Q&A with Nira Singh, Director of Behavioral Health
Q: What is the problem or need in the community that AACI is working to address with the KACF-SF grant this year?
A: In Santa Clara County, 1 in 3 Korean adults reported feeling depressed and nearly 1 in 5 Korean middle and high school students felt sad or hopeless for two or more weeks this past year. However, only 1 in 5 Koreans reported receiving the social and emotional support they needed. (Santa Clara County Asian/Pacific Islander Health Assessment, 2017) With KACF-SF’s grant this year, AACI has been able to focus more resources to address the stigma of seeking mental health services, increase awareness about mental health issues, and facilitate access to appropriate resources. We met and collaborated with key community leaders in the South Bay, including religious leaders, Korean school principals, and others in the nonprofit sector already serving the community. They shared their perceptions and experiences of the needs and challenges as well as their knowledge of past attempts to find solutions. We strategized on how best to conduct outreach to the community, and held three diverse events that each provided psychoeducation, addressed the stigma of seeking help, and resources for support. We were able to gather information about the views and needs of the community at these forums to further develop services for the community. Through our Korean-speaking trained therapists, we were able to provide culturally and linguistically competent comprehensive mental health services from children to older adults in the Korean community who are MediCal and Medicare beneficiaries. Ultimately, we hope to increase the number of Koreans and Korean Americans seeking and receiving mental health services.
Q: What are the main challenges to addressing issues related to mental health in the Korean and broader Asian American communities, and what is AACI’s strategy for addressing those challenges?
A: One of the biggest challenges related to mental health in the Korean and broader Asian American communities is addressing stigma. There are still widespread beliefs that mental illness is something individuals should be able to “get over” on their own. Many find the issue of mental health too uncomfortable to discuss and choose to keep it secret, even within their own families. Mental illness is also often perceived to be shameful and even threatening. AACI’s strategy involves collaborating with respected community leaders to support and reinforce outreach efforts aimed at reducing the stigma. We incorporated our learnings from the community into how we advertised outreach events and conducted workshops in the community. We were able to provide psycho-education in Korean about mental health, information on resources available, and education on how to manage stress, to address issues that may effect performance in school or at work, and to advocate for themselves and family members who might be dealing with mental health issues.
Another major issue is the relative lack of culturally competent services with language capacity available to serve the diverse Korean population. AACI currently has two Korean-speaking behavioral health counselors and one Korean-speaking doctoral intern. We hope to be able increase staffing resources as demand increases from the Korean community in the future.
A further challenge is that we contract with Santa Clara County to provide services to MediCal and Medicare beneficiaries and, while we serve Korean Americans who qualify, we currently don’t have the funding to provide a sliding scale fee for direct services to those who have private or no insurance. This is a missing resource necessary to address the needs of a broader range of community members who want access to culturally competent providers.
Q: What do you hope to accomplish over the next few years, building on the progress made so far with regard to the Korean American community and mental health?
A: Our outcome data shows that we have made some shifts in views about seeking help and receiving mental health services. We hope to continue outreach and education, and build upon the relationships both within the South Bay Korean community as well as with the network of KACF-SF grantee partners addressing mental health. Over the next few years, we hope to build our capacity to provide more mental health services to Korean children, youth, adults and older adults regardless of their insurance coverage and ensure that community members and allies are aware of the range of services available to support their wellness.
Q: AACI is a large, well-funded organization, and KACF-SF’s funding has been relatively limited. How has the partnership with KACF-SF made a difference to AACI’s work?
A: The majority of our Behavioral Health services are funded through Santa Clara County to provide direct services. Through the KACF-SF partnership funding, AACI was able to dedicate staff time to targeted outreach and education efforts in the Korean American community to address the very important element of stigma around mental illness. The funding enabled us to apply the expertise of our Korean-speaking counselors to collaborate with community leaders and provide three successful outreach presentations on how to recognize and address emotional and mental wellness. AACI has been asked to continue presenting on this issue at future Korean community events, and we look forward to building on progress made this year.
Q: Besides in the area of behavioral health, what other AACI programs and services are available to the Korean American community, and what would you want this community to know about accessing those services?
A: AACI is a multi-service agency that provides primary care health, behavioral health, and wellness services. Behavioral Health includes mental health, substance abuse, domestic violence, and human trafficking services, in addition to our Center for Survivors of Torture. We know that behavioral and physical health are interrelated, so we provide integrated behavioral health services in our primary care setting. At AACI you can come in and see one of our culturally competent doctors. Our medical staff also understand that due to stigma or lack of understanding, some physical problems (e.g., headaches, stomach aches, lethargy) can have a mental health component underlying it, so they are trained to recognize signs of mental health issues and refer the patient to our psychologist in the clinic. The ability to see a psychologist in a medical setting for non-severe issues helps reduce the stigma of seeing a mental health professional.
In addition to our medical services, we offer patient navigation services. The healthcare system is difficult to navigate for native English speakers, so the situation is more difficulty for someone who is not fluent in English. Our patient navigators help translate patient visits, connect patients to the resources they need (e.g., housing, prescription drug discount programs), walking them to get services at a nearby building, etc). One patient was able to receive the diabetes medication she could not afford because her patient navigator enrolled her in a program that allowed her to receive more than $4,000 worth of medication. Our navigators help close the gap between patients and the services/programs they need.
AACI also provides a myriad of wellness services that benefit the community and promote healthy living, such as senior wellness programs, after-school youth programs, and HIV outreach, prevention, and education services. Our senior services provides potentially isolated senior citizens with a sense of community and belonging. Programs include English and computer classes, free blood pressure checks, field trips, and a weekday reduced-price hot lunch. AACI’s youth programs include lessons in civic engagement, leadership, and arts.
Lastly, AACI offers a domestic violence shelter program — Asian Women’s Home – and other services to individuals and families affected by domestic violence (DV) and facing added challenges due to cultural and linguistic barriers. The program includes prevention outreach and training, emergency shelter, legal and social services advocacy, 24-hour hotline, and a first-of-its-kind multilingual website with information and resources for victims of DV.