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Cultural Immersion and Agency Assessment: The Family Resource Network

Veronica L. Trathen

Wilmington University
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My population of choice for the purposes of this paper is to learn more about people with

mental illness. The Family Resource Network (FRN) serves several populations. FRN serves

children as well as adults with intellectual and developmental disabilities of various races, social

classes and religious affiliations. However, it is not commonly known that FRN also supports

people with dual diagnosis including that of mental illness. Since this is an area that we serve it

would be advantageous of me to learn more about it making it a perfect selection for my cultural

immersion paper. Due to my lack of knowledge I am least comfortable being a resource to

families I support today who have this dual diagnosis. Though it is more common than I care to

admit I think we could do a better job of providing more education and training in this area. I

think this exercise will more than prove to be beneficial to me and FRN.

Understanding the collective history of mental illness is essential to cultural competence.

Though initially thought of as evidence of demonic possession at some point it began being

considered a physiological disease. Mental illness has had any twists and turns in history from

institutionalization to supporting people with mental illness in their own communities. Though it

was thought that a hospital setting maybe the cure it did not work out that way. When Mental

illness started to be studied it provided some perspective but again did not solve the issue. It

wasnt until the 1930s that treatments began being considered and through treatments were an

effort to help we were still a long way away from supporting people with mental illness.

Harry Truman signed in the mid-40th the National Mental Health Act which called for the

conducting of research into the mind, brain and behavior. Because of this law, The National

Institute of Mental Health (NIMH) was formed. Shortly after the first truly effective drugs for

the mentally ill started to be introduced. In the 1950s hospitals were at their peak but with the

help of modern medicine the number of institutionalized mentally ill dropped by 130,000 in
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1980. (The History of Mental Illness) In the 1980s, advocacy groups such as the National

Alliance for Mentally Ill (NAMI) and the National Alliance for Research on Schizophrenia and

Depression were formed to advocate for the mentally ill and finance research. For the first time,

it seemed as through real supports were underway.

Today, many new medications have been introduced and successfully treated most people

with mental illness. Very few people are placed in mental hospitals for long periods of time but

this is due more to the lack of funding though most people can be successfully treated right in

their own community. This has not stopped many from becoming homeless or incarceration

because of the misdiagnosis, treatments and available resources. So, while we have come far

there are still a lot to be desired for this population including breaking down stereotypes that

disrupt people with mental illness from being fully inclusive in their own communities.

Now that I have taken into the consideration the history for people with mental illness it

makes sense that I would find deeper understanding. I have done this by participating in an

indirect cultural immersion activity that has furthered my practical knowledge on the topic. I

choose to watch the movie A Beautiful Mind by Ron Howard a 2001 DreamWorks film about the

life of a professor with mental illness. There were several strong messages or themes I got from

viewing this movie that I will take with me into my personal and professional life. The

strongest message I received was that I need to come into each interaction with people with fresh

eyes. Each of us live in our own reality. In this movie, John Nash was living his reality the best

way he knew how. Once he began to realize his reality was only his perception he had a real

internal struggle which is the bases for the entire movie. At war with himself and unaware of the

damage he was doing around him to his wife, colleagues and friend John was lost. In a lot of

ways whether you have mental illness or not you believe what you believe. However, what is
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real and what is in our minds may not always be the same. John Nash with the right support

system and help started to make sense of his life. He started to come to terms with the best

version of himself even if it was not what most would considered normal. Those that loved

him and supported him helped to find a way to give balance to his life since he could not obtain

this completely on his own. This movie also shows how even though someone is struggling they

have great gifts to give. John Nashs intelligence was valuable, admirable and he was far more

than just his mental illness.

For my direct cultural immersion activity, I choose to interview a person with mental illness.

This interview was special to me because often the people I do work with have developmental

disabilities which has blinded me to the mental health concerns. She helped me to see that

mental illness is complicated and is a life long struggle. She did admit to me that in her darkest

days she did consider suicide and she had been placed several times in an outpatient program. It

was during this time they tried different medications to help her focus in school but she said a lot

of the time the mediation would help with one thing but only make her anxiety or depression

worse. The worst thing she said a person can do is to pretend you have been there when you

havent or tell me to get over it. As a professional it is now clear to me that even though I

dont have mental illness and I may not understand I can still be supportive in several other

ways. I can start by listening. I can also man myself with the education and resources. She was

classified in 3rd grade and even though she knew something was different from the on-going

doctors visits and the special treatment at school, she did not understand what was happening

until much later in life. She felt very sheltered from the reality of the situation until she was a

teenager which she did not appreciate. This demonstrated to me the importance of honesty as

