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Addressing the mental health needs of immigrants in primary care: prototyping an immigrant mental health program at Massachusetts General Hospital

OBJECTIVE: Immigrants to the United States represent a variety of ethnocultural backgrounds, experiences, and languages. They face stressors unique to migration that may exacerbate or cause mental health concerns. Despite this increased risk, immigrants access treatment at rates far below their native-borne counterparts. Structural and cultural barriers to mental health service utilization expound this disparity. The present thesis proposes a novel system to provide psychosocial support for US immigrants seeking treatment at Massachusetts General Hospital (MGH). 

METHODS: Recognizing the need for a new paradigm of care, an Immigrant Mental Health Center prototype was conceptualized using a Human-Centered Design approach. The foundations for this prototype align with the Patient-Centered Medical Home approach to integrated primary and mental healthcare. Narrative reviews informed the theoretical basis of the prototype. A brief review of the existing literature yielded five integrated care themes, forming the basis for prototype evaluation criteria. Communication materials for stakeholder meetings and expert advisory panels were prepared as the next step in the Human-Centered Design approach. 

RESULTS: The prototype extended care to a diverse spectrum of US immigrants within the MGH healthcare network. It involved a multidisciplinary team of specialists, whole-patient orientation, a personal practitioner, increased accessibility, and viable internal (MGH) and external (community) linkages. 

CONCLUSIONS: The next steps in the Human-Centered Design approach include iteratively designing solutions to co-optimize the prototype for implementation at the MGH Center for Immigrant Health. Recommendations for the iterative refinement stage include clarifying financial metrics and addressing structural barriers to treatment accessibility. A series of feasibility pilot trials and efficacy randomized-controlled trials precede implementation. Future directions include extending the target population to second or third-generation immigrants, attending to severe mental illnesses, and fostering inpatient mental healthcare linkages as a bridge to long-term care.

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48202
Date26 February 2024
CreatorsFong, Saige Reiko
ContributorsFranzblau, Carl, Bakhshaie, Jafar
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation

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