SOAR Webinar: Representing Immigrants and Non-Citizens with the Social Security Administration

SOAR Webinar: Representing Immigrants and Non-Citizens with the Social Security Administration


– [Pam] Hello, everyone. And welcome to today’s SOAR webinar on representing immigrants and non-citizens with the
Social Security administration. Today’s webinar is presented by SAMHSA Soar Technical Assistance at Policy Research
Associates under contract to the Substance Abuse Mental
Services Administration of the U.S. Department of
Health and Human Services. My name is Pam Hyde, Senior Project Associate here at the TA center and I’ll be your moderator. Before we officially begin the webinar I’d like to present Kristin Lupfer, Project Director here
at the SOAR TA Center who will give our welcome this afternoon. – [Kristin] Thanks, Pam. Good afternoon. Welcome everyone. We are so pleased to have
three esteemed presenters who each have many years experience providing services to
the immigrant community. Many of you know, after each webinar we ask you to complete an evaluation which includes a question that asks, “What topics would you like
covered in a future webinar?” And you asked for a webinar addressing representing immigrants. And we are thrilled to
finally be holding one on this very important topic. Many challenges that are
inherent in assistance which includes obtaining documentation, accessing appropriate
mental health treatment, finding culturally competent services, and identifying appropriate multilingual or translation services. We hope today’s webinar
helps you better understand Social Security’s eligibility requirements of citizenship and residency, and also how to engage and
provide appropriate assistance to the immigrant community. – [Pam] Housekeeping item before we begin. Just a reminder, your lines will be muted throughout the webinar. You’re being recorded and will be available for download on the SOAR website in about a week. Right now, you may download
the PowerPoint slides. You have two options: First, if you look to the
top left of your screen you will see the word file, then you want to click this. And then document to
download the materials. Your second option is to
visit the store website, the link is provided in the slide, click webinar, find today’s topic, and the PowerPoint slides are ready to download and print. At the conclusion of the webinar, as Kristin mentioned, you’ll be directed to a link
for an online evaluation. We really do value and
appreciate your feedback. And as you can see, use it to improve and
inform future SOAR webinars and ideas. In fact, this webinar today, as Kristin said, was chosen because of your feedback. So, you briefly review
our learning objectives and for today’s webinar. On this webinar, we hope that by the
conclusion you’ll understand a little bit better how
immigration, refugee, and residency status impacts eligibility for SSA benefits. And also, better understand
the cultural concepts of mental health and how these differences
influence access to treatment and other services. Understand the documentation required by SSA, specific to non-citizens, and also tips on how to
obtain this evidence. And then, learn about
some valuable resources that are there to assist your effort when providing immigrant services. So, today we are again
lucky to have with us, Lee Alviar, with the Dallas Regional
Public Affairs Office, as Public Affairs Specialist with the Social Security
Administration in Dallas. She’ll be speaking to more
of the technical aspects of SSA rules requiring
citizenship and residency. Sarah Nagy, Special
Needs Care Coordinator, with the International Rescue Committee in Baltimore will be discussing some
of the mental health and access issues often faced
by the immigrant community. And then, we’ll be listening
to Geraldo Benavides, Disability Assistance Outreach Specialist, with Health Care for the Homeless in Baltimore. We will talk more about
utilizing the SOAR Process in the immigrant community. So, this brings us to
our first poll question. We would like to know whether or not your agency is providing
SOAR representation as a part of your overall immigrant services? Just take a minute to find out indeed if your agency is providing
SOAR representation at this time as part of your overall
immigrant services. Please, take a minute to fill this out. Great. Not very much about it. About 1/3 of you do provide
SOAR representation. I hope for you folks who do
not at this time or are unsure, I hope that after this webinar you’ll see how you will be in a better position to add this to your array of services. Thank you for participating in this poll. Without further ado, I would like to present Lee Alviar with the Social Security Administration. Lee? Lee, is your phone unmuted? – [Kristin] It is. – [Lee] It is unmuted. – [Pam] The floor is yours. – [Lee] Awesome. Thank you. My fan in here. I do want to start the
presentation with Social Security. I will be covering Social
Security Disability and Disability under the Supplemental
Security Income Program. For both Social Security
Disability and SSI, you will need to meet the
definition of disability. Now, our definition by disability
is stipulated by Congress and the definition, the literal definition is on the screen which is “a medical condition
or combination of impairments “preventing substantial
work for at least 12 months, “or expected to result in death.” We also take into consideration age, education, and work experience. Now, what does that mean? It means whatever your impairment is, we’re going to look at it. And will that impairment
last for at least 12 months? It has to last at least that
long or result in death. Now talking about education and work, we will look at what
work experience you have. Are you able to continue to do that work? Or any type of work that would fall, even if it’s a lesser type of work. There are different
