3C Project: The Courage to seek Counseling starts with Culture

Immigrant and Refugee Support

Pilot or new project, program, or initiative

Immigrants struggle with obtaining health services of any kind in the US. Add to this discomfort the stigma of mental health or obesity. In traditional South Asian culture, we think that a person with mental illness brings shame, is dangerous, and "crazy"- we ignore or hide the issue and dissuade ourselves from seeking help. And yet, immigrants carry a heavy emotional burden and face radical lifestyle changes that impact health behavior. Seniors suffer from isolation and the fear of foreignness. Women's visas force them into a situation of dependency upon their spouse, making them vulnerable. South Asian youth confront the anxiety of conflicting cultural values and 'model minority' expectations. Many immigrants consume excessive amounts of unhealthy foods in a strange new country. Immigrants are particularly prone to mental health disorders and chronic diseases but are among the last to seek and receive help.

Since 2019, Saahas ("Courage") has become a known and trusted service provider in the LA South Asian community. We work to reduce negative mental and physical health outcomes like anxiety, loneliness, isolation, diabetes, and heart disease. South Asians come to us when they would not dare to reach out to an American provider, worrying that they won't be understood, believed, or treated fairly. We speak their language and know their culture because we are South Asian too. Saahas also understands and works tirelessly to break down the stigma around mental health, domestic violence, obesity, and other public health subjects that are taboo in our community. With support from LA2050, Saahas is delighted to launch: (1) Mental Health Support: (a) "Women Helping Women" group counseling that meets for 8 weekly sessions, and (b) Individual counseling/therapy sessions tailored to the needs and expectations of SAI clients. (2) Nutrition and Exercise Support: Community outreach and one-on-one counseling on nutrition, exercise, body image, and self-esteem. This will join our existing yoga classes and dance sessions. These services are provided in a culturally relevant manner, free of charge to low-income SAI and their families. Saahas' will use its proven outreach techniques to identify potential clients in the community. We go to them on the streets, in shops, at temples, and at their doorsteps; we do not expect or wait for them to come to us first, due to cultural norms.

Saahas wants to ensure that the health needs of SAI in LA are being addressed, so they feel seen and served. This means tackling stigma and making services accessible, both financially and culturally. Our short-term goal for the first year is to hold 4 Women's Group cohorts and provide individual counseling to at least 30. We will also train student interns. If the demand is high, our outreach has been successful. In the longer term, our goal is to add providers & locations, train more students, and inspire other organizations to offer culturally based health services. Our awareness-raising & stigma-busting outreach will be seen by thousands in LA. LA will become a place where the 100,000-strong South Asian community is vibrant, healthy, and courageous in the face of mental and chronic physical illnesses. South Asians will feel like they are welcome, supported, and know they can access high quality services that are based in their culture.

To measure demand (some that we generate ourselves) and service delivery, Saahas will collect data on the number of encounters and the amount of time spent on outreach, group counseling, and individual counseling. We will keep records of the estimated numbers reached through outreach and the exact numbers of counseling clients. When we welcome new clients for counseling, we gather intake information which will give us a baseline on mental and physical wellness and lifestyle behaviors. About 6 months after the start of services we will conduct a follow-up interview with all individual clients to take a second measure of wellness and behavior. This will ascertain if recommended practices have been adopted or not and if clients are doing better.