Bergen County is home to approximately 40,000 uninsured adults who are ineligible for Medicaid or health subsidies. At BVMI in Hackensack, 1,000 hard-working people are provided comprehensive, integrated healthcare thanks to physicians, nurse practitioners, social workers and volunteers who donate professional services to the working poor.
BVMI services the population most hard-pressed when it comes to obtaining care.
Their “Average Patient” is 40-50, Hispanic, a single mom who also cares for a parent in their home, works and earns $12,000 or less annually. Almost all rely on public transportation. 60% are undocumented, filling low-paying but necessary jobs we rely on to keep our homes and communities running.
40% of BVMI's patients are from Hackensack, but according to CEO Amanda Missey, “We service clients from almost every town in Bergen.” 65% of their clients are female, but more working men have sought services as BVMI grows.
BVMI began administering a mental health screening to all patients in 2015. This year, a $40,000 grant from the Aetna Foundation enabled them to hire a part-time, bilingual social worker, Kathy Acosta, LCSW. Her services were built into the Women's Health Initiative Program, run by volunteer Dr. Kay Fagan, PhD, RN, APN. Kathy provides the counseling and refers those in need to ongoing mental healthcare.
BVMI is staffed by physicians from many specialty areas, but they are still seeking the volunteer services of a psychiatrist to aid them in long-term prescribing and complex cases.
“There is no such thing as free outpatient mental healthcare,” said Ms. Acosta, “so we can't just refer clients out. It is nearly impossible to find a psychiatrist for the uninsured patient.”
BVMI is currently limited to providing a “PHQ9”- a standard depression screening- and several sessions of counseling per client. The integrated program has primary doctors prescribing medications, and BVMI makes sure clients get a thorough exam:physicians spend an hour with every new patient. For any who need long-term mental healthcare, BVMI struggles to find community partners, and patients must pay for mental health services that many see as dispensable. These women care for themselves last.
The SFZ News was astonished when Ms. Acosta noted that 80% of BVMI patients screened positive for depression. It's not surprising when you consider the daily struggle that poverty, menial work, exhaustion, single parenting, stigma and trauma create beyond expected stresses.
Ms. Acosta explained living hand to mouth causes depression via all those factors. She noted cultural barriers in the Hispanic community towards mental illness, and said initial counseling sessions with women testing positive for depression or anxiety are spent just explaining what depression, a social worker and counseling are, and why a mental health referral may be needed.
“They usually just say, ‘I’m not crazy!,” she sighed. ”So many of our patients come in sick and they don’t know why,” added Ms. Missey, “it turns out to be their mental health, after you dig way down deep”.
“Providing someone who understands their language and culture gives people a comfort level [accepting mental health services],” said Ms. Acosta, “I wish we could do more. If we didn’t provide services, honestly I don’t feel our clients would get any mental healthcare.”
BVMI hopes to increase Kathy’s hours and institute on-sight mental health support groups; making it easy for clients to get to a group and accept help. They have been blessed with social work interns from Ramapo College, but don’t currently have mental health counseling available every hour they are open.
If you are a prescribing psychiatrist, or a social worker, nurse or are Spanish-speaking and can help BVMI provide better mental healthcare for our working poor, contact Amanda Missey at BVMI HERE and volunteer.