types of qualifications under Disability, but basically at least it has 12 months and it doesn’t mean you
have to wait 12 months since it actually started. It just means from the point that you either injured yourself, you had a car accident or
whatever the condition is, from that point forward it is so severe that it
keeps you from working. On the slide, it’s asking who can get with Disability with Social Security, not just with Disability, but as with retirement as well, and in our other programs, in order for someone to be eligible for Social Security benefits, you do have to work at least ten years and earn your 40 credits. In order to receive or earn
one credit in this year, you need to work at least pay taxes on $1220 and you get one credit. In this year if you earn $4880, you get your full four credits. If you’re near and you multiple times ten, those are your full 40 credits. That is for any type of benefits. Now, that would mean
you are fully insured. That means you work ten years, you pay your taxes, you’re going to get some type of benefit. – [Pam] Hi. We have a few people emailing that they’re having trouble hearing you and just that it is from your phone. Are you on your headset or speakers? – [Lee] My headset. – [Pam] Okay. You can take it off, your headset. You can take it off the headset, that might improve the quality. Thanks. – [Lee] Is that better? – [Pam] Much better. Much better, thanks. – [Lee] I’ll hold that headset. Okay, hold on. Did you hear the other
part for Social Security as long as you’ve worked your ten years or earned your 40 credits? You will receive– – [Pam] Yes. – [Lee] Some type of benefits. And predominantly people
think of retirement. But for Disability, the
difference with this program is not only do you have to be fully injured, you have to be currently insured. Currently insured means
from whatever point you became disabled or you had that car
accident, your heart attack, whatever point that happened, we go back ten years. In the last ten years, have you worked five out
of those last ten years? If you have, then you are considered both fully and currently insured. And that’s the part that some people miss if they work sporadically or they retired at 55 and they come in later, we do have to look at five
out of those last ten years. Now for the younger workers, you’re saying, “well if I’m 24, I’m 27, “there’s no way I could have
worked those ten years.” So, we do have special consideration for those that are under the age of 31. For anyone who is 24 years old, as long as you’ve worked
one and a half years and paid your Social Security taxes, then you are considered
fully and currently insured. For anyone aged 29, if you worked and paid
Social Security taxes at least four years, you’re considered fully
and currently insured. Anyone else over the age of 31, well we do have to look to make sure you’ve worked your ten years, plus five out of the last ten. – [Pam] Yep, that’s your slide. – [Lee] Okay. Over on the next slide,
it says who can get in. Well, not only the person who’s applying with Social Security because you’ve paid into the program if you are eligible, if you meet our disability
eligibility requirements, you meet that definition, then your children who you are minors under 18 if they’re still in school, they can receive benefits. If they’re still in high school then they can continue until 19 and two months, as long as they are not … If they are still in school and they get married
the benefits would stop. The person who is applying, if they are married their spouse
may also receive benefits. Now, the spouse would
have to be at least 62 if it were to be based on age or it could be that sometimes
the spouse is not working if they’re earning under a certain limit or they’re caring for the minor children, the spouse could in those
cases receive benefits under the Number Holders record as well. This also includes the divorced spouses. For divorced spouses you
have to have been married at least ten years, from beginning of marriage to the divorce there were at least ten
full years in there. Social Security and I know
we have more information but I’m sure that we’ll probably continue on the next training. For Social Security you,
the person and your family, can receive benefits if
they meet those criterias. On the next slide, for Supplemental Security Income, this program is different because it’s paid out of general revenue. More stipulations under this program because this isn’t something
that you’ve paid into, it is based on need. There is an income and resource limit to receive Supplemental
Security Income benefits. Now in order to qualify, it’s a two-part program. Not only do you have to meet
the income and resource limits, you also have to be
either blind or disabled, that age, or if you’re older, you don’t have to be disabled at 65, it’s just based on that age or older if you are under our
income and resource limits. True, if you are a U.S. citizen if you’re a naturalized
citizen or permanent resident, and meet these basic qualifications, then you are eligible to apply for Supplemental Security Income. For non-citizens, there are
some special requirements and they continue on the next slide. Non-citizens, well first
you have to be a citizen or a national of the United States or a non-citizen who meets
the alien eligibility criteria under the 1996 legislation
and its amendments. Now, there was a
difference before that time but with the Welfare Reform
Act there were some changes that came into this program. On the next slide, with when is a non-citizen
eligible for SSI? Now, and I will start by saying that the next slides are very technical. It’s going to depend on
whether you were here disabled and eligible
before August 22nd of 1996, or if you came into the U.S.
