#811 (Mental Health); Images/Imagenes

I. Hope. Whether Iraq will be to see that I want to report to you about. The meaning of the need and the aid effort in this I can see us at the top of the list for the US. OK what we're going to do today is finish up the project that we've been working on. For those of you who are just joining the group let me tell you that what we do in our therapy here is to start with a problem. And one of the ways we work on the problem is to think about it as an opportunity opportunity for growth. And sometimes while you're in the growth process it feels uncomfortable. We were talking about the fact that sometimes you start out feeling like you were a I've been all alone on a cliff and we were talking about different ways of coming down and different ways of being together. And the first. Thing that. That.

We saw was that you had to be willing to come to any kind of a time when on the earth as a man and this. They says similar being with us only that you were more than a foot in the monied us they they said but especially the young to be so numb don't you dumbass on the one hand and once we were willing to come down various people came here and people came and drew their ideas for how to make a friend come o say I say when you go through them to get into he will think almost I don't know me. You forget when i'm being done going up. What we're up to now is we have our friend in our group. Signora and thus a man I saw in slipping though is that of the dog she has left her house the other host Gus. Right now how does she get to the next place. Some of us is perhaps what you need to go from this place where you are by yourself to the next place to look at the misery that he saw in them but a little bit of this and let us you know going to

find that he and. What you have to do with it could be either one of the other. One unicorn going to the gate us going to the moment with a lot of old. Some movement is from concept and we feel that if you need Could you give us a definition of mental health element of someone's mental health would be their ability to function independently in daily living. The ability to cope with crisis and stress in every day life and knowing when to use what we call your natural support systems your family your friends coworkers on a job and it's having a general sense of self-worth or self satisfaction the problem is that mental health is in the eyes of the beholder and a lot has to do with the cultural context that you're talking about a particular type of behavior could

be defective or valuable depending on what perspective you're looking at it from. So I think in talking about Hispanics in mental health it's important to keep a cultural context in mind for behavior. The Spanish population is less attuned to psychological services they don't think in terms of going to a psychologist or a psychiatrist with the kinds of things that many people do seek help for the kind of things that you would call existential problems. Where am I going what am I doing with my life. Do I want to stay in my marriage. That kind of question so that I think it's a question of education then but people get used to. Hispanics are unique in the sense that they're dealing with a cultural conflict in many cases where you have a family coming here from another country from Latin America Central America

Mexico the island of Puerto Rico. And you find that the parents have a certain way of looking at life and they want their children to grow up and and and develop the kinds of values that they were brought up with and the many times these values clash with the values in the United States and causes problems of communication causes tension between the children and the parents generally a very good sentiment but it's just room for my most recent one you know said. That reporter noisiness I didn't mean to come into the system looks better than it. Labor yet a lot of the biggest settlement Ellis was at that event in their system you can look it up but it got posted to see anything interesting went on on the limb. She'd just seen it because on the feeds today it didn't get much of that but I guess getting them into an onion to perceive people in society but I think personally that people are fortunately for

him I like I said pretty much much more nimble see hook at a lawful and decent of you also put your address into SEO and then M.B.A. things but behind you that's sort of a solid corporate entity some hard social stress is just not randomly distributed in society at large that it impacts it affects some groups more than others in general to the extent that you are a minority person. Different culture a different language. At the bottom of the social stratification heap the magnitude of the environmental stress that impinges upon you is greater and greater. Significantly more than other subgroups within the population. There are approximately 7 percent of people in community mental health services in New Jersey are Hispanic. Which compares to its almost comparable to 6.7 percent of the entire population in New Jersey that suspect and I inmates has given us a standard that

says that if there is more than a 2 percent incidence of a minority group in the population they're considered a significant minority. And really services to a target population should not even just be at the incidence level. It should go 10 or 20 percent above that. So although New Jersey is slightly above the incidence level we really have a ways to go to treat Hispanics as a real target population. You made an interesting comparison comparing the number of Hispanics who serve with a. Percentage of the population right now. She's priming So usually in lower socioeconomic status you know we're educational levels which that will increase their their possibilities of needing such services. They would not increase the rates of patients that should be served. Shit that's why I said the standard should be 10 or 20 percent above incidents because they're much more at risk. There have been consistent findings that the

lower your socioeconomic status is the more you're going to have mental health problems. And I think when you add to that the stresses from migration and being in a dominant culture that makes demands that you're not used to it adds extra stresses. So to say that we're doing all right because we're serving the number of Hispanics that are in the larger population we have to go much further than that. See we're talking about London way too yeah I. Don't have the land so we can't get anything we want to. Get him. What is he going to do you know there was a couple in the book that. We can put new pants. We can start thinking about what we want to take with us from our old land. Someone you notice put in on the Cuban flag because that's something that there I was part of your identity. You don't want to leave all of it behind though he supported the hold on that over there he

said to God we're going to put it on those who buy the guy looking within to different things but I will remember to do. Better. Graphic the last problem then. Even in erroneous thinking.

