The lack of culturally and linguistically appropriate mental health professionals is a serious limitation of the current mental health system. The limitation becomes even more problematic for racial/ethnic minorities with limited English proficiency who live in linguistically isolated areas. As a means of increasing accessibility to mental health services, we propose the use of technologies that fall into the category of telemedicine. Telemedicine has proven effectiveness as a vehicle for implementing both physical and mental health interventions. Commonly used to provide care in rural areas, remote counseling via videoconferencing technology is admirably suited for situations in which ethnic minority populations with language or cultural barriers have limited or no access to appropriate mental health care, regardless of where they live. Remote counseling may also be effective in allowing the client to avoid the discomfit of disclosing problems to clinicians who are members of the same close-knit community. In order to further reduce the stigma of mental health treatments often found among racial/ethnic minorities, we propose to position a telecounseling center in a university setting. The proposed pilot study targets one group with a heightened need for mental health services but limited access: Korean Americans in Florida. Results, however, will serve as a model for improving access to mental health care for any linguistically isolated population. The overall goal of the study is to develop and evaluate a telecounseling program. The project will be conducted by a research team at the University of South Florida (USF) in collaboration with the Korean American Behavioral Health Association (KABHA) in New York. Three bilingual members of KABHA whose practice is based on cognitive-behavioral therapy (CBT) will serve as counselors. The counseling will be available to Korean American adults with probable depression (score e 10 on the PHQ-9) who live in the Tampa Bay area. We anticipate 24 participants (eight clients per counselor). Each participant will receive counseling at a telecounseling reception center to be located at the USF. Using a mixed methods approach, both survey and in-depth interviews with clients and counselors will be conducted to evaluate the program. Evaluation criteria include feasibility (i.e., adherence, acceptability, satisfaction) and efficacy (i.e., changes in depressive symptoms) of the program. The project will provide a model for making services accessible to those in need of culturally and linguistically appropriate services. Given that Korean Americans are just one of many racial/ethnic minority groups that suffer from linguistic isolation and a consequent lack of access to culturally and linguistically appropriate services, our approach will have wide applicability to other underserved populations, creating a system of tailored treatment that can be replicated.
Responding to the need to improve access to mental health services for ethnic minorities with limited English proficiency, this project proposes to utilize telemedicine as a vehicle for service provision. The project is designed to develop and evaluate a telecounseling program that links Korean Americans in need of services with culturally and linguistically competent providers who are established and readily available elsewhere. This project holds implications for service delivery for many other linguistically isolated populations.
| Jang, Yuri; Chiriboga, David A; Molinari, Victor et al. (2014) Telecounseling for the linguistically isolated: a pilot study with older Korean immigrants. Gerontologist 54:290-6 |
