What kind of impact do you get to have working together as a team?

We are always integrating with other social services to help our clients navigate the whole system in order to get them the best care possible. Like, if I have a Korean or Arabic speaking client at my clinic, I’m going to reach out to providers at other clinics who can speak their language because it’s so important to receive care in your native language. Or sometimes I won’t know about a resource and a colleague will say “hey, your client can get such and such. Here’s the number.” We all work together in helping our clients get what they need even when it’s beyond mental health care.

What’s a typical day like for you?

In my current role, I see myself as a coach or mentor, supervising peer counselors who are newer to their careers. I help them feel comfortable and empowered. I help them find the best resources for their clients or for our community center. That’s what my days are usually like.

How do you know you’re having an impact?

When I started doing this work I wasn’t searching for it, so my perspective has changed on how much you can impact someone’s life. I still run into clients that remember something I said or did. It means so much to know that I’ve helped them.

What advice do you have for someone who’s considering a career with LACDMH? What should they know before they sign up?

Make sure you’re ready for the day-to-day variety. Bring your flexibility, your humility and your open mind. If you can bring these things to the table, you could be a perfect fit for public mental health and LA County.

How do you support people in pivotal moments?

It’s my privilege to remind my clients to reflect on the obligations they have to themselves. I create an environment where they can reflect on their own needs, and where they might be neglecting themselves.  In our relationships with others, we tend to focus on what they expect from us in the roles we hold relative to them, like husband, son, brother, or father. For some of my clients, our conversations might be the first time someone has asked them to think about their own needs. A lot of men especially are able to open up to me. They might not have an answer as to what they need. There might only be tears, but I provide that safe space to slow down, to cry, and that can be enough in that moment.

Of course, the stereotype is: if you’re seeing a psychiatrist, it has to be about medication. On paper, that’s sometimes what it looks like. But it’s really not about medication. It’s about health and wellness. It’s about helping my clients improve their quality of life. I do that as part of a multidisciplinary team. In some ways, other teammates can go deeper with clients than I can, but it’s in how we work together that we can have the greatest impact. It’s a balance. It’s uplifting. It keeps me going.

What makes collaborating as a multidisciplinary team so powerful?

As a team, we are able to take a broader view in how we empower our clients to look after themselves  — relationally, physically, and mentally. For instance, I had a client who was depressed, they thought “no one else cares, so why should I?”  It was difficult challenging their assumption that no one cared. After a long back and forth, it turns out that they were often sad and sleeping a lot because they were avoiding physical pain, pain that they hadn’t tended to. They believed that because they completed a course of physical therapy after an accident, that that was it. That they just had to learn to deal with it. As a multidisciplinary team serving this client, we were able to help them on several fronts at once. The therapist used cognitive behavioral therapy (CBT) and other techniques to help reframe their perceptions about others caring. At the same time, case managers were working to reconnect this individual with a primary care doctor and the resources to deal with some of the physical challenges. And yes, I could prescribe medication that this individual might benefit from. We were able to pursue several starting points at once and, through our collaboration, this individual’s quality of life has been getting better and better.

What advice do you have for someone considering a career with LACDMH?

The clients we serve often have the greatest need and it can be hard not to take their stories home with us. For me, it’s important to remember that the services we provide, strive to provide the support and resources they may need to face the day-to-day difficulties of their lives. All the work we put in, is making these individuals’ worlds a better place. Who knows if we’re making the world a better place, but we are making each individual’s life better. That’s real.

What’s a typical day like for you?

I’m currently working on the GENESIS Program (Geriatric Evaluation Networks Encompassing Services Intervention Support). It’s a program that supports older adults who are homebound. When I’m out and about I also keep a lookout for older folks who are unhoused. They’re often forgotten, yet they’re the most vulnerable. They typically try to hide away and not draw attention to themselves. You can see the signals if you know what to look for. It’s really heartbreaking but when we find them, we’re able to start building relationships and learn what we could offer to get them to a better place. Sometimes it’s getting them mental health services, or necessary medication or even connecting them to non-mental health related services or resources.

What kinds of impact have you been able to have in your role?

I had a homeless client a few years ago; she was older. She hadn’t bathed in years. We went with her to her doctor’s appointment. She was really good about following his instructions. So I asked the doctor to write her a prescription for a shower. I told him to be sure and write down ‘Use your favorite Dove soap’ in the details. Her eyes lit up when she saw the prescription. We were able to take her to bathe. The doctor didn’t think it would work. But I knew she would. After cleaning up, she was so happy. She was a new woman. She had dignity.

What advice do you have for someone who’s considering a career with LACDMH?

I would tell them: You are needed, especially if you’ve had experiences with receiving services. There are people who are going through what you went through right now. They need to know somebody around here has been through it and been successful.

What motivates you to serve in this role and this context?

Doing something new and innovative has been a defining direction for me. In medical school, I picked psychiatry because it was the most abstract area in medicine at the time. They don’t have all the answers, there aren’t as many people going into it. It is a field ripe for development and expansion, for discovery and creativity. Even when I completed my residency, my first real job was something new within psychiatry —  urgent care services. 

I also connect with the struggles of the people who I’m serving. I’m an immigrant to this country and so I understand the hardship and challenges that can come from trying to build a life for yourself here. There was a time in my life where I needed a lot of help and my family needed support. It’s like a magnet pulled me in this direction because I understood and respected the population. I wanted to serve them. 

What do you like best about your job?

When we can reunite families. Nothing can come close to that. We might get a referral of someone who has been living on the street, who has been lost to the concerns of the world. We make a bond with them. We become what I call their clinical family. They start getting better and maybe they give us a name or a phone number of someone. We reach out on their behalf and find out that their parents or loved ones have been looking for them for years. We call and say “we found your loved one and they’re doing well. Would you like to see them?”

