The Role of a Social Worker as a Behavioral Health Consultant – Martha Saucedo, LCSW

The Role of a Social Worker as a Behavioral Health Consultant – Martha Saucedo, LCSW

Well we practically had to fight over who
was gonna get to introduce Martha today! She’s a- graduated from our program five years
ago- Audience member: Well, four. -and, ah, we all really had the pleasure of,
um, knowing her and watching her grow and doing really great things. And she originally came to Wisconsin, or to
the US, about 14 years ago? Audience member: 14 years ago. 14 years ago from Montero, Mexico. And she has made such wonderful use of her
time and energy and has already contributed so much to our community. So, after receiving her BSW, her primary focus,
she has her LCSW also, has been in the clinical field
and she has been working in the area of Behavioral Health Consultant. Which is kind of cool because I think it really
crosses our concentrations because it’s certainly a social work role that’s out there
serving many different populations in our community. And Martha’s primary focus has been with assessing
and treating Latinos and she’s part of the Behavioral Health Team at Assess Community Health, which
is a very important resource in our community, out on Park St. She also, besides treating individuals
and families, she has really been working hard in raising cultural competence with her colleagues and
some of the agencies in town. And she’s also active on the Latino Health Council. *Looking at Martha* And you’re welcome to
add anything else. Martha: I think that’s it. Introducer: She also has two beautiful children
that we got to watch at various stages, including her daughter when she was first born. So, it’s really great to have Martha with
us today. Martha: Thank you! Thank you so much. It’s very exciting to be back, in another
stage, not as you guys. I remember being sitting down like you and
really enjoying the talks and helping the other side. It’s really a privilege to be here. So thank you, thank you so much. And today, I’m going to talk about what I
have been doing these, well yeah, five years. I graduated in 2010, but I started at Access as an intern. So, in my last year of my field placement. So, it has been five years that I had been there. And I would like to share what I have been
doing. Definitely has been a fantastic experience There’s students of social work there doing
their field placement and I think they have been really enjoying it. I was actually the first social work student
that started at Access because I went and knocked on the door and I’m like I want to be here and then at
that moment, Peggy Sleeper was my Instructor and she did an amazing job with [Neftalisarona], who is a
boss to work that out, to make it, to make sure it was going to fulfill the requirements for social work and all of
that. So, the Primary Care Behavioral Health, what
is it really? So, basically it’s a program in which the people
go and see their primary care doctor, so their family doctor, but if they have any concerns, any mental concerns
or issues or any behavioral concerns they can be addressed as well. So we know that medical providers, sometimes
they are such in a rush and they look at things really quickly. But, people have needs, you know. People have mental needs and some regular crisis lives. You know, we all have and when they come to
Access, they do have that time and space to talk about it. And that’s when we jump in. So it’s a fully integrative and embedded mental
and behavioral service within primary care. Oopsie. The Behavioral Health Consultant, which that’s
what my name is as a title, that’s what I do, so um, we work very close together with the primary care doctors. They are family doctors, some nurses, you
know, working with the doctors and that’s it. But, we don’t have any specialty there. We don’t have, you know, a particular, you
know, EMT doctor, or, you know, OB. No. It’s just very general medicine. If we, if the patient needs anything- and I’m gonna- I know we call them clients-
but I’m just gonna say just patient because that’s the name they call them in the clinic -so if they need a particular
expertise, you know, we’ll do those referrals. So, our documentation as a Behavioral Health,
it’s very much like the Medical documentation with a SOAP Note, which is a Subjective, Objective, Assessment,
and Plan and it goes really the same as a doctor’s. It’s very short Our assessment has to be like 2-3 lines so
we don’t do this extensive documentation. It’s in an EPIC system, which is the same system that a doctor uses. And right now the Behavioral staff includes
Psychologists and Social Workers. So, I was the first one and then actually
the other two, that are part of the team, they came also from the same program here. So, we are eight people, which is three Social
Workers and five Psychologists. And we have students coming from Counseling
Psych, PhD. students, and Social Work students working with us right now. Madison, was it? Marriage and Family Therapies students as
well. So, the patients that we see at Access, their
ethnicity, we have, as you can see here on the graphic, 67% they’re- they’re not identified as Hispanic
or Latino, then 29% is Hispanic, and 4% of those, they were not identified. This is just for 2013 and we are seeing that
the Latino patients are increasing and I’m gonna talk a little bit more about that because that’s
where I’m usually working and what I do with these patients and how I manage them differently than a regular
