is having high anxiety now and isn’t able to function,” he
explains. In that scenario, the physician would introduce the
patient to a psychologist who would help with anxiety issues.
“It becomes a team approach and patients respond well to
caring for them holistically,”
Patients first see a physician
for a medical evaluation. If
mental health issues arise, Vento
or Daubney Harper, PhD, the
other half-time faculty member,
is contacted. Clinical decision-making involves consultations
among physicians, psychologists,
nurses, nurse practitioners and
the students. “We’re constantly
having conversations back and
forth about the patients’ needs,”
psychology intern Ralph Crabbe
“Integrated care is our goal,”
Proximity to the Mexican border also means exposure to
Armistead says. “Not just to be
co-located, but truly integrated.”
Second-year doctoral student
Laura James spends 20 hours a
week at clinic sites as a graduate
assistant. She sees a number of
patients with emotional trauma.
“Domestic violence is common
here,” she says. High rates of alcohol and substance abuse are
drug violence. “Most of the patients have family in Mexico,
so they are impacted, even if in an indirect way,” says James, a
native of Mexico herself.
Behavioral issues also can crop up with diabetes, which is
prevalent among La Clinica’s patients. Schwartz says interventions
may be nontraditional, such as helping patients learn how to
prepare healthy foods for glucose control or walking through
their neighborhoods to see if obstacles such as no sidewalks or
aggressive dogs pose barriers to exercise, for example.
“Being able to see a psychologist to address hurdles from
a behavioral health standpoint can help patients take care of
themselves better,” Armistead says.
Language and cultural differences can impede health care,
too. Prior to its partnership with La Clinica, New Mexico State
University used funds from the HRSA grant to begin bilingual
supervision of doctoral psychology students.
“The idea is to do as much training and supervision in
Spanish as possible” with bilingual students, says Eve Adams,
PhD, associate professor and director of training in the doctoral
counseling psychology program. The training isn’t just in
conversational Spanish. Students discuss psychology terms and
concepts in Spanish. The program is one of only a few in the
United States that offers a minor certification in Spanish.
Some La Clinica sites can work only with bilingual students
because their patients speak only Spanish, Adams adds. “My
schedule is very busy for that reason,” says James, whose native
language is Spanish. “In psychology, when we’re talking about
the experiences people have had, it makes a big difference.”
But space is hardly the final frontier. Eventually, the model
being created probably could be translated to other locations,
says Schwartz. “What’s exciting is that it allows the people we
hire to do clinical work and be faculty,” he explains. “They’re
really on the front lines of behavioral health care.” n
Rebecca Voelker is a writer in Chicago.
One-fourth of the population of Doña Ana County lives below the poverty line.