El Futuro fosters cultural understanding in Latino mental health care

Daira Hernandez-Gayosso sits in the therapeutic garden outside of El Futuro. (Photo courtesy of Onelia Gayosso.)

Wednesday, April 24, 2024

By Nayeli Jaramillo-Plata

Daira Hernandez-Gayosso chose to have her high school graduation pictures taken in a garden outside of El Futuro, a local mental health clinic.

For her, that garden signifies the mental and physical growth she experienced because of the services provided by this nonprofit.

El Futuro offers therapy, psychiatry and substance use services. The therapists are bilingual and use therapy approaches that recognize and respect cultural values, beliefs and practices among the Latino community.

Maritza Hondermann, the organization’s communications manager, said one of the culturally responsive therapy approaches El Futuro provides is Family-Centered Therapy, where family members are invited into therapy sessions to address the mental health needs of an individual.

Hernandez-Gayosso said having her parents involved in conversations about her mental health helped her feel supported. Before being a patient at El Futuro, she said, her parents had a stigmatized stance on mental health. They were hesitant to allow her to use medication for her anxiety and depression.

“My psychiatrist spoke to her, and my mom was able to hear from the psychiatrists herself that it’s important, and it might even be necessary,” Hernandez-Gayosso said. “I feel like that opened her eyes, like, ‘Oh, wow. My daughter does need help. And this could help make her life better.’”

Stigma about mental health is common among the Latino community, and talking about it can be viewed as a taboo. A little more than a third of Hispanic adults with mental illness receive treatment annually, lower than the U.S. average with is about 46%, according to the National Alliance on Mental Illness.

Dr. Juan Prandoni, a clinical psychologist and training director at El Futuro, said culturally Latinos are often collectivistic and family oriented. That also means they seek their family’s advice on important decisions.

“Sometimes when the family doesn’t approve of what they are doing and are looked down on as someone who “esta loco” [is crazy] that collectivism can be a negative in terms of making people shy away from seeking help,” he said. “Now, I mean, that’s a negative example of how this can play out, but it is something that we see happen a lot.”

Dr. Luke Smith, the founder of El Futuro, said human warmth, respect and trust are El Futuro’s guiding light.

“With every person who comes on board, when we do an orientation, we say ‘here are our guiding lights,’ here are the things that we need to do to make our services special,” he said. “Don’t get too excited about who you are, you’re important, but how we do the work is even more important.”

Smith identified a need for El Futuro after he moved to Durham to complete his residency training in child psychiatry. He said he realized the traditional medical approaches often did not consider the cultural values, beliefs and experiences of the Latino community, which resulted in Latinos struggling in silence.

“I had gotten my big title as an MD, and I knew how to prescribe medicine and did this therapy practice,” Smith said. “And yet, it didn’t mean anything if I didn’t establish the comprehensive calor humano [human warmth].”

El Futuro began as a volunteer project led by Smith in 2001, then incorporated as a nonprofit in 2004, and now has a second location in Siler City. This year, it will celebrate its 20th anniversary.

Smith said transitioning to nonprofit was challenging because there were budget cuts to mental health services in North Carolina as part of the Mental Health Reform Act of 2001 which led people to question El Futuro’s longevity.

El Futuro’s initial funds were work grants, contracts and grants from charitable foundations. However, over time, El Futuro received monetary contributions from community members.

“That’s one of the great success stories that I think we’ve had, to see a community who values immigrants and our mission and says, ‘I want to help,’ I love that story,” Smith said.

The organization serves more than 2,000 Latino youth and adults each year through outpatient clinics, according to the website. Its Durham location employs 70 people, including psychiatrists, therapists, social workers, case managers and administrative staff, Hondermann said.

“This year is important for us because it’s our 20th anniversary servicing the community. So we’re going have a lot of different events this year,” she said.

Hondermann said El Futuro will have three community festivals to celebrate the people they reached over the past two decades, patients like Hernandez-Gayosso.

Hernandez-Gayosso said she feels privileged to be a patient at a clinic that focuses on Latinos. For one thing, not having to translate for her mother removed one stressor.

“Instead of being worried about translating correctly, I could focus on my problems,” she said. “My mom is also able to express to the doctor exactly how she feels, and then the doctor would understand. It was just really nice.”

For many years, Hernandez-Gayosso believed she was consistently medically ill. But she said she was experiencing physical pain and symptoms from anxiety. She said she used to feel reluctant about mental health but never realized it was the root of her problems.

“I would go to doctors and doctors, but I would not be able to gain weight,” she said. “I was very severely underweight. And El Futuro helped me. I don’t know how they did it. But, I’m a healthy weight now.”

She said the growth she received helped her graduate high school. Now she is a sophomore at the University of North Carolina at Chapel Hill and is still a patient at El Futuro.

“It changed my life. I always grew up feeling like there was something wrong with me or my body,” she said. “But I felt like I was finally being helped and seen.”