Marya Endriga

Asian and Pacific Islander Americans (APIAs) are a diverse group, representing many cultures of origin, a range of immigration experiences, and varying access to economic and other resources. Despite stereotypes such as the "model minority" and cultural values that stigmatize mental illness and complicate mental health help-seeking, APIAs' psychiatric rehabilitation and recovery needs are significant. These needs are inadequately treated within existing systems of care. Passage of California's Mental Health Services Act (MHSA) in 2004 created the opportunity for Sacramento County to fund a full-service mental health clinic designed to meet the needs of the APIA community. The process by which this clinic, the Transcultural Wellness Center, was conceptualized, advocated for, and launched is described. This clinic is considered a best practice model within the MHSA system redesign effort.

Do the many feeding problems associated with isolated cleft palate (CP) and cleft lip and palate (CLP) adversely affect the emotional bond between mother and infant? This question was addressed by observing the feeding interactions of 126 mother-infant pairs (57 infants with CLP or CP) at 3 and 12 months of age. Infants with CLP were found to be less communicative during feeding at 3 month than comparison group infants. However, by 12 months, the CLP group had improved to a level indistinguishable from the CP and comparison groups. This change was unrelated to the timing of cleft palate surgery. Although maternal sensitivity during feeding at 3 months did not predict the attachment quality of infants with clefts, maternal sensitivity at 12 months was concurrently related to attachment. Change in maternal sensitivity between 3 and 12 months was also predictive of attachment in the cleft groups, with mothers of avoidant infants showing greater attenuation in maternal sensitivity than the mothers of secure infants.