May 6, 2024
Champion Spotlight: El Futuro
The Social Mission Champion series highlights the important work done by those who are engaging in social mission by advancing health equity and addressing the health disparities of the society in which it exists.
In April, we spoke with Dr. Luke Smith, Psychiatrist and Executive Director at El Futuro, a community-based nonprofit organization that seeks to transform mental health care in North Carolina and beyond. They provide bilingual therapy, psychiatry, case management, substance use treatment, and other mental health services to North Carolina’s Latino community in a welcoming environment of healing and hope. El Futuro hosts residents and students, and leads efforts to support and educate those who are interested in serving the Latino community.
Social Mission Alliance Conference attendees had the privilege of visiting El Futuro during this year’s conference, along with other locally based healthcare service organizations. One attendee who was moved by the work being done at El Futuro shared, “[Attendee] and I had tears in our eyes during this community site visit.”
In our interview with Dr. Luke Smith below, we explore the services El Futuro provides, and the community, values, and vision that drives their work.
About El Futuro
“We serve over 2,500 individuals and their families each year who come from 53 of North Carolina’s counties. With more than 17,000 clinical encounters and touching many more people with our community engagement work across North Carolina, we are not just responding to the mental health crisis, but pro-actively helping shape communities into safer, more welcoming spaces.
Founded in 2004 to meet the otherwise-unmet need for bilingual mental health services for North Carolina’s growing Latino immigrant community, over the last 20 years El Futuro has grown to become North Carolina’s trusted resource for trauma-informed, culturally-responsive mental health services. El Futuro provides services based on a foundation of community engagement, trust-building and empowerment. El Futuro’s Teaching, Education and Consultation programs not only host residents, like current psychiatric resident Dr. Nahmias, for year long rotations, but support a network of over 2,100 people who tune in to webinars, ECHO case consultations, learning cohorts, conferences, seminars, workshops, and consultations tailored to help support individuals and organizations who are endeavoring to serve the Latino community. El Futuro’s robust research arm and evaluation efforts consistently attract local, state and federal support.”
Contents
Q&A
What is your vision for mental health care in North Carolina’s Latino community? How do El Futuro providers and families collaborate in this?
At El Futuro, our mission is “to nurture stronger familias to live out their dreams.” When I think of a vision for mental health and substance use care for the growing Latino community in North Carolina, I think of the many ways everyone can pitch in to support and nurture our new Latino neighbors and community members. We want to help them get settled and also get services when needed. At El Futuro we often talk about services that we provide inside the walls of our clinics, like psychotherapy, substance use counseling and psychiatry treatment, but we also talk about the services outside the walls of our clinic.
Outside the walls, we deploy Spanish speaking Community Mental Health Workers, Peer Support Specialists, and community engagement specialists who meet individuals where they are to strengthen and support families. Each of our services is planned with community members who work with us to help us better understand cultural nuances and the areas where we need to focus our energies. Many Latino families feel the stress of migration and acculturation. Research shows that by strengthening family relations, bolstering ethnic pride, and connecting to resources, immigrant communities can better withstand acculturation stressors.
We collaborate with community members to create spaces and opportunities for families to be strengthened, to celebrate and honor their rich cultural heritages, and to facilitate linkages to resources. An example of this is our seasonal Kermés community fiestas which are inspired by the traditional fairs in much of Latin America. Through food, dancing, games and other activities, hundreds of people will come together on a Sunday afternoon to grow closer and stronger. In fact, we have one coming up on May 19 with a focus on celebrating mothers for Dia de las Madres. Ultimately, this is the vision of El Futuro – to strengthen and nurture families who came to the United States with dreams, and we are passionate about helping them to realize those dreams.
How do you address structural challenges when providing mental health services and programming?