And I would think that this study indicates that the U.S. should. The color issue place to keep holding these people that will relate to people. This is particularly well pointed out in terms of the likes. That most blacks for example get sent to prison for example get sent to state hospitals. To Frank. So the comedy show has to be taking notes. And I would speculate that it's the same with spandex particularly if they come in and they cannot communicate or speak with an accent. Oh you think English is very broken. Feeling. Sorry for you. Because I mean for people that will be going to the hospital.

What are some of the reasons for your utilization of mental health facilities. That's a question that we need to find some answers to. We're going to begin to provide effective mental health services to respond by pollution. There have been a lot of studies done on the fact that if white middle class therapists have negative feelings about treating either lower income people or minority people it comes through in their therapy. The client is not as comfortable of the negative expectations lead to a self-fulfilling prophecy and clients especially Hispanic clients that get to a mental health center often drop out earlier than other clients before they're finished with treatment. So I think the system has to do several things we have to do more outreach into the community instead of making people in need come to a center with unfamiliar staff we have to get the staff to go out into the community

meet people in community centers that they're more comfortable with go to their homes have either paraprofessionals or professionals that speak Spanish that are familiar with the culture so that people won't feel as alienated and judged in terms of their culture let alone their or their perceived mental health problems. Another aspect that has made a distinct difference in certain centers is to prepare and train the clinicians to know what to expect from their minority clients. To understand more things about the static community and research findings have shown that the clinicians that are trained in that way. Do a better job. They're able to establish better require the client stay in treatment longer. And the outcome of the treatment is much more positive. In a moment when you can

get another Vietnam in Jersey City and get another Vietnam. Many of the veterans that we see in the inner cities as well as the rural areas many of them suffer from stress they suffer from problems health problems. They suffer from alienation of feeling between their wives and their whole families stay they have unemployment problems because they have acting out problems where they where they have explosions on the job which is cause them trouble and then they become unemployed. That I already knew and had examined by medical center overnight. If you know he has said more loss and the only guy you're going to sign you want to call it the program once again was a good boy him blow air castles Seattle I mean it isn't there that I'm getting that winning out equal and going to get my cause I can see and play you know 100 out

of four people that something there oh no I said no. Through the help of the Bradman who come here at the station they can they can talk to one another and face one another because they know they've been through similar atrocities and through and had to overcome similar. Barriers since they've been back and through this feeling they can brace one another. The stress was lowered just from that fact and then they came through individual counselling. They can re read develop their whole lives by stablish treatment plans for them and then we help them find jobs find work. Someone might be movie going much as I do not get it we're not in there now you know they looked up at me like oh you know not until someone breaks but I thought and then I said my God you have as a woman I mean my well not be like you without a month then you're going to think that I have paid for there long but I think neither do one thing specially we're very concerned about the veteran and how we how he treats his wife this

is a most big issue with us. OK. And we want that veteran to understand that he can live in life that he can hold down a job that he can treat that woman well. It's his best resource and he shouldn't be hurting that person. OK. Which he does which he tends to and it's a big job it's a big job dealing and delving deeper into the emotions and trying to re patch especially something that has been inside them for over 12 years. We're experiencing another stressful problem especially now in 1981. In addition to what happened 12 years ago in addition to overcoming the stress that they felt you know from Vietnam and all that what's happening in America now with the with the cuts and with the clothes and then the seat is and people are not able to. People who we're told now that they have to go into the private sector. There's been no transitory section set up in the community

to assist these people make the transition. From working in the city from being unemployed in the city from being a rougher in the city. How are they supposed to get these jobs in the private sector. Well these cuts are coming and the cuts are coming of welfare the cuts are coming in food stamps the cuts are coming across the board at our own center is under the threat of being cut. After after the congressional mandate was passed that we would be here for three years that we're even being threatened by the car. But there is a chance in the veterans feel the probably we won't get cut. But still this is going to cause panic. This is going to cause a lot of stress we anticipate a resurgence of the stress more acting out behavior more stressful situations more domestic problems in the house people fighting and screaming and whatnot and we're going to see this we're going to see the Senate vet centers and America's going to see it in the streets of America you know I look at that AK. I have not been ok so I don't know where they are going with Bertha and my no. But even more sad look I say Oh but I get about this about I gotta go there if they are not

