The best way to solve complex social problems in the Latinx community is to work with the people who experience those problems daily.
That was the big takeaway from a daylong discussion among nearly two dozen experts in social work, education, and policy who convened in Barat House on March 15 to commemorate the 10th anniversary of Boston College School of Social Work’s Latinx Leadership Initiative.
The message mirrored the philosophy of the LLI, a cohort-based program that prepares bilingual and bicultural social workers to accompany the Latinx community in developing sustainable solutions to complex problems in health, education, housing, and other areas.
Since Professor Rocío Calvo founded the program in 2013, students have taken culturally and linguistically attuned courses in Spanish, completed internships in settings such as schools, hospitals, and shelters, and conducted cutting-edge research that has shaped social workers’ strategies to support Latinx clients.
“Rocío has taken a program from the hill of 㽶 and truly integrated it into the community,” Marylou Sudders, the former Massachusetts secretary of health and human services, said in opening remarks at the symposium. “One of the things that this program has done is to create a community of learning and a community for Latinx social workers to receive supervision that’s congruent in many different agencies.”
With an eye toward continued success over the next decade, the LLI brought together a variety of stakeholders to discusss the program’s strengths, challenges, and potential future paths. In presentations and open-ended discussions, 㽶SSW faculty, University administrators, community partners, and social work deans from Columbia University, University of Chicago, University of Michigan, and Case Western Reserve University addressed the health and mental health challenges facing the Latinx community; took stock of the capacity of agencies to deliver culturally and linguistically congruent social work practice; and provided countless examples of bridging social work research and practice to tackle problems confronting Latinx individuals and families.
Jenna Parafinczuk, the director of social work for Boston Public Schools, discussed a one-of-a-kind partnership with 㽶SSW that exemplifies the LLI’s approach to working with the community to solve complex social issues.
Backed by a two-year, $500,000 grant from Boston Children’s Hospital, Parafinczuk and BPS teamed up with Calvo and her colleagues to develop an initiative in which experienced Black and Latinx social workers in the school system provide supervision and coaching to newly minted Black and Latinx social workers. The initiative’s ultimate goal is to bolster the professional skills of social workers while developing foundational interventions for improving the mental health of Black and Latinx children in the school setting.
The partnership addresses disparities in mental healthcare for socially marginalized communities—an inequality that has been exacerbated by the COVID-19 pandemic. A survey conducted by the Substance Abuse and Mental Health Services Administration in 2021 found that only 36 percent of Hispanic and Latinx Americans received mental health services, compared to 52 percent of their non-Hispanic white peers. Latinx youth are four times more likely than their non-Latinx peers to be retained in a grade and three times more likely not to graduate on time—two factors that, speakers said, negatively impact mental health. And the 2021 Youth Risk Behavior Survey, released by the Centers for Disease Control and Prevention, found that 30 percent of Hispanic high school students had experienced poor mental health in the month leading up to the poll.
“㽶 was meeting a gap in resources that we did not have,” said Parafinczuk, “and we also wanted to make sure that we were creating a linguistically and culturally concordant model.”
The stewards of the LLI—Calvo and Assistant Director Ximena Soto—underscored the program’s commitment to working with the community to improve the physical and mental wellbeing of Latinx individuals and families.
“The Latinx Leadership Initiative doesn’t belong to me, it belongs to the community,” said Calvo. “It belongs to the people who are here today and to a lot of people who are not here today.”
“This model that we have is extraordinary because it is fluid. We move with what the community needs. When social workers at BPS needed supervision, we moved that way,” added Soto. “Listening to the community and allowing them to be that partner that will guide the work you do in research, mentorship, and capacity building is what makes every day worth coming in.”
Joy Rosen, vice president of Enterprise Clinical Services for Mass General Brigham Behavioral and Mental Health, described how a shortage of social workers in clinics and hospitals paved the way for a partnership with the LLI that aims to set up students for career success.