English-speaking patient. Okay. So, the characteristics of those clients in the Behavioral Health
that we have seen in 2013, 19% have been children, 35% men, 65 women, and of those, 75% speak English, 23
Spanish, and 1.2% any other type of languages and I’m describing them here on my slide. We do have interpreters or the interpreter
line. Most of the time we do have the interpreters present in the
room. When it’s a very not common language, we do
have the interpreter line, but most of the time we
do have the interpreters in the room. At this point, there’s three Behavioral Health who are bilingual and just
two bi-cultural. And now, this plays a big difference because one thing is to know the language of the person,
but to understand the culture that comes and plays another dynamic in the room. And I’m gonna talk a little bit more about
my job as training or helping my colleagues in that bi-cultural stage. Like I said, the interpreters are in person
and the majority of these diagnosis are depression and anxiety. That’s the highest, but we have bipolar people,
some of them dealing with a major mental illness like schizophrenia. We do have crisis, like suicidal patients
sometimes and with kids it’s a lot of behavior issues and helping parents how to manage their
kids. So, I really like this place because you see
a lot of different spectrum of problems. It’s not just AODA or not just parenting. Basically, in one day you can start with a
parenting issue then go to the next one AODA issue, and the next on it was a bipolar, someone
struggling with bipolar symptoms, and it’s just so varied of all the things we see in
the clinic. So, as a social worker, and that was the name
of the presentation, what do we do there as a behavior health consultant. So, when you enter there they tell you that
your main client is actually the provider. So you need to help the provider. But when you’re there, and due to our, the
roles that we are learn in behavioral as a social worker, you feel this conflict but
my client should be the client, not the provider. So you learn how to work with both worlds. So what happens is the patient comes and see
their provider, and the provider feels that maybe whatever they’re expressing or their
physical concerns have something to do with either stress or a mental issue. So then they said you we have this group of
psychologists or social workers that will talk to you about it. So he just going to check the physical symptoms
of the patients and then he or she will will come out of the room and tell us. I have, you know, these patients who is feeling
with a lot of stress. You know, having migraines, for example, and
is going through a divorce. So then, in that same moment, we go into the
room, we introduce ourselves, and we start talking about those stressors for the client. So they don’t have to make a particular appointment
with us, we jump in at that same session. This helps that some people when, if somebody
will tell them well you will have to go to therapy or you’re struggling with this or
they don’t do the appointment or they don’t have the time and then we lost those patients. Well, that’s one of the benefits of being
a behavior health consultant. You are there and you jump in, in the same
medical session that the patient came to see the doctor. A lot of our interventions are solution focused. So, it’s what bothering the patient at that
moment while we need to treat now and we see a lot of the functionality of the patient. So, what can we do to improve the functionality
of this person. So we do a lot of CBT, Motivational Interview,
and ACT to work with this. If we find that they need more intensive care,
we do have places we can refer them or sometimes those places are long waiting lists, so we
help as a bridge. We continue seeing those people until they
bridge to a more intensive service. We do a lot of care management and with this
means is that we have a data base of all. So, when the patient comes to the clinic we
always give an H29, which is a screener for anxiety and depression, and if they score
high, even though that was not their main problem, they get into our data base. And by being in the data base, every three
months we check that data base and if the patient needed to follow up [with] either
their doctor or us, and they didn’t show up, we call them, just to check in and see how
they’re doing. A lot of the time these are very, they’re
client who have very complicated lives. You know, they don’t have the time or if they
get out of work they’re not getting payed for those hours and they’re struggling financially. A lot of the times we do a lot of interventions
just by phone and people are very receptive and appreciative of that because sometimes
they have transportation issues, or like I said, they cannot come. So the care management, it’s a very important
piece that we do and we do that every three months depending on those patients who, kind
of, came out of the radar. Each member of our team, I mentioned we were
eight, have an area of expertise. So one of my colleagues, she’s in charge of
psychiatry. We don’t have psychiatry in the clinic but
we do have a consultant psychiatry, which she comes once a week to each clinic because
there are three clinics in town. So, if there is a patient that has a lot of
mental issues and their primary care doctor feels not too sure to provide all the psych