and met those requirements after that date. But, if this is a lot of information and it is in your slides
I want you to know that when you apply for
Supplemental Security Income, we do look at this
information more in detail and we have other pamphlets that we can supplement
with this information. But, I have to read the
following criteria slowly and if you have questions at the end I can go ahead and at the end of the whole two presentations we can
address them at that time. Now, as of August 22nd of 1996, most non-citizens must meet two
requirements to be eligible: To be in a qualified alien category and they must need a condition that allows qualified
aliens to get SSI benefits. They follow all of the other requirements which is the income and resource limits. And so that you know, the income limit for 2016
for an individual is $733. For a couple it is $1100. For an individual who
is applying is $2,000. If they are living as a
couple it remains at $3,000. The those resource
limits have been the same for quite a while. Next slide, we’re going to define. Okay, so now who is a qualified alien? Well, there are seven
categories of non-citizens who are qualified aliens. And if you are qualified alien or you are if the Department of Homeland Security says you’re in one of the following: So, for the next several slides we’re gonna cover the seven categories. The first one is: You must be lawfully admitted for Permanent Residence
or the (LAPR) in the U.S. including “Amerasian immigrant”
as defined in P.L. 100-202, with a class admission AM-1 through AM-8. Granted conditional entry
under Section 203(a)(7) of the Immigration and Nationality Act as in effect before April 1, 1980. Paroled into the U.S. under
Section 212(d)(5) of the INA for a period of at least one year. Or a refugee admitted to the United States under Section 207 of the INA. Granted asylum under
Section 208 of the INA. Deportation is being withheld under Section 243(h) of the INA as in before April 1, 1997, or removal is being withheld under Section 241(b)(3) of the INA. A Cuban or Haitian entrant
under Section 501(e) of the Refugee Education
Assistance Act of 1980 that is to be treated
as Cuban/Haitian entrant for SSI purposes. You have to be deemed qualified alien if under certain circumstances
you, your child, or your parents have been subject to
battery or extreme cruelty by a family member, under or excuse me, while in the United States. Next slide. Under what conditions is a
qualified alien eligible for SSI? Now, if you are in one of the seven qualified alien categories aforementioned, or have been determined to
be deemed qualified alien, because you’ve been subject
to battery or extreme cruelty, you may be eligible for SSI benefits if you have limited income and resources, aged, blind or disabled, and also meet one of the
following two conditions: You were receiving SSI
and were lawfully residing in the U.S. on or before
August 22 of 1996. Lawfully Admitted for
Permanent Residence, a LAPR with 40 qualifying quarters of earnings. It doesn’t necessarily have
to just been your work, it could have been done by your spouse, your parents, 40 quarters. But only for getting SSI
that’s just for this. Someone new. If it’s your spouse,
either you and your spouse. You worked five years. Your spouse worked five. Or the parent did. Someone, somewhere in there
worked those ten years. We cannot count quarters
of earnings earned after December 31, 1996, if you, your spouse,
or your parents worked or received certain benefits
from the U.S. government based on limited income and
resources during that period. If you entered the U.S. for the first time on or after August 22 of 1996, you may not be eligible for
SSI for the first five years as a LAPR, even if you have
the 40 qualifying quarters. That’s where that date
comes is very important. You are currently or if
you’re currently active in the United States Armed Forces, or you are an honorably discharged veteran and your discharge is not
because you are an alien, this condition may also
apply if you are the spouse, widow, or widower, or dependent child of certain U.S. military personnel. You were residing in the United
States on August 22, 1996, and you are blind or disabled. You may receive SSI for
a maximum of seven years from the date DHS granted
you qualified alien status in one of the following categories and the status was
granted within seven years of filing for SSI: Refugee admitted to the
U.S. under Section 207 of the Immigration and
Nationality Act that’s INA. You are an asylee admitted
to the U.S. under section 208 of the INA. An alien whose deportation was
withheld under section 243(h) of the INA or whose removal is withheld under section 241(b)(3) of the INA. Cuban or Haitian entrant as
defined under section 501(e) of the Refugee Assistance Act of 1980 or in a status that is to be treated as a Cuban/Haitian
entrant for SSI purposes. Amerasian immigrant
pursuant to P.L. 100-202 with a class admission
of AM-1 through AM-8. You may receive for seven years. There is an exception to
