July 2008

Grant Results

SUMMARY

From early 2002 to early 2004, the Charles B. Wang Community Health Center, the only community health center in New York City's Chinatown neighborhood, expanded its mental health services to address the needs of the Chinese-American community following the September 11th terrorist attack in Manhattan.

The September 11th terrorist attack had a devastating effect on the Chinatown community, which is only blocks from Ground Zero, and increased referrals to the health center for mental health services.

Because there is often a social stigma associated with seeking mental health care in this population, Chinese Americans may be severely ill or in crisis before they receive any mental health services, according to the project director.

Key Results
The project accomplished the following:

  • The health center now screens in-clinic adult patients for depression during their physical exams. In 2003, there were 3,991 patient health questionnaire screenings done.
  • From 2001 to 2002, the number of mental health encounters at the health center increased from 1,950 to 3,532; from 2002 to 2003, the number of encounters rose to 4,350.
  • Staff at the Bridge Program conducted 16 training sessions for primary care providers and other medical staff.
  • Bridge Program staff conducted six workshops for the public about September 11th-related mental health issues in older adults and adolescents.
  • Bridge Program staff conducted six training sessions at health and community centers and schools in New York City focused on the mental health issues of adolescents.
  • Bridge Program clinicians and health educators hosted two community education radio hotline programs on post-traumatic stress disorder and other mental health issues related to the terrorist attacks.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $150,000 to fund the project between February 2002 and January 2004.

 See Grant Detail & Contact Information
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THE PROBLEM

The September 11th terrorist attack had a devastating effect on the Chinatown community, which is only blocks from Ground Zero, and increased referrals to the health center for mental health services. Because there is often a social stigma associated with seeking mental health care in this population, Chinese Americans may be severely ill or in crisis before they receive any mental health services, according to the project director.

With a Robert Wood Johnsons Foundation Local Funding Partnerships program grant from RWJF (grant ID# 034938), the health center established the Asian American Primary Care and Mental Health Bridge Program in the late 1990s, which integrates bilingual mental health services with primary health care to make services more accessible to the Chinese-American community.

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RWJF STRATEGY

RWJF has funded previous work to assess mental health needs related to the terrorist attack, including two grants to the Asian American Federation of New York. These funds were used to conduct a mental health needs assessment in Chinatown following September 11th, and to identify existing gaps in mental health service delivery in the community (see Grant Results on ID#s 047132 and 044871).

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THE PROJECT

This project expanded the Bridge Program's capacity to provide mental health screening and services for issues related to the terrorist attack; trained doctors at the health center and in the community to become more sensitive to mental health issues; and educated the community about September 11th-related mental health issues and the availability of treatment.

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RESULTS

The project accomplished the following:

  • The health center now screens in-clinic adult patients for depression during their physical exams. In 2003, there were 3,991 patient health questionnaire screenings done.
  • From 2001 to 2002, the number of mental health encounters at the health center increased from 1,950 to 3,532; from 2002 to 2003, the number of encounters rose to 4,350.
  • Staff at the Bridge Program conducted 16 training sessions for primary care providers and other medical staff; six sessions were with physicians and nursing staff at the health center, and they conducted 10 sessions with community-based physicians.
  • Bridge Program staff conducted six workshops for the public about September 11th-related mental health issues in older adults and adolescents, four at community centers in Manhattan, Queens and Brooklyn, one at a local high school and one at an elementary school.
  • Bridge Program staff conducted six training sessions at health and community centers and schools in New York City focused on the mental health issues of adolescents. They targeted these programs at parents, service providers and other community members. The health center also distributed more than 67,000 educational pamphlets in Chinese on teen depression in the community.
  • Bridge Program clinicians and health educators hosted two community education radio hotline programs on post-traumatic stress disorder and other mental health issues related to the terrorist attacks.
  • Staff at the Bridge Program began training primary care physicians in an evidence-based model of treating depression in order to expand access to mental health services in a community that has had chronic shortages of trained professionals.</LI>

Communications

Bridge Program staff published an article on the emotional impact of the terrorist attack on the Asian-American community and a book chapter on cultural resistance to receiving mental health services. Mental health providers at the health center also wrote a number of articles for a special edition of the Western Journal of Medicine (see the Bibliography). They developed educational pamphlets and translated them into Chinese for distribution in the community. In addition, Bridge Program staff provided information on disaster relief and post-traumatic stress disorder on ethnic radio and television programs in New York City and in several newspaper articles.

