Behavioral Health Workforce Education & Training Program Interns

I want to work with individuals that have suffered from traumatic experiences because I am a survivor of abuse. It wasn’t until I began my first long-term therapy journey, at the beginning of my psychiatric nurse practitioner program, that I discovered I was suffering from longstanding post-traumatic stress disorder, or PTSD. Therapy and support have allowed me to sublimate the trauma and channel it through teaching, empowering me with a deep empathy to understand my patients and anyone I meet that has experienced trauma. I want to share the tools I have learned and empower others to develop resilience and self-compassion, especially those in my Latinx community.

Learning about trauma-informed care and the many techniques available to assess, evaluate, and make individual- and systems-level change is important for clinicians in helping to promote quality improvement and culture change. This culture change is aided by having champions at all stages who guide an institution towards revolutionizing its work culture and services. I plan to be one of these champions, and to use the skills I will learn to advocate for changes that benefit employees and patients alike.

Growing up biracial, I have seen how stereotypes, racism, and poverty affect the mental health of both Hispanic and Black individuals. I have experienced the feeling of not belonging to one group or another. There is a saying that “hurt people, hurt people,” but I did not understand what this really meant until early adulthood. The hurtful comments made towards me said nothing about me, but everything about the generational and personal trauma that Hispanic and Black individuals have faced. Upon this realization, and with the guidance and encouragement of my parents, it became a personal goal of mine to work in the mental health field, specifically with children of color, to help break this generational cycle of trauma.

Before joining Columbia Nursing, I worked in clinical research at New York University, where I learned about the importance of evidence-based practice and how to apply it.

As a current pediatric nurse and psychiatric NP intern at New Alternatives for Children (NAC), a child welfare agency that works with foster and prevention programs, I have worked collaboratively with an interprofessional team to support and empower families with children and adolescents with special needs. Many of the families we work with are BIPOC and have a history of intergenerational poverty, trauma, domestic violence, and homelessness. As a pediatric nurse, I teach families how to care for children and adolescents with complex needs and what their disease processes mean, while also encouraging participation in mental health services provided at NAC.

In the mental health clinic as a psychiatric NP intern, I will work with children, adolescents, and families to break the stigma of mental health care and provide high quality, culturally sensitive, trauma-informed care. A long-term goal of mine is to open an agency similar to NAC that would provide education, medical, behavioral, and mental health services to children, young adults, and their families. I want to positively affect intergenerational poverty patterns by providing health education, working to eliminate the stigma surrounding mental health issues and mental health care, and fostering a racially, ethnically, and socio-economically inclusive community. ‘

An essential facet of achieving this goal would be to hire people who look like the families we will be serving. While NAC provides excellent support and resources, racial representation is lacking, making some families hesitant to work with us as an agency. Providers who look like our patients and can relate to their experiences can assist them in opening up and taking advantage of all of the services we have to offer.

Providing quality care is more than the power to prescribe. It is the responsibility to hear, relate, and integrate the patient-centered, evidence-based approach that motivates me to practice as a psychiatric-mental health nurse practitioner.

The importance of trauma-informed care in psychiatry cannot be overstated. Trauma is not static; it exists along a spectrum and its effects can take many forms. As a psychiatric-mental health nurse practitioner, I plan to promote safe, transparent, and collaborative care environments focused on healing and empowerment. Further, I plan to remain involved in research and academia. I believe developing and disseminating knowledge is important in breaking down barriers to care and destigmatizing mental health care.   

I strongly believe that access to quality health care should not be a privilege available only to some, but instead a basic human right afforded to all. My sociology and public health background provides me with different frameworks for understanding trauma and violence, and my research experience makes me particularly keen on discussing and evaluating evidence-based practices and how to translate research findings carefully and creatively to various settings. With a career goal of providing trauma-informed mental health care to underserved populations, I am grateful to be a Behavioral Health Workforce Education and Training intern. Collaborating with both nurse practitioner and occupational therapy student peers, I am learning how to best support and empower clients, as well as to advocate for structural and institutional changes to promote health equity and healing; these are skills that will be the cornerstone of my practice as a psychiatric nurse practitioner.