For every 10 new mental health clinicians that are hired in the United States, said Rosen, 13 are leaving the field. And because of a national shortage of providers, one-third of the population lacks access to adequate healthcare.
“We already know that even if we were to hire everyone who comes out of school in Massachusetts, it’s not enough,” she said in a keynote address. “We’re losing people everyday—they feel burnt out, they feel exhausted.”
So, in fall 2021, the MGB healthcare system gave Calvo a $600,000 grant to develop the workforce of bilingual and bicultural social workers in Massachusetts. The grant, part of a five-year, $15 million investment from MGB to support mental health in the community, provides support to 830 students from eight colleges and universities who plan to enter the behavioral health field.
Several LLI students have already completed the program, which provides stipends and professional development to fellows as they work in community health settings that predominantly serve the Latinx population.
“While we hoped that our system benefited from some of these partnerships, that was not our intention,” said Rosen. “We want people working in community-based settings where there is a high need and a real gap in service—and that’s where the placements are.”
Rosen said Latinx social workers face a particularly difficult set of challenges that make it hard for them to stay in the field and climb the corporate ladder. For one, she said, educational debt is 9 percent higher on average for Hispanic and Latinx graduates compared to their peers. Latinx social workers are also frequently overextended based on their identity-based skills, such as translating Spanish into English for doctors and nurses.
In the face of these challenges, Rosen made several concrete suggestions for expanding the pipeline of Latinx social workers in the next decade. She recommended that healthcare agencies reach out to high school students to pique their interest in the social work field and help them see themselves as future clinicians. She also advocated the creation of clear career pathways for immigrants with interest in the field, with a particular focus on identifying ways to build up existing experience, education, and transferable skills.
Gautam N. Yadama, dean of 㽶SSW, and Margarita O’Neil-Arana, director of the Children’s Behavioral Health Knowledge Center at the Massachusetts Department of Mental Health, summed up the challenges of alleviating the behavioral health workforce crisis in the coming decade. “How do you take members of a community who have aspirations to flourish and remove barriers so they can flourish?” Yadama asked his colleagues in a discussion after a series of presentations. “If we bring in such students, where do we need to reenvision our curriculum to give them an on-ramp to take off? That ramp has to be long enough and forgiving enough to allow for that kind of transformation.”
O’Neil-Arana, for her part, described Calvo as a “force to be reckoned with” and advocated more Latinx social workers in leadership positions in academia and government. “How can we elevate our students to be prepared to know how to navigate the system to move up and have more influence?” she said.
The LLI’s approach to educating Latinx students over the past 10 years has drawn the attention of campus leaders and national organizations. In opening remarks at the event, David Quigley, provost and dean of faculties for 㽶, said the program embodies the mission of a Jesuit education. The Center for Diversity at the Council on Social Work Education, the sole accrediting body for social work programs in the U.S., named the LLI a Model Program for Diversity Education. And Excelencia in Education, an advocacy group, recognized the LLI with a top award for accelerating the educational success of Latinx students in a graduate program.
LLI alumni—a network of nearly 240 social workers in 26 states and four countries—regularly acknowledge the program for uncovering the rich history of the Latinx community, improving their self-confidence, and equipping them to better serve Latinx clients worldwide.
At the symposium, 2018 graduate Yvonne Castañeda said that her internship as a clinician at the East Boston Neighborhood Health Center reshaped the way she approaches the Latinx community. Shortly after joining the health center, she realized that her job wasn’t to solve her clients’ problems, but to give them space to share their stories and reveal their truest selves.
“I was so prepared with my interventions because I thought I needed to offer something to clients,” said Castañeda, who now serves as the director of community-based initiatives at 㽶SSW. “But people want to tell their stories. They want to feel better. They want to build a relationship. Their No. 1 thing is trust. I thought my role was to help and to fix and solve and I had to manage my own discomfort.”
Much like Castañeda’s former clients at EBNHC, the Latinx students at Esperanza Academy, a tuition-free, independent middle school in Lawrence, Massachusetts, have been encouraged to embrace their identities.
