Center bridges the mind-body connection
Dollar Lee’s parents came to Colorado during the Vietnam War as young refugees from Laos. The communist-like government in Laos was unfriendly to the Hmong community of which they were both part, so they separately made parallel moves — first to Thailand and then to Colorado.
Near Denver, the couple met, married, and had two sons – Dollar, now 22, and his older brother, Silver. “They thought their kids would be their fortune,” he said.
The Lees both graduated from high school and found work in Colorado. The father was employed as a mechanic and the mother worked the graveyard shift at a factory. “It wasn’t always easy,” Dollar said.
There was, to start, a language barrier. But there continue to be cultural differences, especially when it comes to health. “When one of us gets sick, we would turn to cultural medicine first,” Dollar said. That might involve visiting a shaman, using herbs, or making offerings to spirits. “We believe in the physical and spiritual aspects of health.”
The Lee family’s story of fresh starts and cross-continental moves, and of navigating a new culture, is familiar in Aurora, where more than a fifth of current residents were born outside of the U.S. It’s especially familiar at the Asian Pacific Development Center (APDC), a nonprofit founded during the Vietnam War by a group of psychologists and social workers concerned about the mental and physical health of refugees arriving in Colorado.
Located in a building off of bustling Colfax Avenue, the Asian Pacific Development Center has evolved into a community-driven organization focused on empowering refugees and immigrants through a constellation of culturally responsive and integrated services. The Aurora building is home to the behavioral health clinic, a co-located Metro Community Provider Network primary care clinic with two bilingual medical providers, insurance enrollment services, a victim assistance unit, a legal aid clinic, adult education classes, interpreting/translation services, a community garden and youth leadership programs – all part of a collaborative team effort to help bridge gaps between refugees and immigrants and their new country.
While their numbers in Aurora are growing, refugees and immigrants still fly under the radar of many policymakers and health care providers, according to Harry Budisidharta, a deputy director at the center.
Budisidharta says that health statistics highlighting trends in larger demographic groups can disguise the challenges facing many refugees and immigrants. Asian-Americans rank higher than average on indicators of income and fitness.
“We’re often seen as one homogenous group,” he said.
But many refugees and new immigrants from Asia are dealing with anxiety, depression, or other mental and physical remnants of their traumatic experiences. Acclimating to a new country can be alienating and isolating. Bhutanese refugees in Colorado, for instance, have suicide and depression rates more than twice the national average. Many newcomers’ incomes are well below the poverty line.
They also may be transitioning from facing diseases that pose an immediate threat, like malaria, to chronic diseases like diabetes or heart disease that they may not know how to manage. Positive health practices like meditation or eating less processed food may fall to the wayside in a new environment.
Accessing health care can be an additional challenge. “Many of our clients don’t understand how health insurance works, due to language and cultural barriers,” Budisidharta said.
“Sometimes they feel discriminaton from the mainstream society,” said Jyoti Sapkota, a patient navigator at the APDC. “They feel so lonely.”
Add to that navigating sometimes less-than-ideal housing conditions, new school systems and laws, a new physical climate, and a new language, and the value of a place like the APDC is clear.
At APDC, awareness of those and many other challenges is key. Nearly all of the staff speak more than one language. Many are refugees or immigrants themselves.
The organization’s enrollment specialist helps newcomers sign up for Medicaid or other health insurance. Patient navigators like Sapkota provide health education and work closely with providers and other care team members to help patients manage their medical conditions. They also serve as cultural brokers, communicating patients’ experiences and perspectives to providers in order to help staff understand where their patients are coming from.
Because they know the cultures and experiences of their clients, behavioral health providers at the Asian Pacific Development Center know the right questions to ask to identify depression and other mental disorders in refugees, Sapkota said. Refugees might not answer yes to the question, “are you depressed,” but they may be exhibiting signs of depression, like not leaving their homes or talking to friends.
The Center’s roots in mental health are still evident, but having so many programs under one roof helps address the clients’ needs, Budisidharta said. There is still a stigma against acknowledging mental health challenges in some Asian cultures, he said, and it is helpful to have a place where one might as easily be going to a language class as a therapy session.
Budisidharta said that while refugees and immigrants need supports, they don’t need pity. “These are proud and resourceful people, and if we give them a chance to succeed, chances are they will succeed.” He cited one group of immigrants that are starting a taxi company.
Dollar Lee, now a student at the University of Colorado Denver, said that offerings like the Center’s youth leadership program, which he participated in, can build both community and leadership skills.
Lee is now on the board of the Asian Pacific Development Center. He is studying policy and ethnic studies, and hopes to close the gap between communities and policymakers, particularly when it comes to health. And as a student employee at the admissions office at his university, he’s hoping to help younger people find their paths.
”It’s more of a home than a place for services,” Lee said of the Center. “I see young people spending time there, clients coming back to hang out – it’s a home feeling, the feeling of people who have their back.”
– Jackie Zubrzycki