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The power of collaboration in mental health care

October 08, 2019

Dr. Michelle Silva has found her calling: to promote health equity among vulnerable and under-served immigrant communities. And if she’s learned one thing, it’s that this work cannot be done alone.

A licensed clinical psychologist, assistant professor in the Yale Department of Psychiatry, and director of the Connecticut Latino Behavioral Health System (LBHS), Dr. Silva specializes in collaboration, which she says is a key to building an accessible, effective mental health care system.

As the number of Latinx people living in Connecticut has grown over the past several years, including in New Haven, Dr. Silva and her colleagues in the Hispanic Clinic at Connecticut Mental Health Center have witnessed firsthand the need for culturally and linguistically appropriate mental health care. So she helped to establish LBHS, an umbrella program that increases local capacity to serve Spanish-speaking community members, many of whom have complex mental health needs.

LBHS creates infrastructure through partnership. It is based at the CMHC Hispanic Clinic (a clinical site of the Yale Psychiatry Department) and funded by the State of Connecticut Department of Mental Health & Addiction Services. LBHS supports staff positions and provides professional consultation, enabling Spanish-speaking clinicians to work with Latinx clients at several organizations in New Haven.

A small team of Yale psychiatrists and psychologists meet regularly with LBHS staff to review cases and provide ongoing training and education. LBHS collaborating agencies include BHCare Valley, BHCare Shoreline, Bridges, Cornell Scott Hill Health Center, Fair Haven Community Health Care, Fellowship Place, Hispanic Health Council, and Multicultural Ambulatory Addiction Services.

Dr. Silva says 378 people have been served by LBHS in the past year, including 241 active clients now receiving regular care. “That’s basically the size of an additional community clinic,” she explains. “If LBHS didn’t exist, those individuals would be on a long wait list for care.”

Advocacy is an important aspect of mental health care, not least when it comes to marginalized groups. Representative Patricia Dillon, Deputy Majority Leader in the Connecticut House of Representatives, has long been a voice for equity in mental health care in Connecticut. She is particularly happy with LBHS’s collaborative model, which is both economical and effective.

“I am so proud of the entire Latino Behavioral Health System team,” says Representative Dillon. “They provide mental health care to the fastest-growing segment of our community, people who experience many barriers to care and have special needs due to their language and culture. LBHS shows what positive things can happen when people and organizations come together for the greater good.”

Considering its community-level impact, it’s no wonder that LBHS won the 2019 Clinical Program Award from the Greater New Haven Chamber of Commerce. For other articles about LBHS, click here and here.

Dr. Silva and her colleagues take seriously their responsibility as clinical professionals and advocates for vulnerable populations, including people who have been displaced by violence, severe weather, and other factors. With Manuel Paris, PsyD, associate professor in the Yale Department of Psychiatry, and other colleagues nationwide, she recently co-authored "Vulnerable but not Broken," a report on the mental health challenges and resilience pathways among unaccompanied children from Central America. At LBHS, she is happy to be making a difference at the local level.

“Since Day 1, we have been fortunate to have administrative, community, and legislative support to carry this program forward,” says Dr. Silva. And the clinicians, she says, are the unsung heroes. 

“LBHS would not be possible without the dedicated team of clinicians championing this effort,” she observes. “The work is challenging, but this team does not give up. Engaging and learning with the LBHS staff is inspiring. They work tirelessly to ensure access to care for the most vulnerable among us, and it’s evident that serving the underserved is a vocation for each of them.”

While the clinical team knows the challenges their clients experience--including, often, traumatic histories--they also see their amazing strengths. Working with these clients, says Dr. Silva, is both a privilege and a responsibility.

“It demands courage and integrity to recognize and give voice to the experiences, needs, and strengths of people who may otherwise remain silent,” she says. “For many of us, as members of immigrant households ourselves, doing this work offers an opportunity to give back, and both advocate for what is needed, but also celebrate the inherent resilience of our communities.”

Submitted by Lucile Bruce on October 07, 2019