Migrant seasonal and farmworker families in the United States are not always aware of or willing to take advantage of mental health services offered through organizations such as the National Migrant and Seasonal Head Start program. Within the migrant community, there is a strong stigma against seeking mental health treatment, and people may be reluctant to discuss family issues with health providers. Additionally, cultural and language differences between individuals and the programs offering these services may seem intimidating or insurmountable to people who need help.
FHI 360’s Guadalupe Cuesta, Director of the National Migrant and Seasonal Head Start Collaboration Office, understands these challenges and saw a chance to change that. She partnered with MHP Salud and the National Latino Behavioral Health Association to develop a pilot project to empower parents to address mental health in their families and communities and bring an awareness of services to a population that does not readily seek these services.
The National Migrant and Seasonal Head Start Collaboration Office, funded by the U.S. Department of Health and Human Services, Office of Head Start, provides grants for local agencies to manage services to families and children under 5 years of age. Head Start focuses on school readiness, child welfare, child care and community services, family literacy and health services.
The pilot project, Promotores de Bienestar, or Promoters of Well-Being, used a peer-to-peer (parent-to-parent) community outreach approach that is modeled on the promotores de salud (community health workers) programs common in Latin America, Mexico and parts of the United States, in which certified and trusted community health workers liaise between members of the community and health and social services.
The project began in 2018 with a survey and focus group among parents to understand needs and challenges. With the information from the parents, the partners developed two training curricula to focus on basic knowledge for and about community health workers and on the well-being and emotional health of individuals and their families. Local partners — Community Action Partnership of San Luis Obispo, East Coast Migrant Head Start Project and Oregon Child Development Coalition — received funding to deliver the training to parents from California, Oregon and South Carolina. Participants were trained to talk about mental health issues and services with other parents, building trusting relationships and communicating in their own languages, within their own cultural contexts.
The success of the project was measured through a pre- and post-test that showed a 15 percent increase in knowledge among 94 percent of the participants. Despite some attrition in participation, the project provided these parents with knowledge and peer education skills they can take wherever they move. The project is currently planning for a new group of participants and hopes to scale to 28 local partners across 38 U.S. states. Project staff are also exploring the possibility of formalizing training hours to apply toward community health worker certification in each state. Meanwhile, the project is working to dispel stigma and is bringing awareness of the benefits of mental health services to migrant families.