the August 22, 1996 law for certain non-citizen Indians. The categories who may be
eligible for SSI non-citizens and are not subject to
the August 22, 1996 law would include American
Indians born in Quetta who were admitted to the
U.S. under Section 289 of the INA. Non-citizen members of a
Federally recognized Indian tribe who fall under Section 4(e) of the Indian Self-Determination and Education Assistance Act. A lot of information on the next slide. We’re going to continue with additional eligible alien categories. This would include Victims of Severe Forms of Human Trafficking, remain eligible under
certain circumstances if the Department of
Health and Human Services’ Office of Refugee Resettlement and the Department of Homeland Security determine that you meet the requirements for the Trafficking Victims
Protection Act of 2000. Iraqi/Afgan Special Immigrants: you may also qualify for SSI for a period of seven years if you’re an Iraqi or Afghani
special immigrant admitted to the United States. To be eligible to meet
the requirements for SSI, on the next slide we’re saying, “well, what is residency?” You have to be living
within the United States or the 50 states and common areas. You have to live in the U.S., the Northern Mariana Islands with the intent to continue living within the geographic limits, or be a child living with the parent in the military service assigned
to permanent duty ashore anywhere outside the U.S., or be temporarily abroad for the purpose of conducting studies as part of an educational program. And that it is a
continuous stay in the U.S. or in those requirements. In order to determine if any of this, if you meet any of this criteria, on our next slide we do
need certain documentation. And these are originals or copies. We do not accept photocopies. This would include a certified copy of your birth certificate
which shows you were born in the U.S. Of course, this is for natural citizens for natural born citizens. A certified copy of a religious record for your birth or baptism
recorded in the U.S. within three months of your birth. Have of course your
naturalization certificate. Have your U.S. passport, A certificate of
citizenship naturalization, an identification card for
use of resident citizens of the United States
that would be the I-179, or an identification card
for use of resident aliens in the United States by both naturalization of parents, the form I-179. For all this information and
sometimes we’re aware that for our older generation
it may be more difficult for them to obtain these documents. So, on the next slide if you
can’t provide this information and we may find you to
be a citizen or national of the United States if you explain why you
can’t have that information. Either information you have which shows that you were living here and you are a citizen
or national of the U.S. Show your date and place
of birth here in the U.S. Otherwise known to be
a citizen or national of the United States. The relationship to you and
the citizenship of any person through whom you obtain citizenship. There has been, I know, a
lot of information to obtain and thankfully you do have the slides. There are some other pamphlets that I’ll send Pam afterwards. For when, if you do receive benefits, the first part being
Social Security Disability, we can send payment outside of the U.S. For additional SSA resources, on the next slide it will send you directly
to our public website which is www.ssa.gov/people/immigrants/ Through our publication of
Supplemental Security Income for non-citizens it can
be found on our website www.ssa.gov/pubs/EN-05-11051 The SSI Spotlight or the
Benefits for Aliens is also on our public website that
does have the information that’s been in this PowerPoint as long as other Publications
that are available to you. To know you have worked
because you’re like, “well okay, you’re
saying I need 40 credits. “How do I know if my
work history is correct? “Do I have those credits, do I not?” On our next slide we offer you information on how to create a my
Social Security account. With my Social Security,
it gives you direct access to your earnings record. It will tell you what years
we have earnings for you. It will also tell you, are you insured are you not insured? It takes your age into consideration. For those that are under
31 or if you are above it’ll tell you you have 29, you have 31, whatever your credits are. My Social Security or for
www.socialsecurity.gov/myaccount. Also, when you go to our public website, it’s one of the main icons
right there on the front page. Press the icon that looks
like right on the fly the my Social Security, it’s what you need on the next slide. In order to create an account you do have to be at
least 18 years or older, a valid email address, a Social Security number, and a U.S. mailing address. Those are the only four things you need in order to create an account. The next slide it will show
you there are four steps to creating the account. The first one is of
course to open up the link on our website. As soon as you read
the requirements you go right to the bottom of the page