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LESSONS LEARNED

The project generated the following lessons:

  1. Using indirect and non-threatening educational activities to engage the community increases awareness of mental health issues and decreases the stigma sometimes associated with receiving mental health care. (Project Director)
  2. A community health center is an effective place to conduct mental health screening and to provide services to the Asian-American community because it may be more comfortable for some individuals to access than a mental health care facility, and allows individuals who are not aware of their own psychological distress to be identified. (Project Director)

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AFTER THE GRANT

With funding from the American Red Cross Liberty Disaster Relief Fund, the staff of the Charles B. Wang Community Health Center established the "Live Healthy, Breathe Easy" program to continue to provide care for those affected by the September 11th attacks. As part of the program, health center staff implemented depression and asthma screening and treatment for adolescents and children. As of July 2008, over 3,000 youth aged 12 to 21 had been tested for depression, and over 800 children had been tested for asthma.

The center also focused on improving health education. In 2005, project staff launched a community outreach campaign that sought to spread awareness of health issues through news articles, radio programs and community events. Since 2004, staff have organized an annual Good Health Day to provide medical information and basic services to local residents.

In 2006, project staff developed "Teen Health, Media and More," a culturally-sensitive workshop series designed to help adolescents manage stress, anxiety and depression. The series, facilitated by trained peer educators, provided a community forum for youth to openly discuss issues related to teen stress, social pressures and coping strategies and resources.

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GRANT DETAILS & CONTACT INFORMATION

Project

Providing Mental Health Support for the September 11 Attacks

Grantee

Charles B. Wang Community Health Center (New York,  NY)

  • Amount: $ 150,000
    Dates: February 2002 to January 2004
    ID#:  044115

Contact

Alan Tso, M.D.
(212) 379-6999
silversurfer@pol.net
Teddy Chen, C.S.W., Ph.D.
(212) 379-6933, x225
tchen@cbwchc.org

Web Site

http://www.cbwchc.org

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Book Chapters

Fang L and Chen T. "Community Outreach and Education to Deal with Cultural Resistance to Mental Health Services." In Mass Trauma and Violence: Helping Families and Children Cope, Webb NB (ed.). New York: Guildford Press, 2004.

Articles

Chen H, Chung H, Chen T, Fang L and Chen JP. "The Emotional Distress in a Community After the Terrorist Attacks on the World Trade Center." Community Mental Health Journal, 39(2): 157–165, 2003. Abstract available online.

Western Journal of Medicine, 176(4): 2002.

  • Chung H. "The Challenges of Providing Behavioral Treatment to Asian Americans," pp. 222–223.
  • Kramer EJ, Kwong K, Lee E and Chung H. "Cultural Factors Influencing the Mental Health of Asian Americans," pp. 227–231.
  • Chung H, Nguyen D and Gany F. "Initial Behavioral Health Assessment of Asian Americans. Part 1. Key Principles," pp. 233–236.
  • Chung H, Nguyen D and Gany F. "Part 2. Putting Principles into Practice," pp. 236–238.
  • Chen JP, Chen H and Chung H. "Depressive Disorders in Asian American Adults," pp. 239–244.
  • Abright AR and Chung H. "Depression in Asian American Children," pp. 244–248.
  • Chen JP, Reich L and Chung H. "Anxiety Disorders," 249–253.
  • Ferran E, Barron C and Chen T. "Psychosis," pp.263–266.
  • Chen JP, Barron C, Lin KM and Chung H. "Prescribing Medication for Asians with Mental Disorders," pp. 271–275.

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Report prepared by: Scott Edwards
Reviewed by: Karyn Feiden
Reviewed by: Molly McKaughan
Program Officer: Jane Isaacs Lowe

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