Like many other Dominican Americans, my first home was the vibrant and diverse community of Washington Heights. My family immigrated to America with very little money, and I am the first to graduate from college. My family and I have received our health care from Columbia University Medical Center ever since I can remember. I remember coming out to my doctor as a gay teenager and having an honest conversation about STIs, HIV, depression, and how to tell my family while also acknowledging the stigma of being gay in Dominican culture. My dream, coming full circle, was realized with my admission to Columbia University School of Nursing. I plan to work for non-profit, community-based organizations in New York City, which generally do not offer competitive salaries to combat the debt that I will accrue from an Ivy League institution. The Behavioral Health Workforce Education and Training (BHWET) scholarship’s investment in me will allow me to follow my passion to make an impact in underrepresented communities like the one I come from. The BHWET scholarship allows me to further invest in my passion for health care for all people regardless of their background.

I have a background in community-focused healthcare, which ultimately inspired me to pursue nursing. Working at Callen-Lorde Community Health Center, a non-for-profit organization serving LGBT and HIV populations, gave me the opportunity to create safe spaces for members of my community. In my role as an HIV case manager, I worked closely with the nursing team to intervene when patients were newly diagnosed with HIV. Here I was able to cultivate and witness the strength of collaborative care, which I believe is the cornerstone of the profession of nursing. Many of my clients were homeless, and we provided them with holistic care medically and socially, connecting them to resources that would grant them permanent or temporary housing. I was also able to counsel and provide therapeutic communication to patients in acute distress due to a significant diagnosis, which has proven to be a strong skill-set in psychiatric nursing. Providing trauma-informed care and also culturally sensitive care was integral to this role and to interacting with patients from this particular population. Long-term, I envision myself practicing as a licensed psychiatric nurse in the community setting.

My parents’ experiences as Guatemalan immigrants in the United States influenced me to work with individuals who have suffered traumatic experiences. My parents both grew up in a small agrarian town in Guatemala called Totonicapan. During the 1970s, the town lacked access to clean water, educational institutions, food security, and safety from crime. My parents felt excluded in Guatemala and consistently lacked proper nutrition, education, a sense of security, and access to quality health care. Shattered by their experiences, they immigrated to the United States in order to escape their deprivations and live a better life in a country that embraced opportunities for growth and prosperity. However, they faced significant hardships along the way, such as chronic financial instability, minimal access to institutional support, racism, and discrimination. As in Guatemala, they continued to face limitations in society and kept their traumatic experiences to themselves. However, they never sought mental and physical health care due to their economic and social status in Guatemala and in the United States. After learning and being a part of my parent’s story, I understood that many people continue to face similar hardships. My parents’ experiences highlighted to me the disparities that exist in our society. I have felt a powerful calling to do what I can to address the systems and structures in our world that contribute to these social problems. My goal as an occupational therapist is to utilize the skills I learn in trauma-informed care to alleviate the suffering and feelings of powerlessness that many people experience, especially those who have suffered trauma and do not have access to resources based on their economic and social status.

Oftentimes, the true needs of individuals affected by psychological trauma are ignored. When seeking therapy, they are typically only assessed based on what can be observed on the surface. Through my work experiences, I’ve learned that treating a person so they may reach their health goals and achieve the happiness they desire takes so much more than surface-level treatment. This process must include assessing medical, social, and familial history, as well as mental readiness for change and meeting personal goals. Many of the populations I have worked with have lived with physical and/or mental disabilities for years, some since childhood, with no solution. Their daily lives are typically disrupted, and they often live in discomfort. Some are over-diagnosed with multiple disorders, misdiagnosed, or not diagnosed at all; then they are given additional/wrong medication as treatment or are unable to access medication. Historically, trauma has often been brushed off or minimized. This was and still is often experienced by underserved populations, thus adding to their trauma and increasing distrust for medicine/mental health services. It is this increased trauma that drives my passion to work with these individuals. I wish to help repair a system that has not always supported or advocated for those who may not be able to do so due to trauma. 

These populations need someone who will take their patients' needs and experiences into consideration to provide culturally competent treatment.  As a Black woman who has both experienced and supported those who have been exposed to various forms of trauma, I know that with the proper training and support I will best serve these individuals. I will always take my patients' experiences into account, specifically their experiences in health care, and will work to be vigilant about how these experiences might influence the way they experience the world around them (via relationships, career, etc.). With the trauma-informed care skills I learn, I will strive to provide individuals with access to the adequate care they deserve. I hope to utilize my skills to eventually encourage my clients to advocate for themselves and equip them with the knowledge to access appropriate care.