Several months ago, the Center for Global Health at the University of Illinois at Chicago and the Immaculate Conception Parish started talking together about the unaddressed mental health and psychosocial needs of migrant families from Mexico. This church on Chicago’s southwest side serves 4,000 of these families.
Like many others from Mexico living in the U.S., they face serious challenges related to poverty, gangs, violence, discrimination, cultural adjustment, and immigration, including the forced deportation of parents, large numbers of undocumented persons, and “Dreamers” facing possible deportation. Despite the many strengths among these families, these circumstances can lead to both family problems and emotional distress, including common mental disorders in adult and child family members. These families also have very low rates of access to and utilization of mental health services.
It’s a reminder that you don’t have to go halfway around the world to find global mental health problems. It’s happening in our country, in a low-resource community in our university’s backyard. The global is actually local.
To begin addressing this major global mental health problem here at home, together the parish and Center for Global Health formed a partnership and decided to draw upon successful global mental health strategies based on “task sharing”, which rely on laypersons to deliver mental health support.
We formed a Community Council which together developed Fortaleciendo mi Familia. This is a culturally appropriate and scalable way of providing psychosocial support to migrant families from Mexico living in the U.S. It focuses on Mexican families in the church because clergy and church staff are highly trusted and often closely involved in Mexican American communities.
Fortaleciendo mi Familia is delivered in groups with multiple families by lay workers trained and supervised by the Center for Global Health. Our intervention approach draws upon our prior National Institute of Health funded work with Bosnian and Kosovar refugees which successfully built the Coffee and Family Education and Support program. It also draws upon cutting-edge work done by the World Health Organization who have been for advocating low intensity cognitive behavioral therapy interventions designed for helping persons in high adversity, low resource settings where there is little or no access to mental health resources.
We trained lay workers in the church who then go and deliver the intervention to groups of six to eight families. Over time we will document the feasibility, acceptability, fidelity, and effectiveness of the program.
The public mental health significance of this project is crucial. It addresses the unmet mental health needs of Mexican-American's exposure to high adversity and builds and delivers a new model of church-based service delivery for immigrant families which can be deployed in other similar communities.
This initiative is inspired by the achievements of the global mental health movement to bring mental health support to low resource communities in low-income countries. But we don’t think of global mental health problems or strategies as belonging out there, but right here as well. It makes me wonder, what differences we could make in our communities if we applied the lessons that we teach to others all around the world.