3 Ways Culturally Specific Mental Health Services Break Barriers to Community Treatment
Working as a social worker for over thirty-five years with people from all backgrounds, I have witnessed firsthand the struggles individuals face dealing with mental health issues – particularly among immigrant and refugee communities living in America that rarely discuss mental health. Culture and language, compounded with a complicated health care system and disparities in income, education and housing all add to the existing, often debilitating symptoms of mental illness. However, a holistic, culturally responsive approach to mental health services can be designed and implemented to meet community-specific cultural and social needs that puts immigrants, refugees and their families on the road to recovery and long-term stability.
Take Assertive Community Treatment (ACT), an evidence-based, rehabilitative practice developed to improve outcomes for adults experiencing severe and persistent mental illnesses who are most vulnerable to hospitalization. Often referred to as a “hospital without walls,” ACT is one of the most intensive, highly integrated and culturally specific community-based services offered by Wilder. What makes ACT at Wilder so unique is that it is led by the only multicultural and multilingual team in the country that specializes in supporting immigrants and refugees from Hmong, Karen, Vietnamese, Cambodian and other Southeast Asian communities in Minnesota.
Not only do we have to overcome cultural challenges, societal isolation or stigmatic resistance to seeking help, but also break down the barriers to mental health treatment for our diverse communities in the following three ways:
#1: Overcome barriers to communication by employing mental health practitioners who can speak the languages and understand the cultures of the individuals being served.
Mental illnesses can be viewed as an imbalance between the physical and spiritual worlds among Southeast Asians we treat. Use of psychiatric medications can be frowned upon and sometimes a shaman may be viewed as a more appropriate option for treating mental health issues. However, with a culturally responsive team that is familiar with communal beliefs and values, the likelihood of developing a trusting relationship increases, as well as getting to the underlying issues, tragedy or trauma that may have otherwise gone overlooked. Relatable cultural perspectives, and even shared experiences like relocating to the U.S. from a refugee camp, can help overcome any obstacles in communication and interaction between mental health practitioners and individuals being served.
#2: Increase access to connections beyond mental health with a multidisciplinary team for a holistic approach to health and wellness.
Symptoms of mental illnesses can lead to serious functioning difficulties in health, work, relationships, residential independence and even money management. By working together on customized, appropriate solutions with individuals and their families, mental health support is coupled with primary care, substance use treatment, peer specialist support and connections to community resources, like Southeast Asian support groups at the Wilder Center for Social Healing. Additionally, case managers and vocational specialists assist with health insurance and benefits eligibility and also provide access to social and human services like housing, employment, education and transportation.
#3: Meet clients where it is convenient and comfortable for them to continue their mental health treatment.
Building relationships with clients and their family members using a team approach is instrumental in ensuring comprehensive care and continuous recovery. But, let’s be honest, clinics can be intimidating and even overwhelming to individuals already dealing with symptoms of mental health issues, especially having to make that trip when transportation may also be a challenge. Whether at their office, in their home, or any community settings, social workers, like myself, and our ACT team meet clients wherever it is most convenient and comfortable for them.
Mental health services that are rooted in an understanding of culture and language of a particular community help first generation immigrants and refugees served as well as practitioners working on the best possible treatment. Healing becomes culturally informed and individuals stabilize and see themselves as part of a larger society. This holistic, whole-person and whole-family approach to mental health gives providers a chance to continually learn and improve their services that culturally specific communities can count on. One client who is estranged from her family dials our on-call number each evening to say goodnight since to her, “we are family.”
Barbara Williamson, MSW, LICSW, is the Team Lead for Assertive Community Treatment at Wilder Community Mental Health and Wellness.