Assignment 10: Intervention

Despite showing signs of mental illness, Asian American adults (age 20-60) with disorders like schizophrenia and ADHD living in the United States are often undiagnosed and therefore untreated by doctors.

I have found that currently, only one strategies is in place to address this problem. The current strategy is very indirect as it addresses the much larger problem of uninsured Asian Americans, under which this problem would be specified. The indirect strategy is to improve access and affordability of insurance for Asian Americans so that it will be easier to access mental health services, which makes it more likely that they will seek diagnosis and treatment for mental illness. This strategy has been put into place through various policy changes, a fight that continues today at a time when so many still remain uninsured. This first strategy addresses the influence of economic and environmental key determinants by addressing the cost and presence or absence of health insurance. One possible reason why there is only one current strategy could be that the problem I have defined is a relatively small, specific population which has received little individual attention.

For my first intervention, I would recommend working with community leaders of Asian American adults to encourage their followers who sound like they are suffering from symptoms of mental illness to seek professional help. This can be primary, secondary, and tertiary depending on when the community leaders intervene. Ideally it would be primary and the community leaders would advise their followers to seek professional help before they feel symptoms of mental illness. This primary prevention could help eliminate the stigma surrounding seeking it by talking about it, preventing Asian Americans from feeling too stigmatized to get diagnosed. This intervention can be secondary prevention as Asian American adults who suffer from mental illnesses are likely to go to their community leaders like their pastors and priests for help first. Second prevention would happen with this strategy if community leaders directed their followers to mental health services immediately after followers went to them for symptoms. This intervention can be tertiary prevention as Asian American adults who have been suffering from mental illnesses for a long time are likely seeking counselling from community leaders.  Tertiary prevention would happen if community leaders directed those followers who have been suffering for a long time already, to mental health services. This would address the key determinant of social and cultural stigma which prevents them from seeking help.

For my second intervention, I would recommend setting up a mental health counseling center within popular and respected Asian American community, such as church organizations. This could be staffed and run entirely by the community as a simple information center about various symptoms of mental illness and what they can mean. This deals with the environmental key determinant of Asian Americans who are so far removed from mental health services that they do not even consider it an option.

For my third intervention, I would recommend a media campaign together with community leaders of Asian Americans that distributes general information like the typical symptoms of most common mental illnesses, where the nearest mental health services are located, and etc. This would address both social/cultural and environmental key determinants. The media can also target stigma regarding mental illnesses.

Decision Matrix: (3 – best, 1 – worst)

Options Decision Criteria	Intervention 1: Talking to Community Leaders	Intervention 2: Setting Up Mental Health Counseling	Intervention 3: Media Campaign
Effectiveness	3	3	2
Feasibility	3	1	2
Sustainability	2	1	3
Cost	3	1	3
Cost effectiveness	3	3	2
Political acceptability	2	2	3
Social will	2	2	2
Potential for unintended risks	1	1	1
Potential for unintended benefits	3	3	1
Total/conclusion	22	17	19

I recommend talking to community leaders. This is the best use of resources and also the most effective way to get through to a population that may otherwise be difficult to get to. There may also be unintended benefits if a relationship is established between public health officials and community leaders. It will not be costly to just send a representative to these communities. It will be very feasible as it is not hard to find Asian American communities and extensive research has been done  on the social institutions. Sustainability might be an issue but if both parties are devoted, which they probably will be because both are concerned for the safety of the same population, tools like the internet can help maintain the relationship.