Principal Delia Durán-Clark greets students every day with merengue and bachata, two types of music that originated in the Dominican Republic. She said that students, 61 of 64 of whom identify as Latinx, are emboldened to show off their natural hair, describing the support as a “macro-affirmation.”
“Mental health is providing space for people to grow and to be their authentic selves knowing the risk that they take,” said Durán-Clark, MSW’98. “It’s easy for us to say ‘be your authentic self,’ because we created a sense of belonging.”
The academy’s culture of belonging has translated into academic success. Since the school was founded in 2006, 100 percent of students have graduated from high school, said Durán-Clark, and 75 percent have enrolled in college.
“If we don’t honor the culture and use our own cultural experience to connect, those things won’t be happening,” Michael Mancusi, vice president and chief behavioral health officer at the East Boston Neighborhood Health Center, said after Durán-Clark’s presentation.
In 2022, EBNHC and the South End Community Health Center teamed up with Calvo and her colleagues to address a lag in flu and COVID-19 vaccination rates among the Latinx population. Calvo’s team, supported by a five-year, $2.8 million grant from the National Institutes of Health, is testing a culturally and linguistically appropriate intervention for reducing vaccine hesitancy among Latinx patients at both health centers.
The intervention, called MI VACUNA, involves motivational interviewing, in which clinicians use discrete, accommodating language to discuss patients’ vaccination status, views, and concerns.
If a patient is interested in receiving a vaccine, a behavioral health clinician initiates a warm handoff to a nurse for vaccination or schedules a follow-up appointment.
So far, patients who have participated in the intervention in year one of the study have reported lower vaccine hesitancy compared to patients who have received their usual care. Surveys show that 80 percent of patients in the intervention believe the COVID-19 vaccine is necessary, compared to 75 percent of respondents who have received their typical care. Meanwhile, 70 percent of respondents in the intervention have said that the vaccine is effective, compared to 66 percent who are in the control group.
“We hypothesize that COVID-19 and influenza vaccination rates will be higher among Latinx behavioral health patients during years when MI VACUNA is implemented compared to usual care,” said Calvo.
Several other 㽶SSW faculty also shared how their research-practice partnerships are improving the wellbeing of the Latinx community.
Carolina Vélez-Grau, an assistant professor, discussed her ongoing investigation of the interpersonal theory of suicide, which posits that feeling burdensome and disconnected from others motivates people to think about taking their own lives. In particular, she examines the relationship between these two risk factors—perceived burdensomeness and thwarted belongingness—and suicidal ideation among depressed and non-depressed Black and Latinx adolescents.
She said suicidal ideation among Latinx youth has increased 5 percent in the past decade. “Mental health needs and suicide behaviors have increased among youth in general, particularly ethnoracially minoritized youth,” she said, “but Latinx youth are more likely than Asian, Black, and non-Latinx white peers to have persistent sadness and hopelessness.”
Vélez-Grau is currently working with three community organizations—La Colaborativa, Turn it Around, and Inquilinos Boricuas en Acción—to develop population-based approaches to mental healthcare for Latinx individuals and families.
“If we are serious about reducing rates of suicide, we need to change the way we deliver mental health services so we go to our youth and tap into resources that our community already has,” she said.
㽶SSW Professor Christopher Salas-Wright gave an overview of his 10-year career as a researcher who studies the social, cultural, and economic challenges facing immigrants—a role in which he has primarily focused on working directly with the people he’s trying to serve.
Salas-Wright highlighted one ongoing study that aims to address the needs of Venezuelan migrants who fled to Colombia, an investigation that is supported by a five-year, $2.1 million grant from the National Institute on Minority Health and Health Disparities.
He and 㽶SSW Postdoctoral Researcher Maria Fernanda Garcia are surveying Venezuelan migrants to learn more about their experiences in Venezuela before migrating, their experience in Colombia, and their relationships with their families. The pair is also interviewing a select group of parents and children to develop a deeper understanding of life pre- and post-migration.
