7 - (IOP 7) Reducing Mental Health Disparities by Integrating Trauma Informed, Structurally Responsive Care in Underserved Community Settings for Youth Exposed to Community Violence

Direct and indirect exposure to community violence is associated with increased risk for a wide range of mental health problems (Turner et al., 2019). Youth living in communities impacted by violence face compounding forms of oppression including high rates of poverty, limited access to mental health services, and systemic racism, all of which perpetuate disparities in trauma-related mental health sequalae and access to care (Castro-Ramirez et al., 2021; Kravitz-Wirtz et al., 2022). While evidence-based, trauma-focused mental health treatments are well established (Dorsey et al., 2017), there are multiple barriers to receiving such services for children reared in under-resourced communities, such as lack of local mental health providers trained in evidence-based modalities, multiply stressed caregivers who may not have the time or means to take children to traditional outpatient clinics, and mistrust in providers embedded within government agencies (Castro-Ramirez et al., 2021). The proposed presentation will describe our doctoral clinical psychology program’s Violence Intervention and Prevention (VIP) initiative designed to reduce structural inequities in mental health services by working with community agencies as partners and training the next generation of health service psychologists in key structural competencies.

Structural competencies for health service psychologists include developing structural humility, recognizing structural factors that shape clinical interactions, and attending to structural factors when designing and implementing interventions (Malone et al., 2024). We will describe how utilizing a framework of structural competency informed our approach to student training, community partnerships, and service implementation. For instance, an afterschool program serving adolescents noted it was difficult for most teens they served to commit to weekly therapy sessions, and requested we also provide drop-in services akin to walk-in consultation services provided by psychologists in primary care clinics and college counseling centers. Another afterschool program noted challenges for the same children to attend a multi-week closed group and requested single-session group interventions. Student clinicians received trainings in empirically supported treatments for youth exposed to traumatic events (e.g., TF-CBT), evidence-based cognitive behavioral group interventions (e.g., CBITS), evidence-based cognitive behavioral single-session interventions adapted to a group format (e.g., Action Brings Change; Schleider et al., 2020), and structural competencies such as being flexible and respectful when providing services in community spaces. Over the past two years, student clinicians have delivered services to over 350 individuals across eight sites (e.g., schools, afterschool programs) via individual therapy, single-session groups, multi-week closed groups, and drop-in services as well as professional development training to youth development staff. We hope this presentation will be valuable for mental health professionals and doctoral programs seeking to develop structural competencies and reduce mental health disparities.