In Philadelphia’s ethnic minority zip codes, violence is a daily occurrence. It ranges from microaggression, moves through bullying, and has neighborhood borders watchtowers. For many generations this has meant suffering a Post Traumatic Stress Disorder that people are mostly unaware of.
Violence and mental health were the focus of a conversation with Dr. Héctor Ayala, President and CEO of Hispanic Community Counseling Services. He holds a Master’s degree in Human Services at Lincoln University in Philadelphia. He has a well-structured discourse when talking about recovery, resilience, trauma and violence in community settings.
Ayala believes in causality. The pandemic offered human behavior therapists an opportunity to “reinvent the way service is delivered.” In his case, his efforts are focused on the Hispanic family. However, he has to be familiar with all settings because his patients live in a multicultural metropolis; they are not isolated.
He looks neat and splendid in his gestural language. He wears a “fashion’s long goatee beard” that conveys maturity and status. At least that’s what is said in a hirsute faces study published by Behavioral Ecology. The Puerto Rican roots doctor wears an earring that portrays him as a self-confident man. He wears it with the same truth with which he blames “poverty as one of the social determinants” that fuels the flames of ignorance, ignites the fire of rage, that which sparks violence, even armed violence, and generates harmful effects ranging from mental and emotional health disorders to psychiatric disorders.
Héctor Ayala on poverty
Our interviewee holds a Master of Health Science and began his professional career as a Human Services-Board Certified Practitioner. After passing through the world of theory and with 20 years of professional experience, he knows what poverty does to communities and individuals.
“Violence is a result of poverty, poor access to resources, lack of education and jobs. In 2020, we lived in Philadelphia with these symptoms that create the perfect storm for these acts of violence. And because of the trauma there are people who are completely detached. They have no empathy for other people´ feelings. The reason for this is the trauma that plays a huge role in our emotional, psychological reactions and the way we look at the world.”
-What do you think about this new normal?
“This has been an extremely interesting process for us as an organization. We are in a moment of evolution. Unfortunately the COVID situation has happened. But we were able to reinvent the way we provide services as a result of it. We also figured out how to provide treatment within the Hispanic community.”
Dr. Héctor Ayala said it has been an organic process for the institution. “It has forced us to look at the situations we have as clinicians. We now understand mental health within our community through a totally different perspective.”
The online school experience
We asked Dr. Héctor Ayala about the impact of online schooling. Many believe that it will cause repercussions that should be resolved with urgency.
“This is an issue where the public is divided,” the specialist said. “We are dealing with situations that are completely out of our control. I don’t think anyone has been prepared. We have to understand that possibly this year all the school or academic goals we had planned for our children are not going to be achieved.”
In this section, the issue of poverty came up again. Our ethnic group’s lack of access to the Internet and the availability of a computer are evident.
Immigrants and mental health
Hispanic Community Counseling Services (HCCS) is a Latino-operated, community-based ambulatory agency chaired by Dr. Héctor Ayala. It provides mental and behavioral health services. It helps individuals and families to meet the challenges within the realm of today’s “life issues”.
HCCS is a multidisciplinary, multicultural, bilingual behavioral health care practice. Their primary focus is the provision of culturally appropriate behavioral health services. They are focused on the communities of North Philadelphia.
-Are immigrants more vulnerable to mental health problems than nationals?
“We have to define what an immigrant is, who immigrants are and who are not,” said Dr. Héctor Ayala. “And although the problems may be similar in the way they respond socially, how they solve their situation is completely different. Each ethnic group is a different solution, because the needs are different.”
“Our immigrant communities have been among the hardest hit. Lack of access to services and information. They are also affected by a feeling related to vaccination. Some believe it is being stolen from them.”
“And in this case our immigrants are the ones who are being affected the most. The statistics also show that they are the ones who are getting infected the most, the ones who are entering hospitals the most, and they are the group where the number of deaths is higher. On the other hand, they are first liners in hospitals, as paramedics, nurses and men in blue”.
Mental health challenges
Dr. Héctor Ayala’s speech is extremely fascinating. He believes that in order to “have a better Philadelphia we would have to attack and pay attention to education, employment, access to services. We have to take into consideration how other social aspects affect our communities. This is not something that is limited to our community. We know that not having access to certain resources fosters mental health issues.”
The problems of youth must be addressed. Discomforts that creep along generational paths. They are mental health problems that detonate in violent processes, such as those experienced in the racial riots.
“I do not justify violence in any way. I can only understand it. The rage unleashed in those days of looting can be translated. The young people in the streets with their actions shouted ‘I am in control. I am here, I matter, I am worthy and I can control'”.
The point is that “if my cognitive processes have been affected by trauma, especially before the age of 6, personality problems develop. Humans develop post traumatic stress disorder (PTSD)”.
We asked Dr. Héctor Ayala about the existence of a successful working model adapted to Philadelphia´s reality. “This is an extremely interesting question. The problem is the lack of information and studies on these issues. I am the Chair of the Latino Behavioral Health Coalition and there we have taken on the task of being able to answer precisely that question”.
“What we are looking for now in the Coalition is to be able to answer this question. To be able to design a therapeutic model that can address language, social, cultural and also cognitive processes.”
Translated by José Espinoza