Rodriguez, a second-generation Mexican American, and Doswell, an African American, are nurses who conduct research that focuses on improving the health of minorities—an area that has lacked a great deal of attention. They have been able to pursue their research, in part, by participating in a 30-year-old program long known as the Ethnic Minority Fellowship Program at the ANA. (The program is now called the Sub­stance Abuse and Mental Health Ser­vices Administration Minority Fellowship Program [SAMHSA MFP, or MFP for short] at the ANA.)

Some Statistics

A 2001 SAMHSA survey showed that fewer than half of the 15 million adults with serious mental illnesses in the United States were receiving treatment. Further, the survey data revealed that whites were more likely than African Americans or Hispanics to have received treatment or counseling in the previous year.

When looking at the provider side of the issue, the National Mental Health Information Center reports that although minorities constitute roughly one-quarter of the population, only about 10% of mental health providers are ethnic minorities. The SAMHSA MFP wants to change the latter statistic by helping minority students pursue doctoral and postdoctoral education and therefore advance their work in psychiatric–mental health nursing, psychiatry, psychology, and psychiatric social work. The ultimate goal is to ensure that diverse populations have access to and receive the culturally appropriate care they need and deserve.  

By design, the program at the ANA, which is funded by the SAMHSA MFP, specifically targets minority nurses by helping them attain advanced degrees in mental health and substance-abuse–related areas in order to find jobs in research, education, practice, and public policy.

“Mental health is the bed­rock of an individual’s overall health,” said Faye Gary, EdD, RN, FAAN, executive consultant with the MFP. “Graduates of the fellowship should have substantial knowledge in psychiatric–mental health and substance abuse nursing.”

When seeking fellows, MFP nurse leaders assess whether participants will help further SAMHSA’s established priorities. One of those priorities centers on building a core group of behavioral health professionals who are minorities and can lead, consult, train, and administer services to community agencies, primary care provider organizations, and educational institutions providing services to ethnic minorities with mental health and substance abuse disorders.

“However, within SAMHSA’s goals, there is a lot of room for conceptual thinking,” said Gary, the Medical Mutual of Ohio Professor of Nursing for vulnerable and at-risk persons at Frances Payne Bolton School of Nursing at Case Western University in Cleveland.

So far, 266 nurses from African-American, American-Indian, Pacific-Islander, Asian-American, and Hispanic-American communities have participated in the fellowship program. They’ve gone on to build scientific and clinical knowledge in psychiatric and mental health nursing and provide high-quality, culturally relevant care to people nationwide, as well as globally.

MFP fellows receive stipends, tuition, dissertation support, mentoring, and career guidance. They also participate in intensive research and clinical workshops and network with nurse and other mental health experts.

Doswell, who was in the first group of fellows in 1975, credits the MFP with providing her with the tools to go forward with her career in nursing and her research on the health of African Americans.

In addition to the financial benefits, Doswell said she benefited particularly from the opportunity to meet other fellows and leaders in nursing, who helped her hone her research skills.  

“Much of the research being done examines health disparities between races and ethnicities,” said Doswell, a Pennsyl­vania State Nurses Association member and current MFP national advisory committee member. “We need more re­search that looks within—not across—race and ethnicity.”

To that end, Doswell has focused much of her recent research on preventing risky behaviors among African-American girls. From 1997 to 2000 she conducted research that explored the behavioral risks taken by African-American girls. She subsequently looked into developing interventions to delay the onset of early sexual behaviors among girls ages 11 to 14. During the course of that research, she learned that the girls’ mothers often felt ill-prepared or uncomfortable when discussing sexual behavior with their daughters. That led Doswell to her current study, which involves determining effective strategies to help mothers discuss these issues with their young daughters.

For Rodriguez, the financial and networking aspects of the MFP were crucial.

“I’m the principal breadwinner in my household, so it would have been very difficult to go through a doctoral program and work full time,” said Rodriguez, a Texas Nurses Association member who was awarded a fellowship from 1998 to 2003. “I spent hundreds of hours at a clinic just recruiting for my study, and I know I would have dropped out without the fellowship. I also had the time to really study and that made the program a lot more rewarding.”

He also found other aspects of the MFP extremely helpful, such as workshops aimed at assisting fellows in learning more about the life and role of an academician, including strategies for getting published and obtaining grant money for research.

The study of psychoneuro­endocrine relationships and their potential influence on psychiatric disorders is a wide-open field, rich with research possibilities. And Rodriguez firmly believes that the MFP has made it possible for him to develop into a researcher who can begin to tackle such complex issues.

Rodriguez currently works with data he obtained from his double-blind, placebo-controlled, randomized clinical trial on the effects of adding a small amount of active thyroid hormone to the established drug regimen for treating hypothyroidism. The purpose of the study is to see if the combination of active and inactive thyroid hormones works better to offset the fatigue, depression, and memory problems of hypothyroid patients than the current standard of inactive thyroid hormone alone.

“It’s my belief that people already at risk for depression, such as adolescent Hispanic girls, are more likely to develop full-blown depression should they develop endocrine diseases, such as hypothyroidism or Cushing disease,” Rodriguez said.

Building Strength

As successful as the program is, Gary and program manager Janet Jackson said they are currently working on efforts to strengthen the MFP, from building its mentoring program to enhancing its Web site (www.emfp.org) by including up-to-date information on mental health issues, associated federal agencies, and electronic fellowship applications. They also want to create intensive summer institutes where fellows can learn more about various aspects of mental health and substance abuse.

Ongoing efforts include a recent conference sponsored by SAMHSA that brought together about 300 current and alumni fellows to learn about topics ranging from community-based treatment and prevention efforts to reducing the stigma of mental illness. Three SAMHSA directors and other staff also participated in the conference.

Gary said one of the byproducts of holding interdisciplinary conferences is that they give nurses the opportunity to build networks with other mental health professionals and perhaps embark on joint research projects that will improve the health and well-being of ethnic and racial minorities in the United States and throughout the world. They also serve as “incubators” of ideas for research, theory-based clinical practice, and the development of public policy.

Gary and Jackson also talked of the ongoing challenges of identifying nurses for the fellowship program.

“There is a limited supply in the pipeline of nurses in mental health and substance abuse who are master’s prepared,” Gary said. Therefore, MFP nurse leaders are expanding their efforts to recruit potential fellows from nurses who are participating in fast-track, bachelor’s-degree-to-doctorate programs, as well as long-distance learning programs.

Further, because of the national trend toward community-based, population-focused care, Gary said the MFP needs to continue to bolster elements of its program to ensure that fellows are proficient in areas such as psychiatric epidemiology, diagnostic and treatment approaches, and preventive care.

“We hope that through our strengthened program, more fellows really have a chance to establish their careers and move science to service—and service to science,” Gary said.

For more information on the MFP, contact Janet Jackson at jjackson@ana.org or (202) 651-7247, or go to the web site at www.emfp.org.

Susan Trossman is the senior reporter for the American Nurse, published by the ANA.

Return to the 2004 AJN Table of Contents

Return to the AJN Home Page

Search	Contact ANA	Join/Renew Membership	Members Only	Online CE
NursingInsiderSpecial Offersnursesbooks.org © 2008 The American Nurses Association, Inc. All Rights Reserved Copyright Policy | Privacy Statement