Roundtable participants stand together following the meeting at the International District clinic. Standing row, left to right: ICHS Chief Medical Officer Dr. Lakshmi Deepa Yerram; Washington State Health Care Authority Director Sue Birch; Seattle Indian Health Board President and CEO Esther Lucero; Seattle Indian Health Board Chief Operating Officer Ryan Gilbert; WA State Department of Health Deputy Secretary for Prevention, Safety & Health Services Lacy Fehrenbach; U.S. Department of Health and Human Services (HHS) Regional Director for Region 10 Ingrid Ulrey; Youth Eastside Services Director of School Based Behavioral Health Kristie Neklason; and HHS Regional Health Administrator Renee Bouvion. Seated row, left to right: ICHS President and CEO Teresita Batayola; U.S. HHS Assistant Secretary for Health Admiral Rachel L. Levine; and U.S. House of Representatives Congressman (D-WA 9th District) Adam Smith. Photo courtesy of ICHS.

Congressman Adam Smith (WA-9) and U.S. Assistant Secretary for Health Admiral Rachel Levine to kicked off President Joe Biden’s National Tour to Strengthen Mental Health by visiting International Community Health Services’ (ICHS) International District Medical and Dental Clinic as their first stop on the national tour.

On the tour at the clinic, ICHS president and CEO Teresita Bataloya discussed how community organizations and public officials can work together to address social determinants of health like safe housing and job accessibility which could help prevent mental health issues and strengthen mental health care systems for communities.

“We are honored today to have the presence of three different people who are taking a tour and listening to us,” Batayola said, “in terms of the issues that have come up because of COVID and the accelerated mental health admissions of our patients and our community members.”

Healthcare authority director Sue Birch and Washington Department of Health deputy secretary for prevention, safety and health Lacy Fehrenbach were other public officials present.

In the press conference, Fahrenbach shared that 1.6 million Washingtonians reported suffering from anxiety and 1.1 million reported symptoms of depression. Over 600,000 adults said they needed counseling but were unable to access behavioral health services.

Other behavioral health specialists were at the tour, including Youth Eastside Services director of school-based behavioral health, Kristie Neklason, Seattle Indian Health Board president and CEO Esther Lucero and COO Ryan Gilbert attended the press conference.

“Not only does a specific community need care,” said Randon Aea, ICHS behavioral health manager about the immigrant and refugee community ICHS serves, “but it’s important that the care that community receives, looks like them. So if you’re Asian, and you want to get primary care, or maybe talk to a counselor, it tears down one of those barriers, if your doctor or your counselor is Asian like you.”

Aea said the demand for behavioral health services has increased over the past three years of the pandemic. While this demand has increased, the supply of counselors and behavioral health providers has decreased.

One third of nurses plan to quit their jobs by the end of 2022, according to a study by Incredible Health, and nearly 1 in 5 or 18% of health care workers quit their jobs since February 2020 during the COVID-19 pandemic. The health care workers exodus is attributed to high-stress environments and burnout.

Aea and Bataloya said this is true for ICHS. Community health organizations like ICHS face challenges, like having trained health professionals to stay with the the clinic over going to higher paid positions.

“I would say that a lot of the community-based healthcare systems like ICHS, whenever we’re given the spotlight, we are constantly reminding people of the fact that you know, community-based services are important,” Aea said.

Asian American communities faced barriers to mental health care even prior to the pandemic. Asian American elderly women have the highest suicide rate out of all women over 65 according to the American Psychological Assciation. Southeast Asian refugee communities suffer from trauma, violence and resettlement conditions like PTSD and depression.

Fallout from the pandemic, like unemployment, hate crimes and racist attacks against Asian Americans, has overall exacerbated existing mental health risks within the Asian American community in which cultural stigma around mental health is prevalent.

There is a need for community health services like ICHS to break down barriers to mental healthcare services like language, cost, cultural and institutional racism and bias. Aea said ICHS provides team-based care, in comparison to traditional health care models where patients are referred by their doctors to different places for specific issues.

A patient’s care team includes staff with different backgrounds like a dietician, registered nurses, population health as well as behavioral health.

“It’s more like a one stop shop, no wrong way to access care kind of philosophy,” Aea said. “So when you take away all of the barriers to care, you’re more than likely going to get the care you need.”

ICHS is at the forefront of equity during the COVID-19 pandemic, serving 28,000 patients in clinics and service sites across the Seattle region. They provide culturally and linguistically services with staff speaking over 17 different languages, relevant health services as well as health education, insurance enrollment and community outreach to immigrant and refugee communities.

It was one of the first health centers to provide COVID-19 testing, vaccines and therapeutics to expand access to high risk and hard hit communities.

Following the visit, Rep. Smith issued a statement stating the necessity of expanding access and funding to mental health care as well as investment in community organizations.

“I think the pandemic is basically uncovering all of the disparities and all of the needs that are already there,” Aea said. “COVID just dropped all of these blinders, so now we’ve all been impacted by the mental health fallout related to a pandemic.”

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