Monday, Mar. 28, 2022
Mental health is wholly intertwined with community health, an aspect that the traditional, reactionary approach to mental health care doesn’t understand. Preventative, holistic, liberating, destigmatized and culturally specific mental health care is hard to find, not responsive to the cultural values of the community and expensive. Our partner organization, Raíces de Bienestar, is working to address that in our region. Founders Dr. Ruth Zúñiga and Bonnie Lerner separately came to similar conclusions on what was lacking in the mental healthcare field and began working together to form the nonprofit in 2020. After witnessing the devastation wrought by increasingly destructive wildfires, Lerner and Zúñiga contacted United Way of the Columbia-Willamette seeking a less tangible, though no less important, way of supporting affected communities. Seeing the importance of their work, United Way of the Columbia-Willamette quickly became a fiscal sponsor of Raíces de Bienestar.
Lerner and Zúñiga had a vision for what their programs would look like, but knew that in order for their work to be effective, it had to be community-informed and community-driven. They reached out to parish leaders, promotores de salud, community members and more to begin to devise a system of providing mental health care in the wake of disaster that fit with the community’s needs.
“My true love is addressing mental health and community from a public health perspective,” Lerner said. “The community has the answers, so we let them create the solutions.”
This broader, systems-change oriented methodology took them to the heart of mental health issues within communities of color. A 2017 study from Oregon Health Authority and Oregon Department of Human Services showed that the Latino community in our state is less likely to seek mental health therapy and lacks access to bilingual and Spanish-speaking services. Raíces de Bienestar looks to fill that gap and approach mental health in a more responsive and inclusive way.
“We have such poor mental health outcomes in the U.S., and in Oregon specifically,” Zúñiga said. “We, in the mental health field, expect communities of color to come to and understand these white-founded institutions, but at Raíces de Bienestar we believe community is the foundation of mental health, so we went to the community.”
The organization began their work immediately to destigmatize mental health beyond a pathology. They work to help communities redefine what it means to be healthy and balanced, helping people practice preventative measures that build resiliency instead of simply responding to crisis. Zúñiga believes that, especially in the Latino community, la salud mental is a loaded term and the system has taught people to be focused on pathology. This doesn’t aptly describe what it means to be healthy. She works to show community’s that pursuing harmony, peace of mind and caring for your neighbors and family are all parts of a more holistic view of wellness and mental health. These concepts of mental health and wellness are understood and embraced by the communities they work in, showing that a new approach to mental wellness is needed.
We, in the mental health field, expect communities of color to come to and understand these white-founded institutions, but at Raíces de Bienestar we believe community is the foundation of mental health, so we went to the community.
Promotores de salud, also known as promotoras, is the Spanish term for “community health workers”. They are recognized health workers who work in Spanish-speaking communities.
“Stigma, in regards to mental health, is based around mental disorders and illnesses, not about mental wellness itself,” Zúñiga said. “Every community I visit has an interest in mental health: How to be a caring parent, how to deal with stress from work, how to deal with disagreements and conflict, how to deal with peer pressure and how to live a better life. All that is mental health as well, and a community having conversations around these issues can help deal with stigma.”
Resiliency and recovery are a lifelong journey, and Raíces is along for it. They believe in community empowerment and community liberation, an approach Zúñiga has received criticism for in the past for not being evidence-based in the Western concept. However, she says lately the psychology of liberation that informs her work has become more relevant and talked about as a framework for social justice and wellness. This idea drives the work Raíces does, from las charlas (community talks) they hold and the services they offer communities all the way to the name of their organization: roots of wellness. It centers the community as the cornerstone of wellness, highlighting the natural wisdom of those living in the community to heal. The integration of collective voices uncovers and addresses intergenerational, historical and cultural traumas in a way that doesn’t rely on systems built by those who created that trauma.
If everything is about code switching to that idea of therapy, it becomes harder for people of color to navigate mental healthcare and deepens the stigma.
“If it is expected that you come to a mental health therapist, you have to navigate a bunch of systems and structures that many of us don’t have experience in. So, the stigma comes from that. People believe the therapist in a seat and patient on a couch trope, and typical therapeutic approaches relied on individualistic views of thoughts and emotions. All of these methods dominate how we view mental wellness, but they are set up for one type of culture,” Zúñiga said. “If everything is about code switching to that idea of therapy, it becomes harder for people of color to navigate it and deepens the stigma.”
Their idea is to meet the community where it is at (literally, in the case of their March 2021 trip to wildfire affected areas) and promote a non-traditional, more nuanced resiliency around mental health. They believe that, on top of traditional health workers, community health workers and promotores de salud should be further recognized and supported by structures in the state.
“We believe community health workers like the promotores can abridge the mental health services gap, and act as a front line,” Lerner said. “They are a positive, known face that can show how emotion and mental health care is so much deeper than pathology, and people in their community know them, trust them.”
Raíces de Bienestar is in the midst of developing their strategic plan, hoping to see a proliferation of their programs that brings in more traditional health workers and recognizes those in the community doing the work already. They hope to replicate their model in more communities of color and rural areas where the need is greatest. Instead of solely focusing on access as a metric of their work, they also want to gather data showing the feelings of empowerment, better moderation of stress and the resiliency they can bring to communities as well. Another goal is to offer mobile services in the field, with health workers coming straight to communities to meet the need. They also hope to one day champion a special certification for promotores de salud and others in a community that can become a behavioral aide, encouraging them to become bridges to emotional wellness and promote prevention from a cultural lens.
“It’s not about training more healthcare workers in the traditional, white-dominant model,” Lerner concluded. “Really being able to train a new cohort of clinicians that can be culturally rooted in the way they address mental health is a more effective way of building wellness and resiliency.”
To learn more about Raíces de Bienestar, visit their website. Additionally, Raíces de Bienestar is hosting trainings to address the emotional health impacts of the wildfires for the Latino community in Oregon. Registration is open for their May (5/4, 5/11 and 5/18) and June (6/1, 6/8 and 6/15) cohorts. More information can be found on their website, and registration is appreciated before April 30th.
The integration of collective voices uncovers and addresses intergenerational, historical and cultural traumas in a way that doesn’t rely on systems built by those who created that trauma.