meds, we do the referral to the consultant psych. He does the recommendations and sends those
to the primary care doctor. Then the doctor continues prescribing those
medications to the patient. So that’s the way we try to help people who
they don’t have services for psychiatry. We do inform them they this is not, you know
you are going to be seeing the psychiatry consistently, it’s just a consultant psychiatry. So one, like I said, one colleague, she’s
in charge of that and in getting in charge also with general and mental health and have
those connections in the community. We have another person on the team in charge
of the management. So she takes care of the database, does the
calls, and tries to figure out why our patients aren’t coming back to see us. What’s the problem, things like that. In my, in the team, my expertise is Latinos
or minorities and what I’ve been doing, it’s like, Susan who introduced me, my job is to
go out in the community and get in touch with places who are serving Latinos and see how
we can make connections with them so we can offer more services to our patients. Now, I’m usually in the new clinic, which
is in Park Street because we have a big amount of Spanish speakers there and most of these
patients are uninsured. So, I need to make sure that if I’m going
to send them to a particular place out in the community, we can cover that. Either the clinic can help or that it’s a
place that they don’t charge for them. I’m going to talk more about Latinos in a
moment. So, one of the things that I’ve been realizing
is that with Latinos, what they face, like I said, they are uninsured, a lot of the time
because of their legal status. So, Access will not accept any of those patient,
there’s a waiting list. We tell them to call. So, if you don’t have any health insurance
and they want to get service in the clinic, they have to call the clinic constantly and
there’s opening like a lottery. You know, they decide on Thursday there’s
going to be an opening. If you happen to call in that moment, you
become a new patient of the clinic. Now, in order for them to see us, the behavior
health team, they need to have a primary care doctor because sometimes they have called
me and said “oh, you know, they want to see you because you speak Spanish but they have
their doctor in UW.” I can not do anything with that. They to first either have their primary care
doctor in the clinic and then they can see behavior health. So, one of the things I’ve been realizing
is that they don’t have access to healthcare because, a lot of the time, of their status,
their legal status. So, and they also have the language barrier,
in which its complicated. It’s really complicated to find what’s the
best service for you, which doctor to peg, and when you don’t know the language you don’t
even know where to start. And when they, they give you a phone number
and you call that phone number and they start talking in English, you don’t even understand
to press 2 to, know know, hear all this message in Spanish. So, it’s really hard for these clients to
find services. So, my job is to actually, kind of, help in
those barriers. And if I get some information of the clients
of what their struggling with, to help Access change those things and also connect them
outside and help them with that. There’s a lot of discrimination in employment,
neighborhoods, and schools. Going back to the legal status, there’s a
lot of places in which if you’re undocumented they will not give you a job. So, a lot of these people are abused because
they are in a job they don’t like, or they are working extensive hours, or they have
health conditions but they are still working against their health conditions because they
don’t have another option. So, it’s important to be aware of that when
we see these type of clients in sessions. The cultural shock of course. If it’s the first generation, second generation
who is here, they go through a lot of struggles. The poverty they go through, and [a kind of
mixture of those as well].So, just to give you an example of one of my latest “discovery”
in the Latino community that I was facing and I was like what’s going on here. I start realizing that for the past four months,
I was getting a lot of Latinas, teens, with cutting behaviors, but it was like a lot. And I’m like, whats going on here. And they were starting about 12 to 13 years
old, very, very young. Parents were reporting to me that maybe it
was the social media, you know Facebook, getting all these ideas in texting and the friends. And even though I believe that, I though there
was something else. So I start reading, I start researching, trying
to figure out what was going on outside and what I found out was, that these teen girls
were the second generation born here and they were really having a cultural shock. And when getting into the teen years they
were getting the message out in the society that this is your for you to [decide] what
you want to do when you grow up. You know, you want to do… go to your personal
needs, if you want to go to college, or nursing, or what you want to do. That was the message they were getting in
school and all their peers, they were like I’m going to do these classes in high school
because then I want to go to these programs in college and they were thinking about that. But, the message they were receiving at home
was now that you’re older, are you ready to, you know, have a family and you have to be
