Luke Smith could be sitting in a nice office someplace charging a couple hundred dollars an hour as a child psychiatrist. That’s not who he is, though. He’s more of the roll-up-your-sleeves and get-involved type.

Smith is the director of El Futuro, a nonprofit clinic in Durham where Spanish-speaking immigrants can access culturally responsive mental health services. He’s been working with the immigrant community for 20 years, and you can hear some of his “why” when he talks about early experiences.

Like the time the Department of Social Services brought a student into his clinic after suspected child abuse. The DSS representative said the child had told his friends at school his parents were molesting him.

“But the word for ‘to bother’ in Spanish is molestar,” Smith said. “His parents were bothering him. They weren’t abusing him at all.”

Or another experience, when Smith attended an Individualized Education Plan (IEP) meeting on behalf of a Latino family. He remembers the red carpet treatment he received as a doctor, and the very different treatment offered to his patient-family.

There was an element of classism, and it wasn’t limited to the English speakers in the room.

“The translator — yeah, they got the job because they speak Spanish, but they’re not really connected with this family,” Smith said. “He was looking down at this family.”

These early experiences helped Smith see the barriers between Spanish-speaking families and the schools. He realized that the challenges to offering mental health services were not just language-based, but were cultural, too.

“It’s not clear-cut; it’s a little more messy than that,” he said. “And not everybody is willing to get messy.”

But Smith rolled up his sleeves and helped create a place where members of the Latino community — adults and youths — feel comfortable going for mental health services.

El Futuro, which was founded as a volunteer organization in 2001, formed as a nonprofit in 2004 and now has a staff of 43 — including 25 clinicians.

Today, it serves the mental health needs of Latino families in Durham and Siler City — “in a bilingual environment of healing and hope.” And it does so with nearly 75% of funding coming from grants and donations.

Here’s how it works.

Confianza — developing deep trust first, then meeting mental health needs
The first ingredient is trust. But not just any trust — confianza.

“It’s a deep trust,” Smith said. “When an immigrant comes into our community, it’s what they’re looking for and hold onto very quickly. So many of us have that experience of going to another country and finding somebody you can talk to, and you feel like, oh, this is my best friend all of a sudden. I don’t think we always reciprocate that very well as Americans when people come to the U.S. But when we do, we make friends for life.”

Smith talked about a stigma in the Latino community regarding mental health. Based on his work, he said, he realizes that setting up a clinic and offering mental health services is not enough to guarantee El Futuro can serve the community.

Instead of hanging a sign and hoping Spanish-speaking residents will come to it, El Futuro tries to meet the community where they are.

People come for services, but what they find is relationship. And through building relationships, El Futuro has grown more effective.

“We’ve never once had to really advertise our services because people, through those key concepts of confianza and relationships, people found us. We’ve never once had to go out looking for people.”

Calor humano — a focus on compassion
As the organization has grown, it has maintained its personality and focus on calor humano — human warmth.

El Futuro serves nearly 1,800 people a year, about 45% of whom are youths. Most of El Futuro’s clients have experienced trauma related to poverty and migration.

Nearly all, about 98% live below the poverty level and 56% have been victims of crime.

“Making mental health treatments accessible for underserved Latino families,” Smith says, “improves their quality of life and helps people get back to their dreams for the future that brought them to our community in the first place. It creates a better, healthier community for all.”

The mental health services are a priority, but when families come they aren’t just getting prescriptions or therapies. They’re building connection.

Check out the whole article here (article by Rupen Fofaria)

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