Many systemic, structural challenges confront Latino communities and so we aim to not only emphasize cultural competence through our work, but also promote structural competence. It’s important for us to be culturally humble and responsive in all our clinical interactions, but we must look beyond the walls of the clinic into the living environments to make sure our treatments aren’t undone by unfair circumstances. If a child is in a school where, instead of acknowledging her learning differences, school staff label her as a behavior problem, then all our efforts to empower her and her family dissipate quickly. Black and brown children are disproportionately disciplined instead of supported in school systems. Our work goes beyond the clinical support for patients and families and extends into schools and other systems where we help promote better understanding, more culturally responsive services, and enhanced communication between systems and the Latino community.
Additionally, our case management program, Conexiones (Connections), provides critical wrap-around, trauma-informed and culturally-responsive care that our patients cannot access anywhere else and helps connect patients and families to supportive community resources that address social determinants of health such as housing, transportation, food insecurity, job opportunities, and more. We understand that when a family has housing stability, that then helps to reduce chronic stressors and can therefore improve mental/emotional health and family relationships. Moreover, I think it is important to highlight that our Conexiones program doesn’t just connect people with a phone number or address and then send them on their way. The other necessary dimension is to empower that person to take the steps needed to really connect with resources. Sometimes this is addressing the anxiety the person has, but at other times it is confronting the discrimination and systemic barriers that are in the way of people really using those resources.
What does culturally-responsive mental health care services and programming look like at El Futuro?
The work of El Futuro is guided by a number of principles. We work to meet people where they are through “respeto” or respect. We believe the focus of our efforts should clearly be on the person and community, not the other way around. Regardless of how much we have learned in school or the evidence-based practices we use, our perspective can’t eclipse that of the patients we serve. Respect is using an equity lens that considers each person individually and seeks to appreciate the rich context of their history, culture and community. Another core value we believe is paramount and foundational to good engagement is that of “confianza” or trust. Through our interpersonal interactions and the actions of our organization, we can build trust with our patients. One of the ways we do this is through another essential principle of “calor humano” or human warmth. When people feel the warmth and caring of our staff, they feel safer and more open to receiving the support we can offer. These three principles of respeto, confianza and calor humano undergird all the work we do to help us provide services and programming that is culturally-responsive.
SMA Conference attendees who attended the site visit at El Futuro loved the welcoming atmosphere of El Futuro, inside and out, including a garden with a calming water feature, a butterfly mural, and a room recreating Calle de la Fortaleza. Can you tell us about how the space was developed and why it is important to the community?
Our therapeutic green space is an oasis in the middle of an urban environment. With the recycling stream, raised beds garden, play spaces, sensory garden path and beautiful mural, it invites children and families in to spend time reconnecting with each other. And they don’t just connect with each other but also connect with other individuals and families – a phenomenon called bridging social capital: moving beyond mere social capital which might be within a social group to bridge to others who are different from us.
In Eric Klinenberg’s book “Palaces for the People”, he describes places like our therapeutic green space and points out that they create social infrastructure. Such infrastructure, he says, can help build relationships, promote connection to nature and play, and build and sustain positive mental wellbeing. We had some ideas of how such a space would complement our work when we envisioned it, but now that it is a reality, every day we’re blown away with how it is helping not only our patients, but others in the community and our staff as well. It is full of life! The therapeutic green space embodies and enhances our work in many ways.
Social Mission Alliance 2024 Conference attendees visit El Futuro’s therapeutic green space.
What recommendations do you have for other health care providers and organizations?
I think it is critically important to keep listening to the community we serve. Often we feel so committed to the practices we’ve learned in our training programs or from well-designed research studies, but we find that we miss the mark as we try to help. Such application of science to complex community settings falls flat. I recommend striving to be in tune with the community through deep listening and good communication. Ultimately, our best efforts have been those that we adapted and modified based on community input and guidance. Our goal as an organization is to be community informed and community led. This may seem slow and less efficient on the front end, but ultimately it is the most effective type of service we can provide and truly feels better at the end of the day.
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The Social Mission Alliance would like to thank Dr. Luke Smith and El Futuro, for taking the time to talk with us and for their continued commitment to social mission.
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The Social Mission Alliance is a joint activity with the Mullan Institute and George Washington University. Learn more about the Mullan Institute here.
