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The
Community
Psychologist

Volume 55, Number 2 Spring 2022

Prevention & Promotion Interest Group

Edited by Susana Helm, University of Hawai`i at Mānoa

Prevention & Promotion IG Co-Chairs:  Toshi Sasao and Kayla DeCant

Column Editor:  Susana Helm, PhD, University of Hawai`i at Mānoa HelmS@dop.hawaii.edu

The Prevention & Promotion IG column of The Community Psychologist highlights P&P resources as well as the P&P work of community psychologists and allied professionals. Please email Susana if you would like to submit a brief report or if you have resources we may list. 

 

Reflections on Community Psychology Practice in an Academic Job

Written by Susana Helm, PhD, University of Hawai`i at Mānoa

In my role as a Professor in the Department of Psychiatry, trained as a community & culture psychologist with an emphasis in community-based participatory action research (CB/PAR), I participate in a lot of public system of care improvement meetings that convene directors of state and county agencies, community-based non-profits, and consumer groups. Notably, the State of Hawai`i government is quite centralized relative to other states in the union. For example, there is only one Department of Education for the entire state. We have five counties that govern along island geographies:  Kauai (Kauai & Ni`ihau), Honolulu (O’ahu), Maui (Maui, Molokai, Lanai), Hawai`i (Hawai`i), and Kalawao (Village of Kalawao on the Kalaupapa Peninsula of Molokai, site of the Hansen’s Disease Treatment facility). 

It was brought to my attention by a group of elders who are elected leaders of their Hawaiian Homestead Associations, in the wake of a murder and suicide deaths, that though they appreciated our community-academic collaboration on youth substance use prevention, they wanted to expand our efforts to include child and adolescent mental health. They described an undercurrent of community trauma that people do not want to or know how to deal with, and that manifests in substance use, family violence, and mental health problems including suicidality. They identified a child-centered solution based on neighborliness, as a way to help families most in need to access direct support at home by familiar and friendly faces, as well as referral to the local federally qualified community health clinic behavioral health program. Their idea sounded like a hybrid of home visiting and patient navigation, from which we established the Ho`okele model (Guerrero, Chock, Lee, Sugimoto-Matsuda, O’Kelly, 2019). Aside from the usual funding challenges, one of our start-up problems has been a mismatch between community interest in staffing the program with pairs of residents from the neighborhood who know the families and are natural carers (e.g., Gullotta, 1994) and health clinic requirements that employees hold specific certifications, for example Community Health Worker. Thus, we currently are developing workforce strategies that honor lived experience over pre-requisite formal training, e.g., Peer Support Specialists, and provide on-the-job training.

Part of my daily work in getting the Ho`okele model up and running is to participate in a lot more community meetings, which is how I learned about the statewide Trauma-Informed Care Task Force created by the 2021 Hawai`i State Legislature with passage of House Bill 1322, also referred to as Act 209 (2021). Act 209 largely focuses on adverse child experiences (ACE), and thus the Task Force currently is housed in the Hawai`i State Department of Health, Child and Adolescent Mental Health Division.  For this 2022 legislative session, the Trauma Informed Task Force is seeking to establish a Wellness and Resilience Office in the Governor’s office (SB 2482 and HB 1970). In reading the language of both the senate and house bills, it became evident that fundamental aspects of trauma conspicuously were missing with respect to Native Hawaiian wellness and resilience - historical trauma, and the related community trauma identified by the elder-leader group that inspired the Ho`okele model.  I reached out to my community psychology and Native Hawaiian health colleagues at the University of Hawai`i with expertise in historical trauma so that we could quickly craft language that may be useful for the Trauma Informed Care Task Force this legislative session (see Brief Report below). 

Brief Report: Trauma Informed Care, Colonial Oppression, and Community & Cultural Resilience

Written by Rachel Burrage, Thompson School of Social Work and Public Health; Lorinda Riley, SJD, Office of Public Health Studies and Hawai`inuiākea School of Hawaiian Knowledge; Susana Helm PhD, Department of Psychiatry.

To enhance the scope of work that may become possible through a Wellness and Resilience Office in the State of Hawai`i Governor’s office, we provided language to the state Trauma Informed Care Task Force to expand beyond a focus on Adverse Child Experiences, to include traumas related to colonization, racism, and discrimination (Table 1).  First, we provided an expanded definition of trauma.  Second, we emphasized community and cultural resilience.  And finally, we recommended that Native Hawaiian solutions are named explicitly

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References

Burrage, R. L., Antone, M. M., Kaniaupio, K. N., & Rapozo, K. L. (2021). A culturally informed scoping review of Native Hawaiian mental health and emotional well-being literature. Journal of Ethnic & Cultural Diversity in Social Work30(1-2), 13-25.

Cronholm, P. F., Forke, C. M., Wade, R., Bair-Merritt, M. H., Davis, M., Harkins-Schwarz, M., ... & Fein, J. A. (2015). Adverse childhood experiences: Expanding the concept of adversity. American Journal of Preventive Medicine49(3), 354-361.

Evans-Campbell, T. (2008). Historical trauma in American Indian/Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities. Journal of Interpersonal Violence23(3), 316-338.

Gone, J. P., Hartmann, W. E., Pomerville, A., Wendt, D. C., Klem, S. H., & Burrage, R. L. (2019). The impact of historical trauma on health outcomes for indigenous populations in the USA and Canada: A systematic review. American Psychologist74(1), 20.

Guerrero APS, Chock S, Lee AK, Sugimoto-Matsuda J, & O’Kelly AS. (2019).  Mental health disparities, mechanisms, and intervention strategies. Perspectives from Hawai`i. Current Opinion in Psychiatry, 32 (6), 549-546. doi: 10.1097/YCO.0000000000000551 

Gullotta TP. (1994).  The what, who, why, where, when, and how of primary prevention.  Journal of Primary Prevention, 15(1), 5-14.  

Helms, J. E., Nicolas, G., & Green, C. E. (2012). Racism and ethnoviolence as trauma: Enhancing professional and research training. Traumatology18(1), 65-74.

Hirschberger, G. (2018). Collective trauma and the social construction of meaning. Frontiers in psychology9, 1441.

Mancini, J. a., & Bowen, G. L. (2009). Community resilience: A social organization theory of action and change. In Jay. A. Mancini and Karen A. Roberto (Eds.), Pathways of human development: Explorations of change, 245-265. New York: Lexington Books.

Norris, F. H., Stevens, S. P., Pfefferbaum, B., Wyche, K. F., & Pfefferbaum, R. L. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127-150.  

Thomas, D., Mitchell, T., & Arseneau, C. (2016). Re-evaluating resilience: from individual vulnerabilities to the strength of cultures and collectivities among indigenous communities. Resilience4(2), 116-129.

Yamane CYEW & Helm, S. (2022). Indigenous Culture-as-Health. A systematized literature review. Journal of PreventionDOI 10.1007/s10935-022-00666-3