ready and giving all these roles about being at home caring for a family. But, all of these were an implicit message,
right? It was not really being said to them directly. So these girls were having conflicts. They felt that at home they were not being
accepted or they feel that conflict with mom and dad or they were just feeling rebellious
about why do I have to clean my room and my brother does’t. Why me has to clean all the rooms of the house? And all those types of cultural issues were
coming up. So, I started discovering that pattern in
these families and what I started doing in session was just bringing those issues directly
between the parents and the daughters and negotiating. And instead of making the parents be very
attached to their own culture and these girls to be attached to the culture of this country,
because that’s were they were born and raised. I started creating, or helping them create,
a culture of their own. So, that means a balance. A culture that was not going to forget what
the parents were wanting or the girls were wanting, but a balance. Something that could be in-between, both parties
will be happy. And when we create that own culture that that
particular family, because I have to say it was different in each family, the depression
and the anxiety and the lack of self-esteem reduced in these girls. So, that kind of behavior was not even present
anymore. But when they came to the clinic the doctors
were pushing medication – SSRI, cutting behavior – SSRI. I’m like no, no, no they are too young. Let’s do something about it. But that’s, you know, that’s the beauty of
understanding the culture, what was really going on, and what was getting the demand
of this country where they were living. And the girls were not wrong, neither were
their parents. They were both right in their values. We just needed to help communicate that. Now, it was hard to the parents because they
were raised in another country in which things were totally different, and these girls, it
was the first time they were teenagers. Right, nobody teach you about those things. Plus, it’s hard to be a teen, I mean it really
does. So, these are one of the things that I’ve
been doing in my job. Another thing here working with minorities. So, besides me recognizing all those issues
that are going with these clients, my job to, is also to educate colleagues that work
about these things. So, one of the things I do I-. So we have a seminar once a year in which
we educate the new students who are working with us but it also help us to educate each
other and the team. So, actually last week was our seminar of
the year and it’s really helpful. I needed to talk about about minorities and
how to treat them in sessions and what to do with them. But, it’s also for me. For example, to hear about what Micheal Lee
is doing with care management, what they’re doing with psychiatry, because each year things
change because the needs of the clients change. So, one of the things I like to tell them
is when you’re working with a minority, if you have any colleague that you feel that
they know more about that particular group, get in touch with that person. There’s something that you can learn from
them. If you don’t have anyone, so let’s say for
example you are seeing a Hmong patient and you don’t have anyone who is the Hmong community
and you don’t know anyone. It’s okay to ask that person and the client. Be curious. When you ask them and allow them to teach
you, that a good way of opportunity for both. So, now because I’m the professional, I have
the right answer. A lot of the times, they are the ones who
have the right answers and it’s okay to ask them or to be genuous and say I don’t know
about it, tell me more. Tell me more why so hard for you to get out
of work and come to your medical appointment. Instead of making an assumption, like I cannot
[believe], he has diabetes and never comes and sees the doctor. When he goes into a co- diabetic shock, is
that when he’s going to learn the lesson. Instead of making those judgements and assumptions,
be curious. Well, I can only work because I need to pay
my rent and then my dad, and then you start learning and start getting more empathy about
that person. So, be curious. Never be afraid to ask. Get involved in the community. If you are involved in a field placement or
a job in which you see a lot of a minority group, lets say Hmong or Latinos and you don’t
know anything about that population, get involved. Get involved with events that are happening
in the community to kind of get to know more about that particular population. Be curious, listen, read about the community. Even me, I’m a Latina and I’m like what’s
going on with this teens. I really needed to read and I really needed
to learn of my own culture. So, this is a non-stopping proccess. You always, always have to learn and keep
being curious about what’s going on. I think, it was until here I started hearing
about the cutting behaviors. I don’t remember when I was teen that that
was around. I think it’s something that is becoming the
“new” in things. Before it was more drugs or the alcohol but
the cutting behavior is something that is recently new and we don’t know what gonna
come next. So, be curious to read and document and ask
questions. And with that, I wanted to, before we open
it to questions, I wanted to end it with one of my favorite quotes. It’s “We become not a melting pot but a beautiful
mosaic. Different people, different beliefs, different