What skills do people need to do this kind of work?

You have to have a kind heart, to believe everyone deserves a fair chance, and to be driven by purpose. It helps to have some lofty ideals.  At the same time, the art of outreach, the ability to build rapport and connect with someone on the street, can’t be taught. When you see someone in a clinic setting, they’re coming to you. It’s easy to start that conversation asking: “What brings you in? How can I help you?” We’ve had to reframe our entire approach. We introduce ourselves as “care providers on the street” and then focus on meeting immediate needs like food, clothing, and housing. Outreach is showing up every single day and doing that — not just once. You’re staying present, building a bond, showing a commitment to that person. It takes time. There are people who have been doing this work for decades; I’m still learning from them.

What’s a typical day like?

No two days are ever the same. But I like it that way. One day could be quieter; then the next day, we have a crisis where everyone in the clinic has to drop everything to meet a need. In my current role, I’ve moved away from crisis work and direct client work, but it’s important for me to stay connected to that work because it’s what motivates and energizes me.

Working in public mental health in LA County is definitely more art than science. You have to think creatively in the moment. Like, ‘what can I do to build this connection?’ It’s like improv.

What advice do you have for someone who’s considering a career with LACDMH?

Think about yourself in the future. When you are looking back at your life, consider what is it that has really fulfilled you? If it’s feeling a sense of purpose, serving others and connecting to your community — you can get that at LACDMH while making a difference.

What’s it like collaborating with law enforcement?

We make such a good team. We’re able to solve difficult problems because we have both legal and mental health resources on hand. We tag-team questions from clients and families. I can speak to things like conservatorships, and an officer might be able to answer questions about evictions, landlord/tenant disputes, or domestic violence protection orders.

What makes working for LA County unique?

The beauty of working for the county is the variety of work. You don’t have to leave DMH to pursue a different avenue of service that excites you. Before working for the county, at my old job, I got promoted into a supervisory position, but that was it. I was basically waiting for someone to leave if I wanted a new challenge. Here if I get tired of working with law enforcement, I could work in a statistical analysis department, a training department, or do outpatient therapy at one of our clinics.

Working with my boss, I’ve been able to incorporate many of the things I’m passionate about into this role: I started a program where I train all the new officers in mental health basics. Not only that, I get to take the reins with program development. I do some grant writing. I collect data and do statistical analysis, both qualitative and quantitative. I also get to do grass roots community work which really inspires me — things like speaking to neighborhood watch groups and schools. 

And I’ve had great mentorship here. It was my previous boss, from when I was working with the county contract provider, who encouraged me to come to DMH. She loves working for the county and knew the PMRT role would be a great fit for me. My current boss is also a mentor. She has been so supportive and always encourages me to keep learning and growing, to keep trying new things, and developing as a psychologist.

How do you know you’re having an impact?

Even though crisis situations are part of my work everyday, for my clients and their families, hopefully our interaction is the only time they will go through something so intense. That means our work can have a huge impact on their lives. For instance, there was a young woman who had been placed with a foster family for many years. She was a frequent runaway, and we were called out for support when she threatened suicide and had left the family residence. We arrived and were able to detain her, to talk to her, to get her safely where she needed to be. She ended up graduating from high school and doing much better. Years later, I still run into her foster father and he is so grateful for our intervention and is a huge advocate of our program. Having our specialized unit — with a clinician, not just officers — show up and take control, de-escalate the situation and get his daughter the right care while treating her with respect and dignity in her moment of crisis, had a profound impact on him, too. 

I’m also seeing a culture shift within the departments where I work. There’s a willingness to acknowledge that officers need mental health services too.

Why is it so important to bring more people from the community into this work?

When clients come into the clinic, it’s important they see someone they can relate to, maybe someone they recognize from the neighborhood, maybe even someone who looks like them. Not only that, coming from the community means you’re better able to take cultural contexts into account when delivering care. 

We can’t be quick to pathologize individuals. We need to remember our clients may be operating in and reacting to an environment that isn’t supportive of them. Our job as psychologists is to help them find ways to better cope within those environments. It’s well documented that when cultural issues aren’t taken into account, people of color in particular are often misdiagnosed. They may have a mood disorder but they get mislabeled with a schizophrenia diagnosis. 

Right now, there just aren’t enough therapists and clinicians of color to support the need. Mental health has been in the background for so long and recent events, like George Floyd and Breonna Taylor, have brought things to the forefront. Identifying and supporting people who have a heart to work with our population is so important. I can’t do this work alone; it takes a village.

Do you have a philosophy of how you approach care? 

I believe customer service is foundational, it’s like the golden rule: treat others the way you would want to be treated. Just because we’re the county doesn’t mean we deliver second class service.  When people walk into that triage, we want to greet them, to make them feel comfortable, to make sure they’re attended to, and that they don’t have to wait too long to be served. It’s not easy to come into a clinic and admit that you have an ailment or that something is off. 

It’s also important for us to be visible and accessible, to be out in the community. For so long, there’s been a stigma around mental health. Everyone needs someone to talk to. Everyone needs a safe place to be themselves.

Why should someone consider working for LA County or at Hawkins?

Hawkins is the place to be if you have a desire to work with an underserved population with high needs. We have a diverse team of social workers, psychologists, LMFTs, and we take a non-hierarchical approach. We know the case manager knows some things, the therapist knows other things, the psychiatrist has insights too. Everyone’s role is important. We work closely with clinicians to ensure the caseloads don’t get unmanageable, that they have support they need to deliver quality care. 

We also pride ourselves on training. We make sure you’re always growing professionally, and clinically, and learning new techniques in order to best serve our clients.