americans with serious mental illness who were homeless, service providers for people who are homeless with mental illness, and investigators conducted qualitative research with 47 key informants (African Americans with serious mental illness who were homeless and related service providers) to better identify causes to poor health in metropolitan Chicago for this group as well as possible solutions. 12 Consistent with national surveys 6 , the 47 participants believed poor health resulted from lower priority on a homeless person’s list of needs (with exposure to the elements and criminal victimization ranked more pressing), lack of available and accessible services, being stigmatized by the health care system, and being disoriented as a result of recurring psychiatric symptoms. One of the solutions identified by the group consistent with people feeling disengaged from the health care system was assistance navigating this system.…”

“…The resulting manual was governed by several basic principles including eight basic values (e.g., accepting, empowering, recovery focused, and available), seven qualities of being part of a team (e.g., networked, accessed, informed, resourced, and supervised), and six fundamental approaches (e.g., proactive, broad focused, active listener, shared decision making, and problem focused). 12 These led to four sets of helping skills: (1) basic helper principles; (2) skills to work with the person (such as reflective listening, goal setting, motivational interviewing, strengths interview, and advocacy); (3) skills to respond to a person’s concerns (e.g., interpersonal problem solving, relapse management, harm reduction, cultural competence, and trauma informed care); and (4) role management skills (relationship boundaries, managing burnout, self-disclosure, and street smarts). Peer navigators were also informed about area resources as well as a dynamic service engine locator used by the provider agency.…”

“…Moreover, the peer intervention was not informed by service guidelines that have evolved for patient navigators. 14, 27 Hence, the CBPR team conducting the earlier qualitative study 12 used study results to adapt navigator guidelines for the needs and priorities of African Americans with serious mental illness who were homeless. 28 Here, we report findings from a subsequent RCT comparing the effectiveness of this peer navigator program (PNP) to treatment as usual (TAU).…”

Failing to Meet the Good Parent Ideal: Self-Stigma in Parents of Children with Mental Health Disorders

“…To avoid the difficulties that can be experienced during qualitative analysis due to the copious and often unwieldy data produced through verbatim transcription (Halcomb and Davidson 2006;McNall and Foster-Fishman 2007), a leaner transcript was scribed during each interview and subsequently analysed (e.g., Corrigan et al 2015). To do so, a scribe (a third person within the interview, who acted independently to the interviewer and did not participate in the interview) documented salient quotes, repetitive themes and contextual, emotional, non-verbal and any other salient detail likely to influence the interpretation of meaning.…”

Stigma of mental illness and multicultural counseling self-efficacy : investigating the implications of the multicultural training environment, mental health literacy, and empathy.

“…Studies have found that members of racial and ethnic minorities who have mental illness reported more instances of mental illness stigma from mental health care treatment providers than did their racial and ethnic majority counterparts (Gary, 2005) or that concerns about stigma caused them to delay or avoid seeking treatment (Alvidrez et al, 2008;. Additionally, individuals in racial and ethnic minority groups were found to have received mental health services at lower rates, despite assessed need that was equal to or greater than that of the racial and ethnic majority (Broman, 2012;Corrigan, Pickett, Kraus, Burks, & Schmidt, 2015).…”