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Pioneers in Latino Mental Health Part 1

Wednesday, April 16, 2014

Pioneers in Latino Mental Health, Part 1

Dr. Miguel Valencia, Ph. D., Director of Mental Health, Gardner Health Services

This is the first in a series of blogs about Gardner’s Mental Health services and how we are working to reduce the stigma associated with mental illness.

The story of Gardner’s mental health services dates back to the passage of the Community Mental Health Act of 1963, which provided federal funding for community mental health centers. Its purpose was to help move mental health services into the community, away from being offered almost exclusively in hospitals and other institutions.

Over the years, community-based mental health services did begin to flourish but not to a level that was adequate for the numbers of patients who were transferred out of institutions. In addition, certain segments of the population were left out—specifically, the ethnic communities. Their linguistic or cultural needs weren’t considered when developing community mental health services.

In 1976, while I was working on my master’s degree in clinical community psychology at San Jose State University, I took a course in community psychology. One of the requirements was to volunteer with a community agency in order to receive field training. This is what brought me to Gardner Community Health Center. At the time, Gardner had a medical clinic, a WIC program, and dental services, but no mental health services of any kind.  

Along with a group of other graduate students, I researched the current mental health system of Santa Clara County. We found that about 3% of the clients were Latinos although the proportion of Latinos in the general population at that time was only about 11%. This was a very significant discrepancy. And as we studied the community in the Gardner district of San Jose (west of downtown), we found that Latinos were experiencing high incidences of cultural dislocation, low self-esteem, depression, substance abuse, violence, family conflicts and disintegration, and mental illness. However, there were no specific mental health programs addressing their needs.

It became our mission to create an outpatient mental health program for Latinos. When Latino clients of Gardner’s medical clinic showed symptoms of depression, anxiety, or any psychosomatic disorder during their regular medical appointments, they were referred to us. We called our program, Centro de Bienestar, or Center of Wellbeing, and it became the first linguistically and culturally appropriate mental health program for Latinos in Santa Clara County.

However, we were just student volunteers completing the practicum requirement for our degrees. We wanted to make sure the program could become established in the community for the long-term. After extensive proposal writing, we were able to secure funding from the State of California to hire a staff person to direct the volunteer clinicians’ efforts and for a community mental health worker. That is how mental health services at Gardner began.

In my next blog, I’ll explain some of the pioneering work we did to educate the Gardner community about mental health and how our efforts have influenced other agencies in the county.

The Value of Community Health Centers Part 2

Friday, February 28, 2014

The Value of Community Health Centers, Part 2

Dr. Constance Tucker, Chief Medical Officer, Gardner Health Services

 

As a community health center, Gardner is dedicated to serving anyone who steps through its doors. We are constantly seeking to improve the quality and accessibility of the care we provide. At the same time, we are also working to improve our efficiency and cost-effectiveness.  Most of us are not used to thinking of health centers such as Gardner as sources of cost savings and even economic growth for the communities they serve. But new research about the fiscal impact of our work has shown that health centers generate significant returns on investment.

The most obvious "pay-off" is that community health centers reduce the need for costly emergency room visits, hospital stays, and even specialty care. We do this by providing primary care, preventative care, and health education to traditionally underserved groups. We also focus on reducing barriers to accessing care, from fees to transportation to language abilities and more.

The cost savings from community health center services add up quickly. Data from the Agency for Healthcare Research and Quality showed dramatic differences in 2008 between for the average costs per patient per day for these healthcare delivery methods:

Hospital inpatient: $41.36

Hospital outpatient: $7.59

Emergency room: $3.64

All physician settings: $2.64

Health center: $1.67

In fact, the National Association of Community Health Centers has estimated that health centers save $1,263 per person per year, and up to $24 billion annually in the U.S.

Finally, I'd like to mention how we benefit the economy. The health sector overall has been credited with fueling job growth and economic activity, and community health centers are no exception. The National Association of Community Health Centers estimates that with continued investment, health centers will generate $9.2 billion in economic benefits by 2015. And these benefits will primarily be seen in economically challenged areas.

Of course, data doesn't give the full picture of all that we do at Gardner. However, it is gratifying to see research that shows community health centers can provide high-quality care with better results, while still lowering the costs of medical services. This knowledge will be important in helping community health centers demonstrate leadership on the local, state, and national levels in improving our healthcare system.

Data sources:  National Association of Community Health Centers, Inc.; Agency for Healthcare Research and Quality; Bureau of Primary Health Care, Health Resources and Services Administration

DECLARACIÓN DE LA MISIÓN

El objetivo de Gardner es mejorar el estado de salud de las comunidades que servimos, en especial, de sus miembros marginales, pobres y más vulnerables. Nuestra misión es brindar atención médica integral de alta calidad, incluyendo servicios de prevención y educación, intervención temprana, tratamiento y servicios de prevencion de manera económica, respetuosa, adaptada a la cultura e idioma del paciente y adecuada para la edad del paciente.

Our Mission

Gardner is dedicated to improving the health status of the communities we serve, especially the disenfranchised, disadvantaged and most vulnerable members. Our mission is to provide high quality, comprehensive health care, including prevention and education, early intervention, treatment and advocacy services which are affordable, respectful, culturally, linguistically and age appropriate.

Sent at 12:28 PM on Tuesday

Gardner is an affiliation of two 501(C)(3) organizations:

  • Gardner Family Health Network, Inc. - Federal Tax Identification Number 94-1743078

  • Gardner Family Care Corporation, Inc - Federal Tax Identification Number 23-7153068