For a long time, Keodara Moua has known that she wanted to make life better for members of the Hmong community. One way to do that, she figured, is to become a licensed clinical social worker, and offer mental health services to people with life experiences similar to hers.
To realize her dream, Moua, 23, needs to complete a master’s degree in social work. But there were times that goal felt out of reach.
“My family asks, ‘You’re not done with school yet? What are you doing? You should be getting a job,’ ” Moua said. “They don’t even know what it means to be a social worker. My parents are very traditional Hmong parents who expect their children to get out of college and start helping to pay the bills right away.”
A master’s in social work requires an extra year in school and an unpaid internship. Moua, who was raised by a single mother, takes night classes at St. Catherine University/University of St. Thomas, and has daytime responsibility for the youngest two of her seven siblings.
“It’s hard to follow your own path,” she said. “Going to school is expensive. I try to explain my career goals to my family, but it can be hard, because in the Hmong community, we don’t even have words for mental health.”
While the words may not exist, the need does, Moua said: Hmong people, just like people in all ethnic groups, struggle with a range of mental health concerns. Being able to seek help from a clinician with a similar background may make the experience feel less intimidating and encourage more to get the care they need.
With her career goal in sight, Moua still wasn’t sure how she could afford to make it happen.
Then an internship coordinator at St. Catherine told her about Washburn Center for Children’s new Pathways program, a fellowship designed to support people of color interested in completing mental health degrees. The program offers training, mentorship, clinical supervision, a cohort of scholars and an annual stipend of $7,500.
The counselor said, Moua recalled, “‘I think you would be the perfect fit.’” While the Pathway stipend was essential, the program’s embedded supports felt even more important.
“The first thing I thought was, ‘I want an opportunity to be in a position where people will support me and not judge me for the barriers I face,’” she said. “The program at Washburn Center felt that way. I knew that with their help I could make it.”
Helping people like Moua become mental health practitioners is exactly what the Pathways program was designed to do.
While there is a great need for mental health services among children and families of color in Minnesota, there is a clear disparity in the number of people of color completing therapy degrees in the state.
Noting this disparity, Washburn Center held a series of conversations with local stakeholders, community leaders and students of color about barriers students of color face to completing their degree. Since their program is one of the state’s largest training grounds for future children’s mental health therapists, Washburn administrators felt they could do something to help. In fall 2017 they established the Pathways fellowship program.
Tom Steinmetz, Washburn Center for Children CEO, said Pathways was his organization’s attempt at narrowing Minnesota’s mental health care gap.
“For me this program is about equity and access on a very broad level,” Steinmetz said. “We know that there is a huge public health crisis: Eighty percent of children with mental health diagnoses don’t get treatment they need. We also have this huge racial equity disparity. Only eight percent of LICSWs in Minnesota are people of color. Nationally, the number is 12 percent. And only six percent of child psychologists nationally are people of color.”
Narrow the gap
What factors keep those numbers so low?
The local stakeholders told Washburn administrators about barriers that made it hard for many people of color to earn social work and therapy degrees, including a lack of community support and financial limitations that make earning advanced degrees feel unreachable.
Pearl Dobbins, Washburn’s director of equity and human development, said these barriers are real and troubling.
“Most mental health positions require a bachelor’s degree and a master’s degrees,” she said. “You also have to complete an internship component. That piece is often not paid. And once you get your bachelor’s and master’s degrees, you still have to complete hours in the field to become a licensed clinician. You also have to pay for the exams. It gets to be a hefty price ticket.”
Even when the will to reach the goal is there, the means may not be accessible, Dobbins said.
“Sometimes individuals have a strong desire to go into therapeutic services, but they are working full time. They are parents. When you have to do an unpaid internship it can be difficult to support a family.”
Recognizing their organization’s unique position as a national leader in mental health training, Washburn administrators decided to develop and fund the Pathways fellowship program, with a clear goal of supporting racial equity and cultural diversity in the children’s mental health field.
“This program comes from our commitment to advancing equity in the field and to helping expand the number of therapists of color,” Steinmetz said. “We realize our mission through the services we provide to children and families. By expanding the number of therapists of color in the state we directly impact access to care.”
While money can be a barrier to earning a degree in social work or therapy, another was a little harder to quantify but just as important.
Moua, who was one of seven fellows selected for Pathways’ inaugural cohort, said that she would feel lost without the support of the other fellows.
“Without the fellowship money, I wouldn’t be able to help support my mom, help pay house bills and electricity,” she said. “But without the support of everyone at Washburn, especially the other fellows, I’d really be struggling. We hold each other up when things get stressful.”
Dobbins said that encouraging strong relationships among the fellows is important.
“One thing I’ve heard from our fellows directly is they could not appreciate more the opportunity to have a cohort to share their experiences with,” she said. “In many training programs, being a person of color can be an isolating experience. This program tries to change that dynamic.”
Another key component of the Pathways program is the mentorship provided by Bill Allen, Ph.D., a longtime marriage and family therapist, consultant, author and professor. Allen, who has worked as a clinical consultant at Washburn for 15 years, provides formal mentorship to Pathways fellows through individual meetings and group discussions.
“Being able to talk to someone who has been through similar lived experiences and knows the challenges and obstacles but has been able to figure it out and be successful is really critical to the program,” Steinmetz said. “It is an essential ingredient.”
“The core essence of the program is mentorship,” she said, “having dedicated space set aside with a licensed clinician of color to process through the experience of being a person of color in the mental health field. Dr. Allen provides the voice of experience, and the fellows provide personal support for one another.”
Moua said that Allen’s support and advice has helped her understand that one day she will be able to realize her dream of being a licensed mental health practitioner.
“Dr. Allen is amazing,” Moua said. “He’s been able to challenge me and help ground me in so many ways.”
When Moua said she rarely saw a Hmong woman working in mental health, Allen encouraged her to join a professional association. “With Bill to help guide and empower me I found a group of working Hmong professional social workers,” she said. “They help me realize that it can be done.”
Getting out there and having a presence as a mental health professional of color helps spread the news that this kind of work is for everyone. Dobbins said that Washburn hopes to grow the Pathways program to 10 fellows next year, so this year’s fellows have hit the road, spreading the word about the program and its benefits to underserved communities.
Recently, Moua spoke to an undergraduate social work class at Metro State University. She told students there about the program, and why it is helping her achieve her goals.
“If people can see other people of color being clinicians they can start to think, ‘There is hope for me. I can be a clinician too,’ ” Dobbins said. She likes to think of the Pathways fellows as future leaders who are lighting the way for other students of color to take their place in the profession.
“Our fellows know they are role models,” she said. “They believe it is their time to encourage other students of color to consider work in the mental health field. It’s an exciting time.”