well. As a professional you cannot work around a person but with them and for them. They
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cannot be excluded from planning their life and their supports. She was diagnosed with

depression, anxiety and ADD all of which affected so many areas of her life including her ability

to establish relationships. As a professional I think it is important to understand this to help with

relationships when possible. It is key in my own interactions with people that I should try other

ways to reach people not just my own way. She said she tries each day to be the best version of

herself. She used to compare herself to others (and sometimes still does) and she often feels

that she will never be liked or never measure up. She described it like being a prisoner in her

own mind. She said there wasnt much she ever finished because no one knew the struggles she

was having and those that pretended felt she was looking for attention and labeled her as

weird. The fear of others looking at her or the racing thoughts of negativity going through her

mind that she could not control at time were paralyzing. She said she was never in favor of

medications and even as a child would often not take it without her parents knowledge because

she did not like the way it made her feel. She said people often think medication is the answer to

fixing her. She seemed to just want people to understand her.

These two experiences have provided me with some great perspective, knowledge and

experiences of those with mental illness. It has granted me a better understanding to the values

and the worldview of this population. I learned most through my personal interview. I

interviewed a young person who was very comfortable speaking about her mental illness. I think

I received what she was saying so well because I was not distracted by a developmental

disability which automatically seems to take priority. As we spoke I was looking at a person

who looked just like me. I think this is often the problem for people with mental illness. They

do not appear to have anything wrong on the surface so it somehow does not feel real. The

interview put a face to it for me.

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The Family Resource Network, happens to provide supports to people with

developmental disabilities and mental illness but I am not sure walking around the agencys

neighborhood it would provide you a great deal of helpful information on the surface about

mental illness. The office is in a business complex with neighboring organizations that include a

lawyers office, bankruptcy court, AAA and a testing center for students. The main office

located in Hamilton is the central office and where all the Administrative staff reside though it is

a statewide organization. Even though the target population is people with disabilities and/or a

dual diagnosis the selected population is not living or working in FRNs neighborhood. The

initial impression of this neighborhood does not give a clear message without having to ask

questions and dig deeper into conversation with an agency representative. If I were a person

seeking services I do not think I would easy identify with this neighborhood and my needs.

All people with mental illness who come to FRN for services also have a developmental

disability. They are referred by The Division of Developmental Disabilities, Department of

Children and Families or some other government entities. Some referrals are by word of mouth

or families and friends. Most people in this population are supported by others so they are reliant

upon caregivers to provide transportation and their day to day needs. Even though the office is

intended to be a place the public can receive information most people hear about FRNs services

from the referring organizations, their website and through the statewide community outreach

efforts the organization themselves make. Attached is a map of FRNs agencys catchment

areas and the specific county coverage it has in New Jersey.

When you enter the office, there is a sitting area that is very welcoming with what

appears to be big comfortable chairs. There are lots of brochures available on the end tables and

hanging on the walls. It is quiet at times depending on the number of staff in the office on any
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given day. There is a receptionist that welcomes each person as you enter the office. All the

pictures on the walls make an impact since they are all photographs of participates enjoying their

services. I do feel it is an inviting office and most anyone would be comfortable but I am not

sure the pictures or the available information would make a people with mental illness feel this

organization had the ability to support them. The articles, brochures and pictures have a high

concentration on people with developmental disabilities and the mental health is almost an after-

thought. The amount of information available is too overwhelming.

FRN provides lots of training opportunities inside and outside the organization to all its

staff. Most of the trainings focus broadly on the disability population and state required

trainings. However, there are supplemental or special trainings for individuals with disabilities

who have other areas of which require additional education to their staff like that of those with a

dual diagnosis of mental illness. These supplemental trainings are in no way solid enough for a

staff person to feel like an expert in the field but more about getting general knowledge. These

trainings are not required and are available upon request. They are not held with frequency and

are provided on more of an as needed bases. At best, there is a lending library with resources on

specific disabilities that are made available to staff for free. FRN does have several office

volunteers statewide who have a developmental disability which is clearer to see. You would not

necessary know if any one employed by FRN has a dual diagnosis unless they disclosed it.

FRN is funded primarily through government entities that require lots of trainings to

people with disabilities and any of their special needs. However, the funding provided does not

cover training costs but FRN is still committed to providing the necessary trainings for the safety

of the individuals and their staff. However, because cost is a factor specials trainings around
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mental illness and other areas are limited and not necessarily required. This does not make for

good cultural sensitive services to people with mental illness it also gives one concern for safety.

