Alicea Stacey, Pardo Gisselle, Conover Kelly, Gopalan Geetha, McKay Mary
Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA
Clin Soc Work J. 2012 Jun 1;40(2):175-186. doi: 10.1007/s10615-011-0344-3. Epub 2011 May 10.
African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.
居住在市中心社区的非裔美国人和拉丁裔青年心理健康受损的风险更高，因为他们的社区常常与严重的压力源相关联，包括贫困率上升、药物滥用、社区暴力，以及稀缺的青年支持资源和心理健康护理选择。弱势城市环境的许多方面都有可能阻碍青少年的成功发展。心理健康需求较高的青少年可能会出现判断力受损、解决问题能力差和人际关系冲突等问题，从而导致不安全的性行为和药物使用。然而，那些本可从护理中大幅受益的城市青少年却常常回避心理健康服务。因此，为城市低收入非裔美国人和拉丁裔青少年开发具有文化敏感性、与背景相关且有效的服务至关重要。鉴于城市青少年心理健康和社会需求的复杂性，新颖的服务提供方式可能需要考虑个体（即未来成功的动力）、家庭（即家庭内外的成人支持）和社区层面（即工作和学校机会）的临床因素。“奋起计划”是一种以高中为基础的心理健康服务提供模式，旨在加强与青少年心理健康和积极青少年发展相关的关键家庭、青少年和学校环节。“奋起计划”（1）在市中心的生态领域对城市少数族裔青少年进行干预；（2）针对多个层面（学校、家庭和社区）以解决青少年心理健康问题；（3）提供机会以提高青少年解决社会问题的能力和生活技能。此外，“奋起计划”整合了现有的理论驱动、基于证据的干预措施。本文描述了“奋起计划”的临床目标、理论影响以及组成部分和关键特征，并展示了两组学生参与该计划的初步数据。