Salas-Wright and Garcia are working closely with the community in Colombia to shape the study from start to finish—a prime example of the School’s commitment to addressing complex challenges in collaboration with those in need. The pair partnered with Corporación Nuevos Rumbos, a nonprofit in Colombia, to help recruit participants, collect data, and disseminate findings to practitioners and community leaders who are working to promote the well-being of Venezuelan migrants. And the duo created a Community Advisory Board, composed of both experts in the field and members of the Venezuelan community, to tailor research questions and interpret findings.
“All this work,” said Salas-Wright, referring to his robust body of research, “has been done in partnership with people I’ve been working with for close to a decade.”
His research focus is similar to that of 㽶SSW Assistant Professor María Piñeros-Leaño, who is working to improve the mental health and wellbeing of people whose lives have been turned upside down by violence and political turmoil in Colombia and Venezuela.
Supported by a $1.5 million grant from the Conrad N. Hilton Foundation, her team is culturally adapting and pilot-testing a pair of trauma-informed interventions to meet the needs of two distinctly vulnerable populations: internally displaced people in Colombia, who left their homes amid an increase of violence on civilians by armed groups, and Venezuelan migrants, who moved to Colombia to get away from their home country’s economic collapse and political crisis.
The project aligns with the three-pronged mission of her research lab, called MACONDO, or Mothers and Children of All Nations Defying the Odds: identify mental health needs among immigrant and migrant families domestically and globally; address mental health among immigrant and migrant families by promoting access to culturally-appropriate, evidence-based interventions; and develop a pipeline of students to promote understanding, knowledge, and engagement with the research process.
Piñeros-Leaño said her program exposes bilingual and bicultural students to community-engaged research while preparing them for doctoral work and full-time jobs through the publication of research papers. Several LLI students have worked in her lab.
“The idea aims to make research fun, to make it exciting for students, so they can keep going through the pipeline so they can actually go to a Ph.D. program,” she said.
Ana F. Abraído-Lanza, vice dean and professor at Columbia University’s School of Social Work, emphasized the need for schools to welcome anyone with good ideas to improve the lives of people in the Latinx community.
“Schools of social work, we embrace all people who are contributing to the environment,” she said, following a group of presentations. “When there is an opportunity to bring other people to the table, bring in the social workers.”
Participants at the all-day event comprised Ana Abraído-Lanza, Vice Dean and Professor, Columbia School of Social Work; Beth Angell, Dean and Professor, University of Michigan School of Social Work; Rocío Calvo, Professor and Founding Director, Latinx Leadership Initiative, Boston College School of Social Work; Yvonne Castañeda, Director of Community-Based Initiatives, Boston College School of Social Work; Delia Durán-Clark, School Principal, Esperanza Academy, Lawrence, Massachusetts; María Fernanda Piñeros-Leaño, Assistant Professor, Boston College School of Social Work; Deborah Gorman-Smith, Dean, University of Chicago; Michael Mancusi, Vice President and Chief Behavioral Health Officer, East Boston Neighborhood Health Center; Margarita O’Neill-Arana, Director, Children’s Behavioral Health Knowledge Center, Massachusetts Department of Mental Health; Kurt Organista, Professor and Harry & Riva Specht Chair in Publicly Supported Social Services, School of Social Welfare, University of California, Berkeley; Jenna Parafinczuk, Director of Social Work, Division of Student Support, Boston Public Schools; David Quigley, Provost, Boston College; Joy Rosen, Vice President, Enterprise Clinical Services, Mass General Brigham Behavioral and Mental Health; Christopher Salas-Wright, Professor, Boston College School of Social Work; Ximena Soto, Assistant Director, Latinx Leadership Initiative, Boston College School of Social Work; Marylou Sudders, Former Massachusetts Secretary of Health and Human Services; Carolina Vélez-Grau, Assistant Professor, Boston College School of Social Work; Dexter R. Voisin, Dean, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University; and Gautam N. Yadama, Professor and Dean, Boston College School of Social Work.