St. Christopher's- Medical Interpretation

Student Intern: Aura Agudelo Rivera

Aura Agudelo Rivera

The interview with a staff member of the adolescent clinic was remarkable. I was able to learn a lot of new things that are personally affecting this community but also some beautiful aspects of the community as well.

First and foremost, people should know that this community is remarkably resilient. When we think about the community we serve, we tend to focus only on the disadvantages. We often use words like underserved, underdeveloped, and at need. Instead, we should look at the community in the sense of how privileged we are to provide support for this community. You are looking at a very resilient community that has been through a lot of trauma but can still function and succeed the best it can in life. So instead of saying "they are underprivileged," it should be "they have been through a lot, but they are still overcoming." It's the way we talk about the community. Many families have experienced trauma, for example, families that have lost family members to homicide, maybe they have received a gunshot, or experiences homelessness and food insecurity, yet they are still surviving and living. They are still navigating the resources the best that they can to prevail. Sometimes they have learned to advocate for themselves, so instead of saying that they "have an attitude," think about it more like they know what is wrong and how to advocate for themselves. They are just looking for that level of support from us. Similarly, sometimes we can act a bit privileged, thinking that we know what is best, but we need to meet the families where they are. They have survived for this long. They understand and know what is best for themselves as well. We can be there as guidance, but we do have to allow that self autonomy for our families to decide what they think is best for themselves.

Secondly, the sense of family is great in this community. So watching the community support each other, watching the community come together for a family that needs it, for people who are not blood-related. They bend over backward to help each other. They are willing to share the little they have with someone else to ensure that everyone has the support they need. A lot of the community comes together to get resources together. So, there are coat drives or donations, or when for example, one family had their daughter going to prom, and everyone came together to help the family pay for her dress or shoes. All the little things like that show what the community truly is.

One of the best experiences this staff member had while helping this community was that of a family with a daughter with high-risk behaviors. The patient was running away from home, dating people who were not in support of her, and there was a lot of disrespect towards her mom. We got mom connected to intensive prevention services and a lot of community support, and many of these resources came through for her. The school was able to implement prevention services for her. We were able to get her into therapy in the community. Then we had intensive prevention services to change her behavior. This patient ended up doing well in school. It is a B/A student now. It no longer has the same behavioral issues. Every time we see mom, mom is thrilled and tells us how well her daughter is doing. So this is an excellent example of how the community comes together around someone. Most importantly, it is a perfect example of when everyone does what they are supposed to do. When everything comes together and work is done the right way, it makes a massive change in a child's life. She is going to college now. Ultimately, everyone contributed and cared enough to take the extra step to ensure this patient got the support they needed.

Unfortunately, however, there are many factors affecting this community. There is an increase in youth committing violent acts. On one end, many gun violence perpetrators are youth, between 15-17 years old. On the other end, many children have been shot or lost a loved one or friend to violence. It seems to be getting worse because so many kids tell you that they saw or know of someone who was shot or have a family member in prison. There was a 15-year-old patient who came in and now doing 30 years in prison for killing someone. That is where the importance of the prevention programs services comes into place: to support these families before it is too late. It is scary that we are seeing this. Then some patients are not part of the street life but happen to be in the wrong place at the wrong time, like walking to school when they got shot. This is why we must be mindful of the recommendations we give families. Telling them to send their children to the recreation center might not be a great solution if they do not feel like these centers are safe for their kids or if leaving their homes is a risk. It is such a hard decision because most parents would like to have their children having fun outside and making friends, but they are in an environment where that can be risky. That is why it is essential to understand the community. We should acknowledge that some parents do not want their children to get resources in their community because they do not feel safe.

In addition to violence, COVID also affected this community. Many patients say they went to the ED because they thought they had a heart attack. When you look at the record, you can see that they have been in the ED three times in the last month. They feel like their heart is beating fast, have a lot of racing thoughts, and can't sleep well. So the providers will get that patient to a cardiologist, but their heart is usually not the issue. They are just suffering from anxiety or having a panic attack. You only see these physical attributes because they don't know how to cope with what is happening in their environment. There is a motivation to normalize mental health, but we get a lot of pushback from the parents. These parents came from this community, and they have a lot of failed experiences with the community. So it becomes super important for us to follow through with what you say you will do. Also, because these parents were from this community when they were younger, they could have interacted with the same resources we recommend to take their children. But because these programs failed when they were younger, these parents no longer trust that institution, creating a cycle of distrust. There are also a lot of cultural stigmas about mental health, which could also influence the parent's apprehension to accept treatment for their children.

Finally, although teenagers do not use cigarettes, many teenagers are vaping and smoking marijuana in teens as well. A lot of it is to cope with mental health. About 80% of the teenagers we see respond that if they don't smoke, they feel like their head is spinning, they are overthinking, or they feel angry if they don't smoke. So, typically is a coping mechanism to avoid the stressors in their lives. With vaping, there are a lot of misconceptions, so we need to educate teens more about what vaping is and how harmful it can be.