Daniel Gonzalez, MD, MPH

2018-2019

Medical Director, MCREW division of outpatient adult psychiatry, Cambridge Health Alliance, Cambridge, MA

Dr. Daniel A. Gonzalez is currently the Adult Psychiatry Chief Resident and a Clinical Fellow at Cambridge Health Alliance, Harvard Medical School.  He is also a service leader on both the Latino Mental Health Clinic and the Gender and Sexuality Clinic and Consultation Service at Cambridge Health Alliance. From 2006-2010, he served as a Research Associate and an Outreach Educator at Fenway Health, a Boston-based community health center whose mission is to enhance the wellbeing of all lesbian, gay, bisexual and transgender communities, as well as people in the local neighborhoods and beyond, through access to the highest quality health care, education, research and advocacy. Dr. Gonzalez is most interested in improving the quality of behavioral health care and patient experience for LGBTQ+ Latinx patient populations. His clinical interests include intersectionality research, LGBTQ+ Latinx mental health advocacy, minority health policy, resilience-focused interventions, and wellness promotion. Dr. Gonzalez received his medical degree from Geisinger Commonwealth School of Medicine (formerly known as The Commonwealth Medical College), Scranton, PA in 2014. 

 

Targeting Behavioral Health Gaps among Latinos in Los Angeles County

Background:

Common behavioral health conditions among Latino communities include major depression, generalized anxiety disorder, posttraumatic stress disorder (PTSD) and alcohol use disorder. While Latino communities show similar susceptibility to behavioral health disorders as the general population, Latinos experience significant inequities in access to treatment and in the quality of care received. This inequity places Latinos at a higher risk for more severe and persistent forms of mental and substance use disorders.   The Los Angeles County Department of Mental Health (LAC-DMH) is committed to treating vulnerable populations, including Latino communities. LAC-DMH is the largest county mental health department in the United States. It directly operates 75 program sites, serving over 250,000 patients annually.  Although LAC-DMH leadership and staff are motivated to targeting behavioral health inequities among Latinos, there is no centralized patient information database that readily identifies patient demographic information or clinically pertinent information regarding their specific behavioral health needs. As such it is challenging to develop and implement robust interventions that will address the behavioral health inequities on a population level.  The purpose of this project is to gather LAC-DMH Latino patient information that will assist in developing potential behavioral health initiatives at the county level to address behavioral health inequities among Latino populations.

Objectives:

1.  To provide general patient demographic information and behavioral health inequities among Latino adult (18+) patient populations served by the Los Angeles County Department of Mental Health.
2.  To gather qualitative information from meetings with affiliated behavioral health experts, clinical providers, policymakers, and administrators regarding the challenges to providing behavioral health services to their patient populations.
3.  To report potential behavioral health initiatives at the county level to address behavioral health inequities among Latino populations. 

Methods:

1. Gathered existing Los Angeles County reports, and organize and provide information regarding patient demographic information and behavioral health inequities among Latino (18+) adult patient populations served by LAC-DMH.
2. Constructed an interview guide, and collected qualitative information from meetings with key informants. Analyzed data through coding and identified salient themes.
3. Reported potential behavioral health initiatives at the county level to address behavioral health inequities among Latino populations.

Results:

Both patient demographic information and qualitative data highlighted two important barriers to quality behavioral health care:
1) Lack of communication and coordination across LAC-DMH sites; and
2) Fragmented care between primary care and behavioral health services.

Future:

1. Evaluating the efficacy of enhanced interoperability of electronic medical records to enhance provider communication and coordination of services across sites.
2. Collaborating with local academic institutions, such as Charles R. Drew University of Medicine and Science, to expand training and clinical opportunities in Los Angeles County.

Preceptor: James Corbett, MDiv, JD, Initium Health