Postcard from the Field

Whenever her eyes fall upon the Statue of Liberty, New York resident Grace Wong (PhD '90) mentally waves and recalls the words of Emma Lazarus' poem: "Give me your tired, your poor, your huddled masses yearning to breathe free, the wretched refuse of your teeming shore. Send these, the homeless, tempest-tossed to me." These words have particular significance for Grace in her work at the South Beach Psychiatric Center on Staten Island, a state hospital that often inherits patients who have the greatest difficulty stabilizing. The challenges for these patients and the staff that works with them are immense, but are even greater when the patients do not speak English.

In the past, these non-English-speaking patients were scattered throughout the New York psychiatric hospital system, often getting less than adequate care. In response to a suit filed by the Asian Coalition on behalf of patients who were not receiving culturally competent services, New York State created two sites with beds designated for Asian patients, staffed by individuals who speak their language. Wong works with monolingual Chinese-speaking patients on one of these special units, and has seen the program lead to better and more focused treatment. Psychoeducation is more effective, medication compliance has improved, patients' resistance to the idea of mental illness is lessened, and the patients themselves feel they are better understood.

The issue of cultural competency in mental health services is drawing increasing attention as its significance is recognized. Wong has been part of a panel of the New York State Psychological Association that is pushing for cultural competency for all psychologists. The panel has been working to develop both guidelines and training for psychologists in New York. "I think as a psychologist, I realized you can't just sit in your office and do your work. You really have to get somewhat politically active," Wong says. "It's very important to be aware of culture. I think we can no longer afford to be insular, not only insular-thinking in terms of the United States and whole world, but even now within your own neighborhood."

Reaching out to these "tempest-tossed" neighbors requires patience, flexibility, and lots of creativity. Working on a shoestring budget, the unit has nonetheless created an outpatient day program for monolingual Chinese patients, along with the inpatient program, in order to better serve this population. In addition to her expected duties as psychologist, Wong jumps in where needed, from driving the patient van to helping members of a patient's family navigate through the hospital and city. Wong acknowledges the challenges, but is not daunted. "The issues we face are like many other hospitals – restrictions from HMOs, changes in priorities in funding, and multilayer bureaucracy," she says. "Through it all, the staff fights for retaining a sense of humanity in ourselves and for our patients."