Mental Health Practice Mental Health Practice Model for the Treatment of Model for the Treatment of Mental Illness of the Mental Illness of the Spanish Speaking Indigent Spanish Speaking Indigent and Uninsured and Uninsured Davor Zink, Margie Hernandez, Hannah Lindsey, Vala Burton, Tara Jackman and Antonio E. Puente University of North Carolina Wilmington Jennifer Buxton and Allison Altendorf New Hanover Regional Medical Center Presented at the annual meeting of the Southeastern Council of Latin American Studies March 17, 2011 Wilmington, NC
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A Novel Collaborative Mental Health Practice Model for the Treatment of Mental Illness of the Spanish Speaking Indigent and Uninsured Davor Zink, Margie.
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A Novel Collaborative Mental A Novel Collaborative Mental Health Practice Model for the Health Practice Model for the Treatment of Mental Illness of Treatment of Mental Illness of the Spanish Speaking Indigent the Spanish Speaking Indigent
and Uninsuredand Uninsured
Davor Zink, Margie Hernandez, Hannah Lindsey, Vala Burton, Tara Jackman and Antonio E. Puente
University of North Carolina WilmingtonJennifer Buxton and Allison Altendorf
New Hanover Regional Medical Center
Presented at the annual meeting of the Southeastern Council of Latin American Studies
March 17, 2011 Wilmington, NC
U.S. Population: HispanicU.S. Population: Hispanic
US: 301,621,159 (100.0%)
US Hispanics: 46,943,613 (15.4%)
Largest & Fastest Ethnic Minority Group in the United States (and undercounted). Will be the Largest Group in the United States by Approximately 2050.
Source: U.S. Census Bureau, 2007 American Community Survey, Pew 2009
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4
5
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Percent Latino of the Total Percent Latino of the Total Population in the United Population in the United
States: 1970 to 2050States: 1970 to 2050
*Projected Population as of July 1
ProjectionsCensus
Source: U.S. Census Bureau, 1970, 1980, 1990, and 2000 Decennial Censuses; Population Projections, July 1, 2010 to July 1, 2050
Expected Growth Hispanics Expected Growth Hispanics in the U.S.in the U.S.
Projections of Hispanic Population 2009-2050Source: U.S. Census Bureau figures
11/12/2009 8
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
2009
2050
Top Five States by Latino Top Five States by Latino Growth Rate: 2000 to 2006 Growth Rate: 2000 to 2006
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Rank State
Growth Rate
(percent)
1 Arkansas 60.9
2 Georgia 59.4
3 South Carolina 57.4
4 Tennessee 55.5
5 North Carolina 54.9
Source: U.S. Census Bureau, Population Estimates July 1, 2000 to July 1, 2006
U.S. Hispanic Educational U.S. Hispanic Educational Attainment Attainment Graduate or Professional Degree: 10.1%Bachelor’s Degree: 17.4%Associate Degree: 7.4%Some College (no degree): 19.5%High School Graduate: 30.1%9th-12th grade (no diploma): 9.1%Less than 9th grade: 6.4%Note: Nationwide, 47% of undocumented
Hispanics have less than a high school degree
Source: U.S. Census Bureau, 2007 American Community Survey
Language & Poverty Co-Language & Poverty Co-variatesvariates
People who speak only English at home (219,092,969) are:
o below (11.2%) poverty lineo above (88.8%) poverty line
People who only speak Spanish or any other language at home (33,833,322) are:
o below (20.0%)o above (80.0%)
Source: U.S. Census Bureau, 2007 American Community Survey
Language ConcernsLanguage Concerns
Variation of SpanishSpanish as a Second or Even
Third LanguageLimits and Perils of TranslationsImportance of Non-Verbal
CommunicationDifficulties With Learning English
““Typical” Mental Health Typical” Mental Health ProblemsProblems
DepressionAnxietySubstance AbuseDomestic Violence
(from literature and 5 years of clinical service at Tileston Mental Health Clinic)
Origins Of Mental Health Origins Of Mental Health ProblemsProblems
Acculturation & IsolationLanguage LimitationsHealth DisparitiesDecreased Social SupportFinancial LimitationsPoor EducationLack of Religious Affiliation
The Tileston Health ClinicThe Tileston Health ClinicA non-profit clinic that has been
serving low-income and uninsured patients in southeastern North Carolina for 20 years.
Mission:◦Provide quality health services at no
cost◦No form of health insurance◦Income falls within the federal poverty
guidelines◦English and Spanish
The Tileston Health ClinicThe Tileston Health Clinic• Medical services• Dental services• On-site pharmacy• Staff
– Healthcare professionals (MAs, CPPs, PhDs and MDs)
– Support staff (undergraduate, graduate)– All volunteers
• Budget– Grants, donations, and money collected from
fundraisers• All services and medications provided by the
clinic and its affiliates are free of charge to all of the clinic’s patients.
• Daily (8-5)
The Mental Health ClinicThe Mental Health Clinic• Founded by A. E. Puente, a clinical
neuropsychologist and UNCW professor, 10 years ago.
• Psychotherapy and Counseling– Clinical Psychologists, counselors