Much of what we know about mental health and mental illness comes from epidemiological studies that seek to identify the rates of mental disorders such as Depression, Anxiety Disorders, Attention Deficit Hyperactivity Disorder, Bipolar Disorder, Post Traumatic Stress Disorder, and Schizophrenia, to name just a few. These illnesses affect tens of millions of people but only a fraction of these receive treatment.
El Centro focuses on mental health issues as they pertain to co-occurring with other health conditions that we study: substance abuse, HIV/AIDS and other sexually transmitted infections (STIs), and intimate partner violence (IPV). Co-occurring mental health problems are important to consider and treat because they can increase a person’s risk for or magnify the effects of substance abuse, HIV infection and IPV. Co-occurring mental health conditions can also affect how someone responds to and follows recommended treatment.
What are we learning at El Centro?
In our work at El Centro, we have found many instances of co-occurring conditions among the individuals and families we serve. For example:
- In a precursor to our SET-Recovery study, we found that 59% of HIV+ (predominantly African American) women who were recovering from substance abuse also had symptoms of PTSD.
- Most Hispanic adolescents entering our CIFFTA-Prevention study had 3 or more co-occurring health or mental health conditions. For example, 61% were depressed, 71% had ADHD and 57% met the criteria for conduct disorder. These co-occurring problems are linked to greater risk for substance abuse and increased risky sexual behavior.
- In the CIFFTA drug treatment studies for adolescents, co-occurring mental health disorders are so common that they are considered to be the rule and not exception. Treatments must be prepared to address both the drug use problem as well as the often hidden mental health problems.
Our experience in finding many intertwined health and mental health conditions in the individuals and families we serve led us to develop a conceptual model to help answer these questions:
How are mental health, substance abuse, violence, and risk for HIV and other STIs related among minority group members, and how do these conditions interact?
We have found that, among Hispanics, socioeconomic disadvantage, acculturation and stress help predict the co-occurrence of these health and mental health conditions, and that strong family ties help protect against their effects.
What are the individual, relationship, cultural and socio-economic factors that may serve as common risk and protective factors for these conditions?
Being able to fully understand how health and mental health conditions co-occur and interact, as well as identifying the risk and protective factors for these conditions, are essential to our development of effective, culturally-tailored interventions.