yearnings, different hopes, different dreams.” So with that now I’m going to open to questions
of, I explained, you know, what I do and what I’ve been doing these four years. What the behavioral health is, it’s a very
medical, kinda, role but still we can put a lot of our social work values there and
I think it’s very helpful. And one of the nice things of the teams is
that we have different fields and that compliments the team really, really well because I learn
a lot from my psychology colleagues about medications and, you know, treatments but
they daily learn from us also about the empathy that you have to have through the patient
and you really have to take into consideration the environment that these people are living
with and all that. So, I think that’s a nice balance that we
have at the clinic at this point. Again, together with the medical providers
and it has been growing a lot and I think also the benefit we are bring to people it’s,
it just wonderful. So, I would like to open it to questions. [Female off screen] So, I was wondering if
you talked about, kind of how, in that case where these young Latina girls are cutting
themselves and the doctors are like lets throw these drugs at them. How do you navigate, I guess, that, kind of,
different perspective ’cause obviously social work doesn’t really come from that kind of
a perspective. So, how did you navigate that, I guess. [Martha] So, I’m going to repeat the question. So, she’s asking that in the example that
I said about Latinas, when the doctor was really pushing medication, how I was able
to approach that with the doctor to kind of hold things and check it out. So, again, like I start my presentation, we
are consultants of the providers. So, you become to create this relationship
with them, with the providers, and they start trusting your judgement. So, one of the things is that, another thing
that you’re talking the load out of them. For example, you know, what I did with these
teens. I told the doctor, yes I know she’s in danger
but I already create a safety plan for her for the next week and their gonna follow up
with me in one week. If things start working out, I would like
to give it a try without medication because they’re too young and if thing work out great
and if not, yeah, we might probably need to start the medication. And, I have to admit, that of, I think there
were seven Latinas, one needed even though we try, it was very chaotic, the environment,
and she needed the medication. But, I have to make sure that she’s going
to be safe. So, in order to do that, it’s talking to the
parents. If there any, you know, they’re going to be
watching her not having any whatever she was using to cut herself. It was a razor from the shower, so remove
those, make a safety [consult] with her, very transparent with their parents as well, and
if I felt confident we were, that we create a good safety plan and follow up in a week,
and I will call her in two/three days, how are you doing, how are things. So, with that, I realized we were going to
be okay. And then of course, I mean really also the
doctors were like, you’re right, she’s too young but I’m just concerned. But when they know that you’re taking, kind
of, care of that, they allow you to do that. Yeah. I think their was another question, yes. [Female off screen] I was curious if you’re
doing one-on-one therapy at any point, clinical work, or if it’s just sort of that triage
case management. [Martha] Yeah, that’s a good question. So, she’s asking if I’m doing one-on-one therapy,
long-term therapy, or just the short-term. It’s just short term, it’s just short term. I do find myself, in my particular case because
I work with a lot of Latinos, that they want to continue see me due to the language and
they cannot go to an intensive therapy, again going back to they don’t have the resources
or they don’t have the healthcare that will cover that, so I do some exceptions. But, with telling them that my time has to
be 20 to 30 minutes. I cannot be there for one hours because we
have a big amount of patients that we see every morning. So I need to be aware that I have other patients
to see. And sometimes, and I tell them, I- you know
you can start- keep coming to talk about trauma or whatever but it has to be 20 minutes to
30 minutes. If my next patient didn’t show up I might
extend that time and they’re aware of that and do- we work on that. Okay. So, I do do acceptations but really it’s just
short-term therapy. [Female off screen] You talked about how clients
without insurance can get into the program but it’s kind of difficult, how do, like,
immigrants or anybody else who doesn’t have insurance even become aware that that’s an
option for them. [Martha] Okay, so she’s asking of the people
who don’t have insurance, how can they know this is an option for them. Once you get into the clinic, you’re safe. I mean, you’re going to be seen and covered
and everything. We don’t have a lot of openings, right? But we do, I do it for the Latinos and I know
they do that in other communities, we do this like fairs in which we inform people about
these things. So, I think it was October when we did the,
I’m involved in the Latino health consults, so we did the medical fair in which we invite
a lot of people. We let them know in the radio and things like
that, and they come for free. And we check, there were medical students
there, they were checking their blood pressure, their sugar levels, there was actually AIDS,
