Melon Haile California State University, Long Beach May 2012

1. A MENTAL HEALTH COMMUNITY OUTREACH AND EDUCATION PROGRAM FOR ERITREAN IMMIGRANTS: A GRANT PROPOSAL Melon Haile California State University, Long Beach May 2012

2. Introduction According to the United Nations High Commissioner for Refugees (UNHCR; 2010), Eritrea was one of the top 10 major sources of refugees in 2010, with a total of 236,035 refugees. The United States welcomes more than half of the world’s refugees seeking asylum, most of whom have experienced protracted violence, hardship, and life in refugee camps (UNHCR, 2010). Diversity is inherent to the American way of life, and so is equal opportunity (Office of the Surgeon General [OSG], 2001). With diversity comes a responsibility to ensure that every immigrant receives culturally appropriate mental healthcare. With increasing numbers of Eritreans seeking asylum and the United States granting the highest number of asylums, there is a growing need for culturally appropriate mental health services for Eritrean immigrants, specifically the need to educate this population about mental health and the availability of services. The purpose of this project is to develop a grant and identify a funding source for the purpose of designing a mental health community outreach and education program. The goal of the program is to improve the mental health of Eritrean immigrant adults at risk or suffering from mental illness through educational workshops.

3. Relevance to Social Work and Multiculturalism Migration presents universal challenges for all ethnic and racial groups leaving their country of origin. A national longitudinal survey in Australia commissioned by the Department of Immigration, Multicultural, and Indigenous Affairs (DIMIA) found that humanitarian entrants, such as refugees, experienced greater levels of stress and social difficulties than other migrant populations (Schweitzer, Melville, Steel, and Lacherez. 2006). According to WHO (2010), people with mental health conditions are among the most marginalized and vulnerable groups, often being excluded from mainstream social and economic activities, as well as from decision-making on issues that affect them. The primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty (National Association of Social Workers [NASW], n.d.). As helping professionals, we must assist our clients by empowering them to reach their goals and participate fully in society. In order to achieve this they must have equal access to opportunities and services. By identifying the needs of this population, we as social workers are able to create culturally appropriate services to accommodate the needs and beliefs of diverse consumers.

4. Methods Target Population The target population is the Eritrean immigrant population ages 18 and over who may be at risk or suffering from mental illness, living in the various cities throughout Los Angeles County. Methods for Identifying Potential Funding Source Sources for potential funding for the proposed project were identified using the foundation library and through Internet searches. Google search engine was used to search potential local, state and federal funding sources. The key terms such as “grants,” “grants for immigrants and refugees” and “mental health” were used to identify potential funding sources. Criteria for Selection of Grant The foundations awarding grants to immigrants and refugees were researched to identify the foundations background, mission, applicant eligibility, previously approved grants and deadlines. Location, population of interest, type of services, and schedule of application were all considered when deciding on an appropriate funding source. The foundations that were considered had in interest in funding programs that addressed mental health, health promotion, health education and or health access.

5. Methods (cont’d) Description of Funding Source The California Endowment was selected as a potential funding source as they have provided grants to both mental health and immigrants and refugees and as its mission is reflective of the goals of this proposed program. According to the Foundation Center’s Statistical Information Service, in 2010 the California Endowment awarded 83 grants for immigrant and refugees in the amount of $12,566,365 and 13 grants for mental health in the amount of $1,257,250. Resources for the Grant Problem Statement The needs assessment portion of the grant compiled information gathered from global, national, state and county data. A thorough review of literature and past studies on related topics identified the needs of the target population. Additional information related to immigrants, community outreach, mental health and mental health delivery will be gathered from the following sources: United Nations (www.un.org), Department Homeland Security (www.dhs.gov), U.S. Census Bureau (www.census.gov), California Department of Mental Health (www.dmh.ca.gov), Department of Health and Human Services (www.hhs.gov), National Institute of Mental Health (www.nimh.nih.gov), and Los Angeles County Department of Mental Health(dmh.lacounty.gov Projected budget Range and Categories This program requires a budget $356,810 to operate for 2 years. This includes the cost of staffing the program, operating cost, and equipment purchases.

