Center Serves Fil-Am Youth as Mental Health Challenges Rise
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Funding provided by the State of California.
Richmond Area Multi-Services (RAMS), Inc. Staff and volunteers (Source: RAMS, Inc. website)
Gail Kong: RAMS has worked for decades in many (Bay Area/San Francisco) Asian communities. Is it correct that you received a government grant just to serve Fil-Am youth?
Angela Tang: Thank you. Founded 50 years ago, RAMS is a nonprofit agency that offers culturally responsive mental health counseling, prevention and early intervention services, job training, and training of mental health professionals. Serving over 12,000 individuals in over 30 languages with expertise in serving Asian American and Pacific Islanders (AAPI), RAMS clients are the most vulnerable--from preschool to public high school students to expecting parents to adults in residential facilities and families in neighborhood centers.
We know there is a critical need as one in five adults and one of six children experience mental health challenges nationally. There are multiple barriers to accessing care including stigma and workforce shortages. Still, the right combination of treatment and support can help many people recover but only with culturally responsive and accessible services.
Here are two examples from RAMS. In 2013, advocacy by a collaboration of organizations and community leaders, the Filipino Mental Health Initiative of San Francisco resulted in funds to hire a full-time Filipino and Tagalog-speaking mental health therapist and a part-time peer counselor. The next year a second project started in partnership with six AAPI nonprofits to serve the Cambodian, Filipino, Laotian, Samoan, and Vietnamese communities offering mental health outreach, screening & assessment, wellness promotion and linkage/referral. A study showed these communities had the greatest need for service.
Is it unusual to receive a grant specifically to serve Filipinos?
Yes. Overall, there is not enough funding and resources to meet national needs. On top of this, there are studies that show severe underfunding of Asian American, Native Hawaiian and Pacific Islander (AANHPI) communities and nonprofits. There are some grants to serve Filipinos, but there are not enough.
For example, RAMS’ funding to expand our children services department was unique in that it prioritized serving families of Filipino heritage at designated schools (Bessie Carmichael School, Longfellow Elementary, Burton High School) and community centers (Galing Bata Childcare, Filipino Community Center). These sites had a large number of Filipino students, who did not have enough services available to them.
What kind of activities and services were you offering?
We served children, youth and families who attended the targeted schools and community centers prioritizing families of Filipino heritage and who may not have other resources available, e.g. private insurance. In addition to what I described above, we also did mental health assessments and therapy (individual, group and family), on-site at the school or community center. We adapted to serve the Filipino community by engaging Filipino elders, community organizations, school principals/counselors and other trusted community members to introduce our staff to their families.
The new project’s mental health therapist and peer counselor were of different ages and one was a parent (to reach other parents). Creating safe spaces and holding cultural events and group activities helped children and families learn about mental wellness. Students with poor school attendance were a priority hoping for a return to school and/or feeling safe to leave their home and come to our outpatient clinic.
Were you able to assign staff of Filipino heritage to the project?
We had to cope with staff recruitment issues. During the project’s nine years, funding could only sustain the therapist (not both project employees). We retained the peer counselor by transferring them to another RAMS program. But the biggest problem was staff turnover, because there is always a lot of competition for these valuable, trained staff. The challenges of recruiting and retaining bilingual mental health counselors is made worse in high-cost urban areas such as San Francisco. Moreover, there are not enough Filipino American therapists to meet the community need. This all resulted in having a vacant counselor position for an entire year.
What did you learn from that experience?
We learned more about how to effectively reach the Filipino community and to focus more on raising awareness about mental health and wellness. Besides RAMS program offices, we need to be in places where the community naturally gathers–schools, cultural centers, faith-based centers, and to do home visits. RAMS had some success making connections with children and families--promoting ways to support wellness such as practicing coping skills, learning the risk factors of stress, and signs of anxiety, depression and other mental health challenges among different ages.
Generally, for all of our school-based work (even in other schools), we sometimes face challenges in getting “buy in” from administrators and teachers who may not be willing to excuse a student from class in order to have a counseling visit because, that same student, may also be behind in their academics. There are also varying levels of awareness about mental health needs in the classroom. Some staff may make referrals for students who “act out” (more outward disruptive) over students who may “act in” (inward and quiet) even though both might need help.
Having the flexibility for our counselor to physically go to where the clients are located and being able to do outreach & awareness are key – there are times when a student may not have attended school for quite some time. Once our counselor visits the home, they may learn that the youth has not left the bedroom for several days. Many youth could have benefitted from mental health services during the first signs of distress (sometimes going back years) but families may not have known what or where to go and then symptoms escalate.
Angela Tang, CEO of RAMS, Inc.
Students pursuing advanced degrees in areas like psychology, psychiatry and social work must always complete a field-based internship (similar to residency programs for physicians). RAMS is the one of the first organizations in the country that is an accredited placement with a specialty working with Asian ethnic groups helping to close the diversity gap. What has been your experience with students of Filipino heritage?
Training the next generation of mental health practitioners is one of the pillars of RAMS because of the significant need for more AAPI providers. Throughout the years, the agency has been able to attract students of AAPI heritage from across the country because of our specialized training and reputation for culturally responsive services. As such, we have hosted interns of Filipino heritage; however, there is still a great need for AAPI practitioners, including Filipino and those who are bilingual.
What would you like people to know about these educational programs, how long they take, the nature of the field experience? What kind of degrees and certificates are conferred? What kinds of jobs do people get, i.e. where are they likely to work?
With many career path ways, mental health education and training can range from high school diploma (or GED) and certification to a college degree that can be a bachelor’s, master’s, or doctorate. For example, Peer Counselors are those with personal experience (including a family member) with a mental health challenge. To become a certified peer counselor in California, there is an 80-hour course and exam.
With a bachelor’s degree in psychology, social work, counseling (or related discipline), job roles can be case managers, substance use counselor, vocational rehabilitation counselor, outreach/intake, and more. To become a licensed therapist, a masters or doctorate degree is required along with post-degree clinical experience and examinations. Job settings include nonprofit agencies such as RAMS, schools (preschool through college), hospitals, government, and private practice. Some pursue community organizing or policy work and take on legislative positions (including with elected officials!).
While financial and time commitments might seem big, there are scholarships and student loan forgiveness programs to help. The peer counselor in the children and families program was a graduate of the RAMS Peer Specialist Mental Health Certificate course. At the time, there was a scholarship funded by the Philippine International Aid for students who were Filipino. This enables more individuals to be trained in the field.
In general, anyone who is interested in the mental health field can explore through volunteering, talking with different providers in the field, and certificate programs to see if this is the right match.
“We know there is a critical need as one in five adults and one of six children experience mental health challenges nationally.”
What would you like people to know about these professions? Why and how are the jobs rewarding?
A career in the mental health profession can be incredibly rewarding. There is a feeling of purpose and meaning because you are positively contributing to our community and making a difference. It’s almost like a “calling” and does not feel like “work” for the sake of work. There is a sense of honor and humility in gaining trust by community members. I know this is what motivates many providers in this field and what helps keep us moving forward despite the setbacks and challenges within our society. We hope to build a better world, together.
How is working in an Asian community organization different from a mainstream setting?
A mental health provider who is interested in serving the AANHPI community, who then works in an organization with that population focus, can lead to more shared collegial experiences, developing new strategies and ideas for treatment approaches. It can encourage the sharing of cultural history, experience, languages. Staff may together discover clinical practices that are culturally informed, while incorporating native/indigenous healing practices. In addition, staff may feel empowered to be advocating for the same communities that are close to their hearts.