about going to the gas I guess I'll have your Night in them but I don't know if you don't get in there who can help it grow they feel iffy about it I'm going to look at you know what they thought of when I get out of town make a bill. Look and if they think that if I do that right now you get that Mark you don't give us a really good kick on the thought that all the sentiment and then. I do nothing legal. Here the people are

going to be. The second your hand see. What are you. What I mean to say you have a group of their profesional is different as the seaplane us in the same category. This state up East us interact and care of the family leave you go for my lack of interest problem. But also can be everything a society in the last year no problem. You're lucky cause you

made the comment she said and I think that is a plain yes. I think that there is a shortage of staff I know that we have. Had to work very hard to find competent and qualified bilingual people by and large when we need to fill a position in the center. At least since I'm here. The rule is that we. Really. Will seek a bilingual person first because after all a bilingual person can serve both our English and Spanish population. And we speaking person can only serve one of that group. I. Missed the envelop a sauna and look at that I have seen in facilities for the mentally retarded not in this state but

in another one where there were just a lot of Hispanic people in the facility that were given IQ tests in English did very badly and were diagnosed retarded and put into an institution. So if we can't develop one that's culturally sensitive. I feel that we shouldn't use them and we should try to use other assessment that you can assess if you will those tests are not designed to a Hispanic population that they are not and they have been at the center of this question for a number of years their standard rice and the general population are not standardized. For me talking with. You

represent the problem. In the Hispanic family the roles tend to be better defined than they are in the Engle family. The rows. Tend to be more open to negotiation between husband and wife parents and children. In Hispanic traditional families the roles tend to be more clearly defined so that it becomes a family Sora big that provides a chance for the family to come in and say this is what we are these are our values and now help us with the way we see the way our life should be. You know rather than getting rid of our traditions in family therapy you're going to be saying I'm going to try to help you to help yourself

but I would also be trying to help your family to be of help to you. One of the last time you say just say anything I don't quite get it would go to and I think with an M&M they don't want to sit and rest like most of us would you know probably a month in advance you only for your by the will of yourself. So you're going to tell just when just before they must have heard of it you know just how we must unite and you know or the postal system worked on the DNA stuff a city that is used to get the operation of a book at the end of the month and it is so boys don't mean to embody a lot of change when the dust of the home. I mean the first I don't know whether for certain you have to understand the culture enough. To find out how is the Hispanic father expresses emotion for the child and how does he

allow and encourage the child expresses emotion to him. OK. I spend a son may very well kiss his father and father may very well kiss his son with an angle father wouldn't do although they may not talk about emotions in the same way you have to understand the culture and value the cult in order to be able to do so with the Hispanic vote. I think that we're weak beginning to talk about now. He's talking over units of family or structure so family family in process. Functional family at a specific time in history when the individual needs. For example the elderly might need a family. So what age 65 75 80. There's more need for the family. But in a year 21. Or an infant needs more of a mother. At the first years of life than during the latency or a month I see them like that Aloha sandals

on Hudson County. Yes you look at the way that this Botham does. Yes I'm going to sit on this and I thought in mass at this time of the cigarettes I mean Gross has been there but saw him as can be anybody can go and see Lois can they kind of discount at the end of a million putting him when I think of you. Which are for you. I came to Dan Senor the last thing you're a man this sort of mother tongue does for me ask you you've gotten a lot of stars for me those two aren't the literacy and the me that I see on my see by the referee school bans this was ever possible single misses in one camp or the ref. Yeah those are you know people have sallied people do you know. But I'll say member of the La Familia. Yes I don't think Sam was

another. This idea will be ACLU. Yes he gave me no examining me. I see you but I think you said you know the way to find your problem asking politely. Yeah CSO in. One day I'm on. The right. I was at all unlike you I CAN THEY DOn't KNOW YOU THAT nice to me and I'm like no you're up and that means to the point where I need you are you still on the money. Long long chain I said they were going on

though obviously you don't seem to make it all bit up. Landing a bit around I get only knowing you know anything just allowed to go like I say coming out eases in doubt. Yes but over the last I will tell you I live in these you know me I really could have been somewhat of a way of saying. This I think it would be so plain sailing to compose a line in the falling. When I thought I will support me now along with the report of the sort of lost mentality. Yes but I must get out of it is the massive mistake I see on you but I mostly know what people's ears perceive you coming to the senior levels. But I'd love to see you guys in Aussie spaniels love none of us going to Aussie owners with I'm going to say either several yards in my BNP saga.