and press Create An Account. It will ask you to verify
some of the information. The information is what
you should already know, your name, your address. This is encrypted meaning
that the questions that you are going to
come across are related to your Experian credit report. So, if you’re wondering how we
know what your passwords are or when you purchased a house, say Lee, you purchased a house in 2008. Did you pay cash or did you finance it through one of these agencies? And you select the correct one. There are several questions
that you will go through. If you are not familiar
with your credit report or you forget a certain account and you get an answer wrong, it’ll tell you, you’re suspended. You can try again in twenty-four hours or you can just go right on in. If you visit one of our field offices because you just can’t
remember the information. If you provide a valid
government document, driver’s license, a passport etcetera. we can help you set up
an account face to face. More information on social
media which is the next slide we are on Facebook, all these other accounts. Effective on the last slide on May 3, we do have a mobile version for our smartphone users. You can get a lot of
information for those of us that are attached. Have our phone at the hip. That information on our public website can be obtained there. Pam? – [Pam] Lee, thanks so much for your great presentation and letting everyone know, all the participants about MySSA.gov. I know it’s really important
for everyone to really enroll in that and to share that
with other share providers and to our applicants
it’s a great resource. So, thanks again. We have plenty of time
for questions at the end. We want to set up our second poll. Just to see if you’ve
been listening to Lee, this question is: All non-citizens can
receive disability benefits? True or false. We’ll take a minute to answer that. Thanks for participating. The vast majority of
you said that was false. We do know that which is the correct answer, we know that non-citizens can
indeed receive SSI benefits depending on the category. Thank you for taking the
time to take that poll. We’re gonna hand the
mic over to Sarah Nagy to talk a little bit
about mental health issues in the immigrant community. Sarah? – [Sarah] Hi, can everyone? America? – [Pam] Yep. – [Sarah] Good. Okay. Let me just introduce
myself really quickly. I work at the International
Rescue Committee in Baltimore, Maryland. I serve as the Special
Needs Care Coordinator. Our program, we do intensive medical care coordinations for refugees who have either physical or mental disabilities, mental complex diseases. And we help them advocate
in the hospitals. We help them try to find
the right providers for them so they can sort of be in
charge of their health care when they arrive in the United States. For our Agency we work with
Baltimore Medical Systems, they’re kind of the health care
providers here in Baltimore. So, all our refugees generally have the same primary care provider. Baltimore City Community College, they’re a great resource. They have English classes
for a lot of our clients. And we have somebody from the
Department of Social Services who helps clients with
benefits when they arrive in the country. When they arrive in the United States. Who is a refugee? Refugees flee their home countries to well-founded fear of persecution. There are a variety of reasons
that people may be refugees. Some of those reasons could be: race, nationality,
political opinion, religion, or social group that they from. As defined by the United Nations, a refugee is a person who is: “owing to a well-founded
fear of being persecuted “for reasons of race,
religion, nationality, “membership of a particular social group, “or political opinion, “is outside of the country “of his nationality, and is unable to or, “owing to such fear, “is unwilling to avail himself “of the protection of that country.” So, it’s somebody who’s
not safe in the country and has to leave the country
out of fear of faith. Which countries are creating refugees? Refugees are coming from areas of Asia, Africa, and Europe. But as you can see here, there are refugees from all over. And refugees are legally
admitted into the United States, welcomed into the country. The difference between
refugees and asylees, is asylees are people who are persecuted, but they come to the United
States on their own method, on their own way to the United States, and once they are in the United States, they seek asylum and ask
permission from the United States if they can stay here legally for fear of returning to their home country. Fleeing, as we mentioned before, there’s different things to consider: What is a refugee? What situation made them
leave their home country? How did they leave their home country? And how long did it take
