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residents to access services for any of the <br /> listed disorders (Major Depressive, Generalized <br /> Anxiety, Bipolar, Personality, Eating, Substance <br /> Language/Cultural-#3 Gap (cont'd) Abuse, or Schizophrenia Spectrum),making <br /> this the #3 gap identified in the survey. There <br /> is need for more diversity in the languages MH <br /> and SA services are offered in (i.e. Spanish, <br /> Burmese/Karen...etc.), as well as cultural <br /> competency training to help providers better <br /> understand how to work with <br /> refugee/undocumented populations. <br /> Culturally-relevant practices that provide <br /> support for LGBTQ teens are also needed. <br /> Education to combat stigma (adolescent Awareness initiatives in the community are <br /> and family) -#4 helping combat the stigma associated with MH <br /> conditions. More could be done to continue the <br /> dialogue encouraging people to seek <br /> appropriate treatment. Parents also need to be <br /> educated about the importance of ensuring <br /> their child gets the help they need. Barriers <br /> exist where parents are either unaware of the <br /> importance of taking their child to <br /> appointments or have busy schedules that <br /> conflict with their ability to do so. Knowing <br /> how to navigate the Cardinal system and <br /> properly enroll their child in MH and SA <br /> services is a barrier to accessing treatment. <br /> Post-diagnosis maintenance of care -#5 Non-emergency treatment options are non- <br /> existent or scarce. Psychiatric care in particular <br /> is a critical need for adolescents yet this type of <br /> therapy is largely unavailable to this <br /> population,especially if uninsured. In general, <br /> there is a need for more varied types of <br /> therapy(i.e. cognitive behavioral therapy, <br /> other types of counseling), as well as therapists <br /> trained to do trauma work both in the school <br /> systems and in the community. <br /> Preventive/Early intervention care-#6 Preliminary efforts to incorporate MH services <br /> into the school system are showing success. <br /> More robust systems for identifying issues <br /> earlier within the primary care and school <br /> settings are still needed.There is also a need <br /> for more variety of screening tools. <br /> Citizenship status-barrier identified Cardinal Innovations does not provide <br /> through stakeholder interviews and survey behavioral health services to residents without <br /> responses proof of US citizenship.Undocumented <br /> immigrants have to rely on the scarce services <br /> provided by other community organizations. <br /> Inpatient Care Usage/Access-barrier 2009-2015 UNC Hospital data obtained shows <br /> identified through stakeholder interviews that after an initial decline in mental health- <br /> and survey responses related Emergency Department(ED)visits <br />