APPLE VALLEY, Calif. – About 85 miles northeast of Los Angeles in the high desert lie the ruins of George Air Force Base. From World War II until the end of the Cold War, activities at the site helped prepare pilots for battlefields around the world. But today, a new fight is taking place on the disused base.
The Symba Center is a free clinic that operates in a former gymnasium converted into a wellness center for the community during the Covid-19 pandemic. Although providing services to the region’s most vulnerable residents has always been a challenge, ensuring mental health was even more difficult, according to co-founder and pharmacist Shawn Smith.
The U.S. Health Resources and Services Administration has recognized that the Symba Center is in a geographically designated health care professional shortage area for both primary and mental health care. Smith said the shortage is even more acute when it comes to the population he and his colleagues care for.
“People on the streets generally have enormous mental health care needs…There are a very limited number of psychiatrists and therapists here, and we wanted to provide services to people who couldn’t get appointments. you because they didn’t have insurance. » Smith said. The Symba Center found that about 40 percent of the homeless shelter occupants they care for suffer from major depressive disorder and general anxiety disorders.
“The number one factor leading to homelessness in our population is mental health disorder,” Smith said.
In Northern California, Jose Perez, a licensed marriage and family therapist, and the care team at Samaritan House, a nonprofit that runs free clinics in San Mateo and Redwood City, face a similar lack of resources . Perez was hired in 2020 to create a mental health department, but faced severe shortages.
“We realized the need for mental health care was enormous,” he said after the clinic began implementing the first screenings. “The demand was there, but we didn’t have the staff,” Perez said, adding that in total only 10 one-hour appointments, paid for by the clinic, were available each week. It reported a 43% year-over-year increase in mental health referrals to its clinics.
Last year, Symba Center and Samaritan House were two of 11 free and charitable clinics that received a $75,000 grant to expand access to mental health care for some of America’s most vulnerable populations. More than $17 million worth of Teva mental health pharmaceuticals have also been made available to more than 400 free and charitable clinics.
With these grants, free and charitable clinics have been able to hire additional staff, launch internship programs, offer educational resources including group sessions, increase collaborative efforts with local organizations and providers, and implement mental health screening programs for their patients. In total, these clinics reached, directly and indirectly, around 22,000 people.
These developments have helped address not only mental health care needs, but also primary health care needs.
“If people don’t feel good about themselves, they are less likely to take showers, clean their homes, eat healthily, take medications and are more likely to engage in destructive behavior,” Smith said . “Before the grant, there weren’t many places to go. There is a gap in services… This has allowed us to expand our services into a completely new model.
Smith said the Symba Center now cares for twice as many patients as before in mental health care. There have been other benefits as well.
“The more services we can offer, the more available we can be to patients, the more they trust us to provide care,” he said. The Symba Center was able to hire a licensed marriage and family therapist who supervises the graduate interns. They also began offering trauma-informed education to shelter staff.
At Good Samaritan, which serves a largely immigrant population, Perez said the emphasis has been on implementing culturally competent care delivered by bilingual providers. They launched a training program and hired a full-time and part-time clinician and a group facilitator. He said his clinic generally doesn’t use the term “mental health,” which he said has a negative stigma in the Latino community.
“Instead, we use the word ‘consejeria’ (advice) or ask ‘do you need someone to listen to you?’” Perez said. “We use these terms to attract them, and then we plan what mental health is and how we can help them. »
Beyond language, Perez said treating patients with culturally competent care leads to better outcomes.
“I look like you, I can help you, I want to help you”… We take the time to build relationships, without that they (patients) will not be open to treatment. Otherwise, I’m just someone telling them what to do,” he said, adding that he is also an immigrant.
Yet even with attention tailored to the local community, some people do not feel comfortable broaching the subject. Recognizing this, Perez commissioned information leaflets on a range of mental health topics, such as depression, grief, anxiety, stress, domestic violence, suicidal ideation and alcoholism. Each is approximately 15-20 pages long and offers techniques that readers can use to help remedy these conditions.
Perez said the most popular topic in Redwood City, which has a clientele of more recently arrived immigrants, has been depression, followed by stress and grief. In San Mateo, which has more elderly patients, it’s those, plus self-esteem and codependency.
The different, yet related, focuses of the Symba Center and Samaritan House reflect how free and charitable clinics meet the specific needs of their communities. Free and charitable clinics and pharmacies provide care to approximately 2 million people in the United States, according to the National Association of Free and Charitable Clinics.
Ultimately, Smith said, it always comes down to the patients.
“If you can provide a level of service to someone and promote healing to ensure that people can really focus on themselves, you remind them that they have a purpose in life and they have the opportunity to live a life they will be proud of.
“I think every person deserves the opportunity to receive services so they can feel well cared for. It gives dignity to humanity,” Smith said.
Funding for these programs was made available through Community Routes: Access to Mental Healthcare, a partnership between Direct Relief, the National Association of Free and Charitable Clinics and Teva Pharmaceuticals, which provides financial and medication support to clinics expanding access to mental health services.
