On Wednesday mornings at the Nogales Senior Center, many of the elders are now excited to participate in a very unique and lively Wellness program known as “Entre Nosotros/Between Us”. A program designed to be culturally appropriate and linguistically accessible, SEAHEC community health workers help elder community members understand how to manage daily experiences, like stress, anxiety and isolation, and offer coping skills, local resources and referrals for people who need additional services.
Lupita Gonzalez, SEAHEC Community Health Worker who co-implemented the program
explains, “Project Between Us/Entre Nosotros addressed the shortage of mental health care
professionals serving rural border and migrant Latino/Hispanic communities of southern
Arizona, through the utilization and strengthening of our community health worker workforce.
We were able to increase skills and knowledge of our CHW workforce to provide mental health education and support in rural border communities of Douglas & Nogales and strengthen capacity of our CHW workforce to provide mental health support services through referrals and partnership, it has truly been a success”.
In January 2023, SEAHEC received funding from the CIGNA Foundation to address mental health issues among rural residents in both Nogales and Douglas Arizona. Our staff took a unique approach to designing, piloting and implementing our own locally appropriate curriculum and approach to discussing and addressing mental and behavioral health issues. With initial surveys in both communities demonstrating that mental health is a priority health concern for both community members and health providers alike, SEAHEC knew we were on to something much needed. At the same time, we understood that we had to take a careful look at stigma, and understanding people’s fears about dealing with these sensitive topics.
“Entre Nosotros” was launched. In Nogales, we utilized a weekly 1 hour format for 6 weeks, in Douglas we held half day workshops. Curriculum was offered in both English and Spanish. Each course fit the unique needs of each community. Topics covered during the sessions included: what is mental health, stress, anxiety, depression, opioids and addressing stigma. After each session CHW's provided a local community resource guide and educational material on each topic. A referral system connecting community members to existing services and sending them directly to existing partners for follow-up was developed with partners Mariposa Community Health Center and Pinal Hispanic Council.
These “warm hand off” referrals helped reduce the gap between the community needs and existing services by SEAHEC meeting people where they are and helping them navigate our complex health care system. Often times, disconnectedness between mental and primary health services is an obstacle for people who need services to seek care. In this coordinated manner, our program is help addressing these obstacles.
Group discussions were held where seniors shared insights on what they had learned. Highlights included stress reduction techniques such as walking in the park, drinking tea to relax, listening to music, playing a musical instrument, singing, and calling a friend or family member if feeling lonely or upset. Seniors mentioned that participating in programs offered at the centers have helped them socially, mentally, and physically.
“Keep coming, keep up the good work,”
"Sigan viniendo, nos hace mucho bien y aprendemos mucho de estos temas."
"Nos gusta mucho que vengan, traigan mas actividades como las botellitas de relajacion."
- Senior Center Participants.
Recently, SEAHEC received funding from National Institutes of Health a first-of-its-kind community-led research program to study ways to improve access to Rural Mental & Behavioral (M/B) Health services. This new initiative will allow us to keep working with our communities and partner agencies to address this priority health issue, in the long term.
21 intake, pre-surveys, and post-surveys were collected after Entre Nosotros curriculum was implemented. 100% of the participants could identify signs & symptoms from each session during a group discussion at the closing ceremony.
Participants improved their knowledge & skills for managing anxiety, stress, and depression and knowing community resources for mental & behavioral health services.
95% of the participants are interested in SEAHEC CHWs to continue teaching sessions at local senior centers. 4 referrals were completed within the first 2 sessions in Douglas and Nogales.
After we implemented the session about anxiety/depression, a female senior in her 80s shared the grief she had experienced after losing her son. She lived alone and often had to ask friends or grandkids for rides to run errands /appointments. She spends a lot of time alone; her go-to place is the Nogales Senior Center. “I get sad when it's Friday because the center is closed on the weekend,” she said in Spanish, followed by sharing how much she enjoys being part of the classes offered at Nogales Senior Center, chorus, bingo, and our Mental Health Awareness sessions. Participants stayed quiet for a moment of respect, and then the staff quickly acknowledged her feelings and thanked her for sharing as a group. We continued our session emphasizing a little more on positive coping activities to try at home; meditating, listening to positive music, reading a book, calling a friend, chair yoga, and others. The rest of the participants also shared activities they do at home that lead to a better state of mind; such as praying, dancing, and traveling as a group of seniors together, these activities reinforce positive mental health It was a great discussion!