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Frontline ReportsFull Access

PASS: A Behavioral Health Care Program for Culturally Diverse Youths and Their Families

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The Prevention, Access, Self-Empowerment and Support (PASS) program provides behavioral health support to youths ages 13–18 and their families. PASS began in 1997 under the New York State Community Reinvestment Act of 1995, receiving funds from savings accrued from the reduction of state-operated inpatient care. At a focus group to determine the needs of individuals of color, families in which there was a parent with a severe and persistent mental illness shared their concern that their children were often placed under children’s protective services for supposedly inappropriate parenting behaviors and that no services were available to help ameliorate the situation. Families and service providers designed PASS to address this gap. The program continues to receive state funding and is sponsored by the Monroe County Office of Mental Health and managed by Coordinated Care Services Inc.

PASS serves youths who have behavioral health challenges or who have a parent with a psychiatric diagnosis. The program augments instead of replaces any current mental health treatment of participants. They are referred by schools and clinics and, often, by former participants. PASS uses a two-tiered mentoring approach, with adult mentors who reflect the demographic makeup of the families being served and have prestigious community roles, e.g., lawyers, teachers, and firefighters, and adolescent peer mentors who are graduates of the program. They assist participants in applying strategies learned in the program. PASS offers annually three weekend workshops for youths (3.5 days) and one for caretakers (2.5 days). After workshop completion, the program continues with 12 months of mentoring and support for youths and caretakers delivered by phone; e-communication and social media; and a monthly 1.5-hour support meeting for caretakers at sites local to them, which is supplemented by an all-site teleconference. PASS has served on average 20 adolescents, 30 parents/caretakers, and 15 graduate peer mentors annually. The graduate mentors continue to receive their own program support. Many participants from prior years continue both to receive and provide support to others. PASS staffing is two full-time–equivalent persons, who work with the youths, plus 12 volunteer adult mentors. PASS equally attracts males and females, and on average 50% of participants are black, 15% Hispanic, and 30% non-Hispanic white.

PASS aims to improve youths’ psychosocial, educational, and community outcomes and instill in them accountability for their own lives by taking ownership of behaviors and actions. At the first youth workshop, participants are asked to identify their long- and short-term goals, along with their most inhibiting behavior or habit. Tools and techniques are used to improve self-esteem, self-efficacy, and personal life skills and include repetition of affirmation statements to reinforce that human potential can be unleashed and lead to a life of happiness, creativity, fulfillment, and positive social change. Adult mentors supplement program personnel in delivery of the curriculum, which includes physical activities (e.g., yoga), role playing, talent shows, and rewards for achievements. Music and displayed images geared to youths help create a culturally acceptable workshop atmosphere. Workshops include practical information for communicating and behaving in public and in school. Skills training is provided for applying to college, interviewing for a job, and advocating in the community. The caretaker workshop provides caretakers with tools and supports to better communicate with their children and to connect with community resources. A structured cultural competency training module is delivered at first workshops, emphasizing the program’s commitment to openness and respect for persons from diverse groups. The final weekend is a celebratory graduation and launches a year of formal follow-up activities.

In its 22nd year, PASS has evidence of success gathered through participant interviews, program evaluations, and small studies that show positive and sustained impacts on youth behavioral competencies. PASS works to create a safe and accepting “village” in settings different from school and youths’ neighborhoods. It is delivered by committed personnel, by senior mentors who endorse the importance of strong mores of community living, and by junior mentors who understand their peers’ challenges and speak their vernacular and who demonstrate that it is possible to feel comfortable in a world perceived as not representing their culture. Programs like PASS are suited to communities of color because the program features have been adapted and molded to fit the community populations they serve.

Cultural Competence and Health Equity Department, Coordinated Care Services, Inc., Rochester, New York (Reid-Rose, Morris); New York University Langone School of Medicine, New York City, formerly at Nathan S. Kline Institute of Psychiatric Research, Orangeburg, New York (Siegel).
Send correspondence to Dr. Siegel ().