Staff at FRN are extremely sensitivity to the needs of the individuals they support no

matter what the population. Even with limited trainings to those with mental illness FRN staff

does not run short on genuine kindness and humane treatment towards everyone. The staff at

FRN are here for the right reasons and just want to help. One of the regular volunteers in the

office has been with the organization for several years. He has a dual diagnosis and requires 1:1

support while he is with FRN. Staff in that office have gotten to know him well. So well that

when they know he is having a bad day they work hard to do what they can to not escalate or

aggravate the situation more. We are not talking about major changes but simply thoughtful

details to help him have the best day possible without incident. This demonstrates to me how

thoughtful and purposeful one can be supported if you know them well.

FRN can make a better effort when it comes to reaching out to the mental health

community to secure vital information and weave this expertise into its program design and

administration. The organization is committed to being more culturally sensitive and recently

started developing policies and practices with this intent. However, it is very new. It is

unfortunate but there are no members of this population that are actively contributing or sitting in

on these committees. It is certainly a recommendation I now plan to make. An organization

cannot be culturally sensitive without including, in this case people with mental illness, into the

process. Annually all services are evaluated. The evaluation is very general. I do think FRN

could do a better job of capturing specific information and utilizing the feedback. Evaluations

are a requirement of funders in most cases but I would like to see FRN take more seriously the

quality changes that can be made from family feedback. I am embarrassed to say that it was only
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a few years ago, that the evaluation was even available in Spanish let alone considerate of other

cultural variations and barriers. FRN does have Resource Coordinators on staff that assist

individuals and families in a one-to-one capacity. This does help to enhance services to the

mental health population as well as any. FRN staff, though good hearted, often learn in more of

a trial by fire way verses using preparation and cultural considerations.

Unfortunately, lack of quality does directly correlate with effectiveness. I know this

because the number of clients from the mental health population being served by FRN is not

reflective in the numbers of the agency services. I would believe that given the materials and our

presentation of services lead this population to not think of FRN for services let alone quality

mental health services. One service of interest to this population is employment and the inability

to have their needs met with appropriate services. In the case of a person with a disability the

difficulties in employment maybe more obvious. However, those with mental illness are not.

Their good and bad days effect their productivity and/or their ability to work. Additional skills

and supports may be needed if they are going to be supported successful in a work environment.

FRN has great community partners. Once someone is realized to be outside of their

scoop they do a good job of out sourcing families. I think FRN is often unsure of which

disabilities dominates and whether to explore or out source. Efficiencies can be created once the

agency decides to either fully support people with dual diagnosis or recognize it in not their area

and be ready to provide alternatives. FRN has a data base of more than 10,000 resources and

they also have skills resource coordinators to make the appropriate connections when needed.

Referrals would be made by calling and discussing the individuals needs and funding options

with each viable resource.

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In reviewing Standard 8 of the NASW Standards for Cultural Competence Professional

Education Social workers shall advocate for, develop, and participate in professional education

and training programs that advance cultural competence within the profession. Social workers

should embrace cultural competence as a focus of lifelong learning. This standard outlines the

key elements necessary in all areas of an organization including programs and its standards

related to cultural competencies. As an agency, cultural competence needs to be made a priority.

Once it is clear you are dedicated to it your advocacy will be your only way to maintain in. The

development along with education and training are the elements that keep it new and fresh with

each new person you hire or with each person who needs reminders. FRN is working on its

cultural competence and is in the early stages of its development. I would like to see people with

Mental illness get the support and become more of a priority but generally FRN needs to be more

competent to various races, social classes and religious affiliations.

At first glance one would think that The Family Resource Network (FRN) supports only

people with intellectual and developmental disabilities. However, often FRN works with people

who are dually diagnosed with not only a developmental disability but also some kind of mental

illness. All our trainings and educational opportunities focus on developmental disabilities.

There is a real lack of information on mental illness. I must be honest when we learn that

someone is dually diagnosed I think we freeze. We freeze because we dont discuss or address

the different needs someone may have when it comes to mental health and we are ill prepared to

do so. For today, because our expertise is the developmental disabilities all our supports address

those needs. However, how can we just omit their mental health needs and think we are

providing a solution? It is for this reason I chose to understand the history and the needs of

people with mental illness so that I might better understand how to support them. I can no longer
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turn a blind idea to the needs of all those populations I support. I cant be so focused on one area

of my job that others who deserve my dedication are over looked. It is up to me to continue to

educate and better myself and the agency I work for if I am going to be effective.
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REFERENCES

A Beautiful mind [Video file]. (n.d.).

Kiser, P. M. (2016). The human services internship: getting the most from your experience.

Australia: Cengage Learning.

Tracy, N. (n.d.). The History of Mental Illness Mental Illness Overview Other Info.

Retrieved July 01,2017, from https://www.healthyplace.com/other-info/mental-illness-

overview/the-history-of-mental-illness/