Designing accessible mental health care in an urban community: Lived experiences of key stakeholders planning emergent community-based services

Disparities in mental health care between African Americans and Caucasians have increased significantly since the 1990s, and social determinants such as poverty, access to resources, education, institutionalization, and housing status can have an additional negative influence these disparities (Hunt et al., 2013; McGuire & Miranda, 2008; Primm, et al., 2010). This suggests that further research is needed to identify and examine the "malleable barriers," that is, research that better explains the pervasive racial disparities in the current healthcare system. This community-driven phenomenology-oriented study employed a multi-method approach, primarily the consultative workshop method (Levers, 2003), a form of participant action research, to describe the lived experiences of urban key stakeholders' experience of community trauma and barriers to healing and recovery.;These exploratory research findings suggest five main contributing risk factors/themes that inform a better understanding of community trauma and the help-seeking process. The five factors/themes are stigma, chronic community violence, social determinants, racism, and transgenerational or historical trauma. The inquiry aimed to capture the lived experience of community trauma in an urban environment. In doing so, the investigation found that the collective and overt nature of multiple types of traumas, as experienced across the life span, can be understood more fully from a community context. This study proposes a new model for addressing the needs of a racial/ethnic trauma-informed community. Adding to the current trend of "integrated care" and "trauma-informed approaches," the idea of community development was integrated into a trauma-informed approach. The trauma-informed community development strategy produced from this study suggests a paradigm shift from focusing behavior health interventions solely upon the individual, to focusing interventions on the environment, in order to mitigate the effects of community trauma and to build resilience.