Francisco Moreno

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Scholarly Contributions

Journals/Publications

• Mendoza, N. S., Moreno, F. A., Hishaw, G. A., Saw, A. C., Fortuna, L. R., Skubel, A., Porche, M. V., Roessel, M. H., Shore, J., & Gallegos, A. (2020). Affirmative Care Across Cultures: Broadening Application. FOCUS, 18(1), 31-39.
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  Affirmative practice is an approach to health and behavioral health care that validates and supports the identities stated or expressed by those served. Affirmative care requires the practitioner to actively honor and celebrate identity while at the same time validating the oppression felt by individuals seeking services. Validation and empathy fundamentally result from increased understanding of individuals’ history, cultural context, and lived experiences. Origins of the approach honored the experience of those in LGBTQ+ communities; however, affirmative care should be valued across cultures, systems, and settings in which health and behavioral health care are offered. Affirmative care principles should be applied across cultures and communities while recognizing the worth of the individual and avoiding stereotyping. Along with delineating historical and demographic contexts, the authors offer recommendations for affirmative care in practice with African American, Asian, Indigenous, and Latinx individuals, as well as those living in rural communities.
• Moreno, F. (2020). Diversity, Equity, and Inclusion in Psychiatry. FOCUS, 18(1), 1.
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  People of the United States may debate the value and desirability of American diversity or the global and historical context contributing to national and local variations in racial, ethnic, socioeconomic, and cultural composition. However, the anticipated trajectory of this country’s increasing diversity, as well as the inequities in social determinants, expressions of health, and experiences with health care, are well-accepted realities requiring urgent attention. Everyone experiences multiple elements of identity, which are fluid, intersecting, and essential aspects of our personhood. Given our undeniably pluralistic society, the study and practice of psychiatry requires recognizing the continuum and spectrum of differences and their impact on personal experiences, our different environments and contexts, and their complex interactions. All may influence the individual’s vulnerabilities and resilience, attribution of experiences, conceptualizations of symptoms, help seeking, and outcome expectations.This issue of Focus is dedicated to addressing diversity equity and inclusion in psychiatry. It is meant to serve as a resource to assist behavioral health providers and leaders to best understand and serve a richly diverse patient population that will invariably include individuals with backgrounds, preferences, and needs that differ from their own. Included is an introduction to the topic of diversity equity and inclusion in psychiatry (1) and various well-informed contributions on timely and relevant topics, such as the social determinants of mental health (2); strategies to increase our awareness and recruit our efforts to improve access and quality of care for individuals who are psychiatrically underserved (3); strategies to improve our sensitivity and skill to approach the care of individuals from various identity groups by incorporating principles like “affirmative care,” “trauma-informed care and cultural humility” in the service of those from minoritized communities (4, 5); and an updated critique of the DSM-5 Cultural Formulation Interview (6) and its various elements, inviting a routine integration of this tool to enhance the assessment and planning approach for all individuals.We hope this issue will also serve as a call to action to our individual and collective commitment to addressing the mental health of everyone.
• Moreno, F. A., & Chhatwal, J. (2020). Diversity and Inclusion in Psychiatry: The Pursuit of Health Equity. FOCUS, 18(1), 2-7.
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  The increasing diversity of America requires a workforce that is able to serve the mental health needs of individuals from multiple backgrounds, with a culturally proficient, inclusive, and affirming approach. To accomplish this, clinicians must be mindful of the multiple challenges presented by social determinants of mental health and access to care; the role of culture in wellness protection, mental illness expression, symptom attribution, and help seeking; the impact of provider factors, such as availability and cultural and linguistic congruence and proficiency; and the interaction of clinician and patient, who are with increasing frequency members of differing identity groups. The authors highlight the central role of clinical providers, academic institutions, and service organizations to advance health equity through training and commitment to increase high-quality services that are available, accessible, affordable, and acceptable, improving the care of all individuals.
• Ranjbar, N. E., Erb, M., Othman, M., & Moreno, F. A. (2020). Trauma-Informed Care and Cultural Humility in the Mental Health Care of People from Minoritized Communities. FOCUS, 18(1), 8-15.
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  The prevalence and impact of trauma constitute a public health crisis that is complicated by the cultural heterogeneity of contemporary society and a higher rate of trauma among individuals from minoritized communities. A trauma-informed care approach can facilitate improved treatment of those who have experienced trauma, and trauma-informed care is increasingly viewed as potentially beneficial for all patients. This article outlines general principles of trauma-informed care and ways to enact it. Because the situations in which trauma arises, the ways in which it is conceptualized, and how patients respond to it are influenced by both culture and individual factors, a cultural humility approach is also described and recommended. Psychiatrists can navigate the complex terrain of cultures and social backgrounds in the clinical encounter and can promote healing when treating patients who have experienced trauma by adopting a trauma-informed care approach and an attitude of cultural humility.

Poster Presentations

• Mora, F., Prichard, G., Aldulaimi, S., Pust, R. E., Moreno, F., Stevenson, A., & Gordon, P. R. (2017, spring). “Global Health at the University of Arizona: The Ecuador Program”. Presented by Mora F at Annual University of Arizona South Campus Graduate Medical Education Scholarly Day.. Annual University of Arizona South Campus Graduate Medical Education Scholarly Day..