like they were checking for AIDS and stuff, they were checking their eyes, so the regular,
you know, medical first appointment all for free, everybody comes. And then we talk about issues, they need to
be aware and this year I was the one presenting about how to take care of yourself. And then there’s another person at the end
of that event that talks about places where you can go to get services or how to do it. And right now, with the Obamacare, there’s
a lot of changes so we have been informing a lot about it to let the word out. In the clinic I know they hired two people
just to talk about in the Obamacare if you want to get enrolled, how that goes and how
to work. It’s even confusing for us. So, we try to get the word out. Yeah. [Female off screen] Sounds like such a good
program. Couple questions: One is, so you got your
liscensure there? [Martha] Yes [Off Screen] Meaning you were
supervised there so that [Martha] Correct [Off Screen] it’s sort of a mental health
focus [Martha] focus. Yeah, so my story is, I did my last year of
my master program in clinical and when I finished that I got hired as a, they call it, pre-,
advanced intern and I did all my clinical hours being supervised there. The good thing is that your supervisors are
with you there all the time. So, as soon as you finish seeing a patient,
you come and talk to the supervisor and in that moment they are telling you yes, no,
do this, do that, dadadada. So it’s a constantly supervised program. Constantly. Every patient you see. And, when I finish my hours and I do my test
and I become licensed and then I’m part of the staff now. [Off Screen] That’s great. So, another completely different question. Can you give us a couple of examples of what
you tell your colleagues about working with, you know, with Latinos in terms of how they
should behave differently. [Martha] Okay. So, and th-, so what Telly’s asking what are
the things that I or how I tell my colleagues about how to work with Latinos. And a lot of the times is when we have this
seminars I was tell like once a year or they know that I, my ‘area of expertise” is Latinos,
if they have any issue they’ll come to me and talk about it. So, for example, it’s very common that they
will come and say Martha I’ve been seeing these Latina women with an interpreter and
I just feel she’s not getting what I’m trying to tell her. Really I don’t know if she’s afraid or what’s
going on. So, at that point I either can make a call
to the patient and try to follow with me and if can’t, because I can’t see all of them,
I just say tell me more about it. And when they explain, the language plays
a huge, huge barrier. So, one of the things I’ve been doing as a
[fonpar], it’s every two months I get my team together at my house, we cook a Latino food,
and then we speak Spanish. So, some of them they don’t know a lot of
Spanish, some of them they do more, but I try to teach them very brief phrases like
how are you or are you taking your medication or how are you feeling right now or how’s
your family. Really small phrases. And, it’s really interesting how, even though
they’re totally English speaking but if they say to that patient I don’t know Spanish but
how is your family in Spanish, for example, that a way of breaking the glass, you know
or the ice how they say it. So, those little tiny things I try to, if
I see a pattern that this is happening I try to thing well how can I help them. And I did that, I would be doing this for
a year and it’s been working and they reply that they like it and they want to know more
phrases. It’s that they’re going to have a fluent conversation
with them but at least they understand or they can get that connection with the client. Another thing for me that is very important,
I keep saying, is don’t make assumptions. Don’t make an assumption that is Latinos not
going to take medication or is Latino and they don’t work or, be very curious and ask
and ask and ask and that’s very important. I think people have make a lot of assumptions
about myself. It has happened to me and I have also made
the mistake sometimes of assumptions and I have learned that it is not- that doesn’t
work. So, just avoid the assumptions and the judgement
and just be curious and ask more things. So, that one, a few of examples of what I
usually do. [Female off screen] So, I had to leave but
I just wanted to say that something that I wanna really thank you for and say that I
appreciate is the examples you’ve given about how you go beyond, you take that step to advocate,
like inviting people, inviting your team to your house. You know, what a great idea. Not only does that pull the team together
but, you know, also that’s kind of taking that next step of helping them to be more
supportive of their clients and make that connection. And I also, just like the, the cutting. You didn’t understand so you dove into the
literature and read up on it, you know, and I just think that”s such a good example about
what we say about social work about advocating for our patients, you know, and really, and
you’re taking actions to do that. So, I just want to say thank you. [Martha] Thank you [Off screen] Wherever you
got your MSW got excellent —– [laughter] [Off Screen] So, I also wanted to say thank
you. It’s really exciting to hear a former student
of ours demonstrating all the kinds of things that we hope they get, like being curious
rather than making assumptions, and you’ve really illustrated how nice it is that your