to leave the country? During this time when they’re fleeing, this is the period that’s most associated with Post Traumatic Stress Disorder. What happens after refugees flee? Major populations: The top five refugee nationalities that resettled in the past fiscal year were from Burma, which is also, you might know it as Myanmar, Congo, Eritrea, Sudan, and Afghanistan. They’re immigrants from other populations. After the refugees flee, The International Rescue Committee, we have offices all around the country. So, this isn’t just the one in Baltimore. We help refugees and other
humanitarian immigrants become self-sufficient and
integrated in communities across Maryland and strengthen the social
and economic health of Baltimore City. Baltimore is really lucky. We have a very vibrant refugee population. They’re business owners, they contribute. It’s really sort of amazing to see how people after a few years
here are able to prosper. Once more we’ve helped
almost 10,000 refugees and asylees since 1999. Their health journey before they arrive in the United States when they’re overseas, this spans the refugee
camps or in another country, they go through a medical screening. We receive before their arrival biodata which is generally a sort
of a brief description of ailments that they might have. Often times, this data is very vague it may refer to a mental illness or it may refer to some
sort of physical disability and say, give a time period for
when follow-up is needed. Really, this information
is not very specific and it’s not maybe the
variety of problems. What they have to do, is they’ll have a health assessment at their private provider within 30 to 90 days of arrival. That’s the first time
that they see a doctor and the doctor might
make referrals for them to see other specialists. Medicaid, it says. As soon as they arrive, but generally Medicaid is
approved approximately four weeks after their arrival
into the United States. They have Medicaid coverage
for eight months after arrival. After the eight months they’re expected to recertify at their local DSS office. These medical screenings that they receive before they arrive, they do get a complete medical review, and a physical exam, and this generally includes a mental health evaluation
and HIV and STD screening for clients 15 years and older when they arrive in the United States that’s when we receive that information. So, we don’t have that
information before their arrival. But, when they bring that
with them when they arrive. Health concerns and risk factors among the refugee population are forced displacement. Extensive traumatic
experiences during conflicts and while living in camps This includes torture, violence, physical/sexual abuse, and domestic violence. Lack of access to primary
and dental healthcare. That’s why you’ll see a lot of times too, you see a lot of mental health
issues within this population because they have been
through so much trauma and trauma has been severe it is a pretty common occurrence. Other risk factors are severe
and chronic malnutrition and vitamin deficiencies. Substantial mental health burden and limited basic health
and education services. There’s a new set of medical concerns that sort of arise here
in the United States. Some of the biggest concerns would be: Our complicated healthcare
and insurance systems. Limited preventive health care coverage, especially with adults as far
as good dental and vision. They’re nervous for the
dental work they might need. The new environment that puts stress, the environment where
you don’t speak English, trying to communicate your needs, to make sure your family’s taken care of, and trying to make sure that they act … while addressing all
the needs for yourself and for your family. And lack of cultural
responsiveness among providers. I’ll try to go into
this a little bit later. More mental health issues. I don’t want it to be
confused with mental illness, I think mental health a lot
of times is tied to trauma and a lot of stress factors
that they have to deal with. I do see mental health
as sort of a common issue that comes up. They have higher rates of depression, anxiety problems including
post-traumatic stress disorder. In some cases, like with PTSD, their rates are ten times higher than the rate of the average population. Torture has been estimated between five and thirty-five percent depending on what population that you’re with, range that variance torture. Resettlement is often cited
as the biggest stressor. A lot I think when they come to America, things will sort of resolve themselves where they’ll get the
medical care they need. They find it much more
difficult once they do arrive. The language barrier is key because they don’t feel
in control a lot of times as being able to sort of navigate, their needs on their own. The financial resources
to take care of themselves and to take care of their families. There’s so many different
aspects that together once you arrive in the United States, and to navigate all of that
is extremely stressful. Many refugees are in a second country before they arrive in the United State. A lot them live in refugee camps. Refugee camps are often in bad conditions and they’re there for years on years waiting to come to the United States. There’s also a lot of violence that takes place in refugee camps. So, it’s the violence not
