From the minute you shake his hand, 24-year-old University of Colorado Denver student Ibrahim Zien radiates warmth. He’s eager to learn, sweetly nervous and thoughtful in choosing his words.
The Aurora resident earned a degree in political science from CU Denver in spring and is studying accounting. He’s a self-proclaimed “huge politics addict” and says he has been since high school.
“The thing I love most about politics is that it’s involved in literally everything in your daily life,” Zien said. “Even though people don’t like to admit it.”
Zien appears to be a model student and friend — someone who is successfully juggling a lot of balls. You might never guess he deals with episodes of anxiety.
Zien initially didn’t know what to do when anxiety struck. He just knew that he desperately needed to put an end to the daily panic attacks and fainting spells that were “the worst feeling ever.” He stopped driving for fear he’d faint and crash. He felt restricted in everything he did.
When Zien decided to seek help, resources rose to meet him. Health care agencies across Aurora are implementing new techniques to better reach residents seeking mental health care.
The Kaiser Permanente office Zien visited was prepared to meet his needs. Kaiser is taking a number of initiatives to lower the point of entry for mental health intervention. Zien’s primary care physician, like others in the health care system, is trained to recognize signs of depression or anxiety. The training is part of a deliberate shift to integrated care.
“We are making mental health services available at the primary care visit,” said Dr. Margaret Ferguson, executive medical director of the Colorado Permanente Medical Group. Ferguson is a Colorado native and practicing pediatrician of more than 20 years. She was working the day of the historic Columbine shooting.
“As a pediatrician, and as a mom of four children now, the youngest of whom is 13, I clearly see the stigma around talking about ‘I feel depressed,'” she said.
That experience means she’s seen what has worked and what hasn’t over the past two decades. Even as the stigma surrounding mental health issues wanes and new interventions succeed, there are still barriers left for health care professionals to tackle, namely when it comes to reaching youths, people of color and immigrants.
Kaiser Permanente timed the kickoff of some efforts to broaden its reach to coincide with National Suicide Prevention Awareness Month in September. Its new campaign, “Find Your Words,” encourages people to discuss their mental illness and treatment and help remove the stigma. One of Kaiser’s public service announcements features a young black teenager walking alone around his neighborhood. He doesn’t speak, but the lyrics to rapper and songwriter Kendrick Lamar’s confessional “i” are recited. It is vastly different from the typical pharmaceutical industry commercial related to mental health.
Kaiser also held a series of town halls in Colorado for mental health organizations and professionals. Ferguson called the energy she experienced at one of the gatherings “amazing,” and said the momentum and outreach “is something that we absolutely can’t stop. We have a very big interest in making this a statewide collaborative.”
Aurora Mental Health Center was one of the largest organizations participating in the local town halls. The more than 40-year-old agency has 23 clinics throughout the city.
“In particular [we work] to capture youth and also to really be culturally congruent for the diverse city that we operate in,” deputy director Mara Kailin said.
In addition to stationing therapists in five school districts, the Aurora Mental Health Center runs the HEARTS (Healthy Environments And Response to Trauma in Schools) program in the Aurora and Cherry Creek school districts. HEARTS works to build a knowledgeable community on every school campus by training staff members, including custodians and bus drivers, to recognize mental health issues. The program also trains teachers to deal with children who have suffered trauma and how to care for themselves, as well.
Aurora Mental Health Center staff members speak 73 languages — part of an effort to widen the organization’s reach into the community’s diverse immigrant and refugee populations. It collaborates with state resettlement agencies and the Asian Pacific Development Center on many services.
“Kids that are coming here as refugees or immigrants or unaccompanied minors, they almost all the time have a trauma history,” Kailin said.
Working with these children often requires rewriting and modifying the evidence-based treatment models, which are largely based on working with kids who have grown up in U.S. culture.
The move toward integrated care has unique benefits to these hard-to-reach populations. Many immigrants come to the United States with a distrust of authority and harbor great cultural stigmas about mental illness, Kailin said. By informing primary care doctors and health officials how to spot and care for mental illness, the center enlarges the community’s safety net.
“It reduces the stigma around mental health. You don’t have to walk into a mental health office — you walk into a school or your pediatrician’s office,” Kailin said.
These collective efforts toward comprehensive, integrated care and reduced stigma made a direct impact on Zien.
After completing a survey designed to zero in on his anxiety issues, Zien was referred to a psychologist. The counselor quickly helped Zien recognize the source of his panic attacks — a mix of fears about the future, his job hunt and body image. He soaked up her advice and learned coping mechanisms.
“It made me relieved,” he said.
Zien learned to ward off a mounting panic attack and practices ways to not “take everything right on the nerves.” He also has learned to not see his body as a personal failure.
Just a week after his counseling appointment, he started driving again.