clinic allows the kinds of roles that are needed, including your job as consultant to
the medical providers gives you an opportunity to target them as an advocate on behalf of
the patients. So, my questions is about what other roles
might be available there. My guess is that in a medical model, usually
the only assumed role is case-by-case-by-case. I wondered if there is any opportunity or
possibility of use of group work, for example, because thinking of seven or eight Latina
teenagers, all facing the same issues, seemed like the perfect opportunity to suggest group
support or group process. Is that possible in your —–. [Martha] Yeah,
so there’s two things that I’ve been thinking about this with the, well she’s asking, and
they ask me to repeat the question, so she’s asking about what other opportunities we can
provide, for example the Latino kids that I brought. Either to make group about it, you know do
groups, support groups, or any way or helping and not individually. So, we have tried groups in the past in different
issues. For example, we talk about also behavioral
things like eating habits or smoke sensation or sleeping issues. And we did make a group for eating habits
for families who were struggling with overweight, but we realized that that turnout was not
good. And then, again it goes back to the funding
and all that. So, we tried the weight management and it
didn’t turn out. We did work with some depressed Latino womens
and that did work out well but it was do to a grant, so when the grant was ended then
the group had to end it. So, it’s something that it’s in the back of
our minds and we try, but sometimes even the time or the funds unfortunately haven’t given
us that opportunity. What I do as, I do know some of the support
groups out in the community that probably aren’t targeting that particular issue but
prob- maybe they’re targeting self-esteem in teens or depressive symptoms. So I might refer them to them. And I have been having contact with the people
who are doing those groups in order to have a relationship with them and being able to
have an easy access to those clients. The other that’s in the back of my head to
do is really present this as a data. You know, start creating this like a this
is a data, it’s- I have this cases, I have documentation about it, and if I get more,
because when I start reading I didn’t find much either. Again, this is something that is just new,
the cutting behavior, so making it more formal in that way as a research too. Yes! [Male off screen] I didn’t get to know how
your organization formed or how it’s been run. You said Access right? [Martha] Yeah, so the name is Access Community
Health. So it’s a community health center and they
receive federal money and then also we have uninsured patients but we also have insured-
patients with insurance, so their insurance pay us. And the question was, he wanted to know where
that compa- Access was getting their funds. Is that correct? [Off Screen] Yes, yeah. So… [Martha] So we get federal money and then
also whatever, people who have insurance, those insurance pay the clinic as well. So Unity, United Way, it’s a big supporter
of, of the funds of the clinic. [Off screen] Okay, secondly, when you have
patients that, I see, you now guys take care of undocumented patients. So if you have undocumented patients that
have very critical cases, you know that maybe you can’t, you know, you can’t handle maybe
because of funding, what do you? [Martha] No, we- we do, like I said, once
they enter the clinic, we take care of them. We are not going to let them go. If, let’s say this patient is uninsured and
has really, really critical mental illness and its a psychiatry, that’s when, again,
I will talk to my colleague who is in case of the psychiatry and say I have this case,
what can we do. And she will help me reroute it to where to
send it or what to do. So we do, like I said, make connections in
the community to try to refer them. Or let’s say it’s a patient who is uninsured
and has a really hard condition that a regular doctor cannot deal with, we do the referral,
we do the referral. Yeah. Yes. [Female Off Screen] So, my first question
was about the clinical tie. What I’m wondering now is after you see somebody,
you know, comes to you from the doctor and then they have, for example, housing needs
or utility bills or they’re getting evicted, whatever, all those kinds of things. Do you work with them in that kind of community
social worker way as well? [Martha] Good question. So she’s asking is if besides the short period
of time that we work with clients if they have any other needs, like housing, and we
take care of that. We don’t. We have in the client social workers who they
are, it’s called community resource specialists and they take care of that. So, if I see a patient and talk to him about
stress and anxiety and all that, and I know that part of the anxiety is related to the
housing then I will walk to the our community resource specialist, who are social workers
too, and they will let them, they will help them with that. Again, providing some resources or guidance
and things like that. So I, particularly in the role that I have
I don’t but there’s other social workers that they do. Yes. Any other questions? No? Well thank you so much for being here. Thank you. [applause] [music]

This talk by School of Social Work alumna Martha Saucedo, LCSW, was presented as part of the Health, Aging and Disability Lecture series on November 20, 2014