The concept of stigma in mental illness as applied to Haitian Americans.

AIM: To report on the analysis of the concept of the stigma of mental illness within the Haitian American community. BACKGROUND: Mental illness is a highly stigmatized condition within certain communities making it challenging for individuals to seek effective treatment. The consequences of such stigma can have lifelong corollaries for the individuals, the families and the communities. INTRODUCTION: The concept of stigma is not fully developed in nursing; clarity of the concept of stigma of mental illness is still needed in the nursing literature. In order to assist patients in accessing mental health services, the concept of stigma must first be clarified. METHODS: The method used for this concept analysis was that of Walker and Avant. FINDINGS: Five attributes were identified, creating the following definition: labelling, stereotype, negative attitude, emotional response, and discrimination. The antecedents for stigma of mental illness are lack of knowledge about mental illness, emotional state and cultural beliefs and values. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The origins of stigmatization of mental illness among Haitian Americans need to be understood. Mental health illnesses are stigmatized within the Haitian culture, which presents as a barrier to accessing help for many Haitian American women suffering from mental illness. The defining attributes can be used to develop tools to help clinicians identify patients being stigmatized. Once stigma is recognized, nurses can develop strategies and policies that can mitigate the effects of stigmatization of mental illness among this patient population. CONCLUSION: Further research is essential to examine the ways in which this concept impacts the Haitian American community, as well as effective strategies to help minimize its effects.

The Dotson Bridge and Mentoring Program: A Diversity Success Story.

BACKGROUND: Even though the Institute of Medicine released a report on the importance of ethnic diversity in the health care workforce to reduce health disparities, there has been little progress in increasing diversity in nursing. PROBLEM: Nationally, health care systems do not have adequate representation of Black/African American, Asian, and Latino RNs. APPROACH: The Dotson Bridge and Mentoring Program is an innovative mentoring program for African American, Latino, Asian, and Native American (ALANA) students. CONCLUSION: Mentoring programs that support ALANA students can lead to an increase in retention, graduation, and NCLEX pass rates and should be an integral part of nursing programs. The outcomes of the program included improving the course pass rates from 50% to 92%, improving the first-time NCLEX pass rate from 74% to 94% and decreasing the attrition rate from 23% to 1%.

Bridging the Chasm between Pregnancy and Health over the Life Course: A National Agenda for Research and Action.

BACKGROUND: Many pregnant people find no bridge to ongoing specialty or primary care after giving birth, even when clinical and social complications of pregnancy signal need. Black, indigenous, and all other women of color are especially harmed by fragmented care and access disparities, coupled with impacts of racism over the life course and in health care. METHODS: We launched the initiative "Bridging the Chasm between Pregnancy and Health across the Life Course" in 2018, bringing together patients, advocates, providers, researchers, policymakers, and systems innovators to create a National Agenda for Research and Action. We held a 2-day conference that blended storytelling, evidence analysis, and consensus building to identify key themes related to gaps in care and root causes of inequities. In 2019, more than 70 stakeholders joined six working groups to reach consensus on strategic priorities based on equity, innovation, effectiveness, and feasibility. FINDINGS: Working groups identified six key strategic areas for bridging the chasm. These include: 1) progress toward eliminating institutional and interpersonal racism and bias as a requirement for accreditation of health care institutions, 2) infrastructure support for community-based organizations, 3) extension of holistic team-based care to the postpartum year and beyond, with integration of doulas and community health workers on the team, 4) extension of Medicaid coverage and new quality and pay-for-performance metrics to link maternity care and primary care, 5) systems to preserve maternal narratives and data across providers, and 6) alignment of research with women's lived experiences. CONCLUSIONS: The resulting agenda presents a path forward to remedy the structural chasms in women's health care, with key roles for advocates, policymakers, researchers, health care leaders, educators, and the media.