just in their country, but when you’re in a second country trying to get the refugee status. So, that’s another stressor that exists. I think we sort of hit on all of these, so these are the different
aspects that stress for people resettling. The fleeing, the encampment or exile
from their country, and the process of resettlement. That is very overwhelming trying
to navigate that together. A lot of clients might be apprehensive about seeking mental health treatment and it’s important to be
cognizant of what that means on client populations. They probably have a different experience with the Mental Health system, psychiatric hospitals, or the oppressive use
of the hospital system, the medical system in their country. Confidentiality might not
be or exist the way as in the United States. And there may be also
different repercussions within the community of
having a mental health issue. There’s an issue that client populations might be more apprehensive about a kind of stress or depression that they’re dealing with. The areas with effective treatment. They may be more apprehensive about trying to seek that treatment. A lot of times I’ve heard
from talking to clients, I see that mental health
issues are present. I approach them in a way that asks them, “it sounds like you’re having “a very difficult time, “I know that you’re under a lot of stress, “and if you do you feel this way, “there’s not anything wrong with you, “it doesn’t mean that there’s
anything wrong with you.” And I often might shape
it as a stress issue and being under a lot of stress and the stresses of resettlement. And inferring, like, you know, can … Refer you to this person that you might be able to talk to about these stressful issues. And generally they are pretty
receptive to add a few. Sort of just like frame it as just like having somebody to talk to. You know, framing it is as a stress and not as like Mental Health. As many of you who do work
with immigrant populations, you know one of the biggest
problems and obstacles is language access. Language barriers are
problematic in mental health to the mental health diagnosis and treatment relies
on direct communication with the client. If you feel like when your with someone in your own language a lot you’re able to
pick up on the nuances of a person saying something
or how a person’s behaving and you can feel when something
might not be exactly right, those social cues are a lot, they’re a lot more difficult to pick up on when you and the client aren’t
speaking the same language. Just a little bit later too, but with interpreters, sometimes there might not
be an in-person interpreter available, or using somebody over the phone who isn’t picking up on the same cues and they’re just trying to make sense of what the client is saying, rethinking the clients words in a way that makes sense to them. For that reason, if it is a conversation and mental health is involved, I might say to the interpreter beforehand that it’s really important to make sure what the client says. We need to know need to know exactly what the client is saying
as they’re saying it. While immigrant populations
may be likely to seek help for mental health problems
from primary care providers, their mental health problems
are likely to go unnoticed. This is the same point that
I just said in the first one, I think missed social cues when we’re not speaking the same language or when there’s somebody in the middle who’s interpreting for us might go by before you
really realize the severity of somebody’s mental health issues. Language barriers also may
make it particularly difficult for primary care providers to meet patients’ mental health needs. This comes up a lot with …. As a far like providing
the proper interpretation for counseling or providing an interpreter to serve … Because of a language barrier. I’m going to go into the
next slide for this reason. Title VI is a Civil Rights Act of 1964. There’s something really important, comes up constantly in our work, any organization that receives
federal funding is obligated to provide an interpreter
at no cost to those who cannot communicate
effectively in English. In other words, to provide the correct interpreter and the correct language. And when I’ve been working, have had hospitals asking for us to bring our own interpreter to treatment and if the agency is
receiving any federal funding they do not require a non-english speaker to bring their own interpreter. Working with interpreters. Interpreters are probably the most invaluable asset to
working with our clients, but often times, working with interpreters, you still may run across
the cultural bias. If the problem the individual is facing has it’s own implications
within the community, the interpreter may sometimes
transfer his opinions on the situation in the
way he or she interprets. This sometimes will cause interpreters to offer unsolicited advice to the client that may not be understood by the caseworker or the provider. Hopefully, this will never be the case.

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