6. Grant Proposal Program Summary and Description The goal of the program is to improve the mental health of Eritrean immigrant adults at risk or suffering from mental illness through educational workshops conducted by native speaking mental health professionals and outreach workers providing linguistic and culturally appropriate literature on mental illness, resources, and referrals. The educational workshops will be conducted by native speaking mental health professionals who will discuss the impact of mental health on the Eritrean community and the various and most common diagnosis and treatment options. Information pamphlets printed in English and Tigrinya will be handed out at community health fairs and placed in churches and community centers where the presentations are made. Case management will also be provided for those who need assistance in obtaining mental health services. Organizational Capacity DidiHirsch Community Mental Health Center will serve as a fiscal sponsor for this project. Didi Hirsch is non-profit outpatient mental health clinic in Los Angeles County offering community education, clinic-based treatment and residential care to people of all ages. Population Served This program seeks to improve the mental health of Tigrinya speaking Eritrean immigrant adults at risk or suffering from mental health problems demystifying the mental health system and improving access to existing services within the community.

7. Grant Proposal (cont’d) Objectives Objective 1: To provide education over a 2-year process to 2,000 Tigrinya speaking Eritrean immigrants who reside in the greater Los Angeles area about mental illness, symptoms, and risk factors. Objective 2: To provide information to over 10,000 Tigrinya speaking individuals over a 2-year period, in the greater Los Angeles area about mental health disorders, treatment options, and resources in the community. Objective 3: Over a 2-year period, to assist 500 Tigrinya speaking individuals obtain necessary mental health services from existing community based mental health organizations. Evaluation In an effort to identify the efficacy of the program, the program will be internally assessed on a consistent basis and an evaluation of the overall program will be conducted by a nonpartisan outside consultant.

8. Lessons Learned/Implications for Social Work Lessons Learned The process of writing this grant has resulted in a greater understanding and knowledge in grant writing and mental health from a cultural context. Based on the information gathered from the literature review, the writer was able to develop an important mental health community outreach and education program for Eritrean immigrants and refugees. The grant writer recognized the importance of grant writing as a skill that can empower social workers to develop and implement programs to meet the needs of the individuals and communities they serve. It is important for social workers who have firsthand knowledge about the needs of the community to be involved in the process of developing and implementing programs. The overall experience and skills developed through grant writing has prepared this grant writer to better serve the social work profession and the community. Social Work Implications Delivering clinical services to a refugee population requires social workers to develop cultural awareness, knowledge regarding cultures from around the world, and unique therapeutic skills. Presently, the United States is experiencing a dramatic change in population demographics that produces a different landscape for mental health professionals working with refugee populations (Kaczorowski et al., 2011). Based on immigration statistics from the U.S. Department of Homeland Security, a total of 74,602 refugees were admitted to the United States in 2009 —representing a 24% increase since 2008 and the greatest number of refugee admissions in a decade (Martin, 2010). The increasing presence of refugee populations in the United States requires social workers and mental health professionals to respond by designing and implementing culturally appropriate programs and clinical services for these groups.

9. References Kaczorowski, J., Williams, A., Smith, T., Fallah, N., Mendez, J., & Nelson-Gray, R. (2011). Adapting clinical services to accommodate needs of refugee populations. Professional Psychology, Research & Practice, 42, 361-367. Martin, D. C. (2010). Refugees and asylees: 2009. (Department of Homeland Security Annual Flow Report). Washington, DC: DHS. Retrieved http://www. dhs. gov/xlibrary/assets/statistics /publications /ois_rfa_fr_2009.pdf National Association of Social Workers. (n.d). Code of ethics (English and Spanish).Retrieved from http://www.socialworkers .org/ pubs/code/code.asp Office of the Surgeon General. (2001). Mental health: Culture, race, and ethnicity, a supplement to mental health: A Report of the surgeon general.Retrieved October 1, 2011, from http://www.surgeon general.go v/library/mentalhealth/cre/ Schweitzer, R., Melville, F., Steel, Z., & Lacherez, P. (2006). Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Australian and New Zealand Journal of Psychiatry, 40, 179-187. United Nations High Commissioner for Refugees. (2010). 2010 global trends: Refugees, asylum-seekers, returnees, internally displaced and stateless persons. Retrieved February 13, 2011, from http://www.unhcr.org/ 4c1 1f0be9.html World Health Organizations. (2010). Mental health and development targeting people with mental health conditions as a vulnerable group. Geneva, Switzerland. Retrieved October 12, 2011, from http://www.who.int/mental_health /policy/ mhtargeting/en/index.html