Culturally Appropriate Services Help Families Cope With Mental Illness
or more than a century, many different
Asian and Pacific Islander groups have
immigrated to the United States and
settled in the San Francisco Bay Area.
Many came in search of jobs in agriculture or industry.
Others arrived as refugees, fleeing wars in their native
countries. Despite their different histories and
experiences, these groups experience many issues
such as stress caused by poverty, intergenerational
conflicts around assimilation and, especially among
recently arrived refugees, post-traumatic stress
disorder. Access to
mental health services
is important if
communities are to
address these problems.
Since it was
established 30 years
ago, Asian Community
Mental Health Services
(ACMHS) has provided
to thousands of Asian
Americans living in
Alameda and Contra
Costa counties. While
Chinese Americans and Cambodian Americans are
the most frequent clients, ACMHS’ services are
provided to many diverse Asian communities in the
Bay Area – in 13 different languages.
In January 2003, TCWF awarded ACMHS a
three-year, $150,000 grant to provide mental health
services to Asian youth and their families. With this
grant, ACMHS is looking at ways to integrate its
different programs to improve the effectiveness of its
services. For example, by improving information
systems, the agency will be able to see how its
various programs may be serving members of the
same family. Another effort is ACMHS’ “no wrong
door” approach to integrating services. They want to
ensure that regardless of how their clients seek the
agency for assistance, they will be directed to mental
health services that best address their needs.
“In many Asian cultures, there is a stigma
attached to mental illness,” said Betty Hong, ACMHS executive director. “It is difficult for
parents to acknowledge that their children are
experiencing these problems. And with different
conceptions of what might cause symptoms such as
‘hearing voices,’ it is not clear to them why coming
here for services could help.”
For more recently arrived groups such as
refugees from Laos, ACMHS has developed
innovative approaches to building community trust
by providing services in nontraditional ways.
Laotian women who have severe clinical depression
bring their children to a community victory garden
for weekly gardening sessions. The gardening
activity sustains links to the agricultural life they left
behind and, to build social support, provides an
opportunity to talk with other participants and
ACMHS staff. The women also learn about sustainable
farming, composting and nontoxic pest control – and
they get to keep the produce they raise.
“We interweave medication compliance,
child-rearing practices and skills of farming to build
self-esteem and self-sufficiency,” Hong said.
Other ACMHS services include individual and
group therapy sessions, substance abuse assistance
and family support programs.
“ACMHS fills a critical niche in the Bay Area’s
network of mental health services,” said Nicole J.
Jones, TCWF program director. “Not only are staff
qualified to provide long-term care, but they are
equipped to address the cultural and linguistic needs
Mental health providers like ACMHS rely
on government contracts for a major source of
funding, despite significant cuts in recent years.
As new policies further narrow the eligibility for
immigrants to access health and human services, it
is possible that fewer public dollars will be available
to support these programs. As a result, ACMHS’
efforts to integrate services and improve information
systems become especially important.