CH@T: El Futuro’s Atkinson encourages parents to ‘make mental health a priority’


The COVID-19 pandemic may have cast a spotlight on the importance of good mental health for most of America, but for some Siler City residents, it’s been a priority for at least the past four years.

Throughout 2017 and 2018, a community planning project — called Building Integrated Communities — brought together 75 people of various ages and backgrounds to assess challenges facing Siler City’s local immigration population and identify ways for town government to better serve its immigrants residents. After completing the needs assessment, project leaders then chose eight primary objectives.

One was youth mental health — a topic to which Siler City’s recently formed Immigrant Community Advisory Committee dedicated half of its monthly meeting last Tuesday.

In light of Mental Health Awareness Month, and the Immigrant Advisory Committee’s focus on youth mental health, the News + Record spoke with Christa Atkinson, a bilingual therapist with El Futuro, about challenges she’s seen youth and families face, particularly in the Latino community.

This summer, Atkinson will complete 14 years at El Futuro, a mental health nonprofit that serves the Spanish-speaking community with a bundle of bilingual services, including therapy, psychiatry, substance use treatment and case management. It has two clinics — one in Durham and another in Siler City, located on 401 North Ivey Ave.

As an outpatient mental health therapist, Atkinson works with children, families and adults of all ages in both the Durham and Siler City clinics. She estimated that she dedicates about a quarter of her work to serving youth and families in Siler City.

Here’s what she had to say:

In your work, what sorts of mental health challenges do you see — or have you seen — Spanish-speaking youth or youth in immigrant families navigating, especially in the last two years?

I would say, overall, it’s a lot of anxiety and depression, but you know, during the pandemic, a lot of the kids were kind of left — you know, not necessarily completely unsupervised, but really, parents had to go to work, and so kids were left to, a lot of time, use devices, and just be on their own a lot, making decisions about their day-to-day activities — [but] they’re not ready to make those decisions and make good choices.

So kids spent a lot of time plugged in, and as we know, that can change brains, and then coming back to reality, people are realizing that it’s really hard to relate to other kids, especially when you don’t have practice doing that and that they kind of like just being fine and just not participating in real life. So, that’s been a big change, and I think it’s really hard for parents to navigate how much screen time kids should have. So, that becomes a big conflict for kids and families. And I think there’s a lot of people that normalize, “Well, I know, my kid wants to go and sit in his room, and, you know, be on his phone,” and they do need some of that, but there’s a time that they also need to come out and join.

… I mean it’s been hard on all of us, but I think the kids, if you think about middle school — I mean, most of middle school is just learning how to act with peers. You know, like, we’re trying to learn how to be human beings, and so we make mistakes, and we do all kinds of things, but that’s our learning time to do that, and they missed out on a lot of that.

What barriers to care, internal or external, have you seen these youth face?

Well, definitely, just access and awareness, and also stigma. I think there’s still a lot of stigma, especially in the Latino community, about mental health. People don’t really know what to expect when they bring their kids in, or — like I said before — how much is just normal average teenage irritability and what’s depression. And then there’s certainly, I think, people — you know, our clinic, our physical clinic in Siler City, has not been open, and so there’s that barrier. We have our clinic open virtually, but we all know that it just does not work as well for kids and adolescents. There’s all kinds of distractions online, and it’s much harder to engage virtually with kids.

I heard a Siler City therapist mention that he worked with children who may not speak the same languages as their parents. Can you speak to that?

Yes, that’s a big issue, and a lot of people do speak, you know, generally Spanish, but [it’s] not the same kind of vocabulary. They’re used to saying, “Here, we’re going shopping,” or, “Let’s clean this up,” but they’re not used to talking about their emotions. And I’d say kids, adolescents, we need to learn just like we learn the basics of math, and then move forward, you know, building on top of that — a lot of times, we just need to learn the basics of emotions and learning: What are those things? And what do you call them? And then it starts to get more subtle. But yeah, some people just lack the basic building blocks of emotional intelligence.

… I mean, most parents want to avoid talking about difficult things, and so we do avoid [them], but I would say, especially in the Latino culture, there’s the idea that you keep moving forward, and you don’t show your kids that something affects you — and that actually can be difficult for children because then they grow up thinking, “Well, what’s wrong with me? Why am I having a hard time with it? Look at my mom, she had nine kids, and she could do it all.”

Speaking of culture, what other cultural beliefs or dynamics within Spanish-speaking immigrant families might lead to these challenges or barriers of care?

Well, it’s something that I mentioned earlier, but obviously, it’s always been an issue — is that parents are working so much. And especially when kids are younger, they might be home more, but when they become preteens and teens, parents are like, “OK, I’m working.” And so, they’re just not available for their kids as much and of course, it’s necessary to work, but there’s not a lot of time spent with your kid.

I think the other beliefs are kind of that they have it easy — that some life in the U.S. is just so kind of cushy, and they shouldn’t have a difficult time, like they shouldn’t be depressed because their life is not that hard. I mean, so many people, adults that I hear, they’re just like, “We just didn’t have anxiety when I was growing up. There wasn’t such a thing.”

So, how can youth struggling with mental health challenges seek help?

Youth themselves have a lot of opportunities using the actual technology that they know a lot more about. There are so many apps that have mood tracking, they have calming, meditation scripts, they have podcasts that have pep talks. So, I highly encourage people that are technologically savvy to access those things if they don’t have access to a therapist. The other thing is that there are so many therapists online now, so even if they might not be able to get in in person at El Futuro at the moment, there are multiple online platforms, and some that do take Medicaid, so people can access more services.

I would say for the parents who are seeing their kid struggle, it’s really creating connection, trying to spend time with your kids, just listening, and also emotional expression, saying, “I’m overwhelmed right now,” can really go a long way for showing kids that emotions come and go and they’re just a normal part of everyday life. Then also validating, like people have a hard time realizing that kids are struggling, and that invalidation of feelings can really be disheartening. And so, just validating even if you don’t understand it, looking at them for how they’re struggling and validating, “I’m so sorry that this is so hard. I’m so sorry that you’re struggling,” even if you don’t understand why they’re struggling or don’t think that they should be.

Many youth often go to their friends for help, so in the same sense, how can friends offer support?

Validating their friends, telling them, “Wow, this is really hard — what you’re going through,” and most of all, just listening. People underestimate the value of someone feeling heard, so even if you can’t feel like you can’t do anything, being someone that listening is incredibly powerful.

Why is it important to seek out help, especially for youth?

The obvious is concerns for safety, and I would want to remind people that if anyone is saying even passive thoughts of suicide, or passive thoughts of death, I would really encourage parents to take that seriously, even if it doesn’t seem like they would actually complete suicide. It’s really important to take that seriously.

And then, in terms of the importance of mental health, like I said before, we need these basic skills. I mean, you and I know that life really — it doesn’t get easier, and so learning how to deal with stressors and things that come, this is the time when you’re able to learn how to deal with things, and how you approach basically life, and so learning that early can really help to set the stage for being able to handle difficulties as they come.

What do you think adults, especially those in positions or institutions overseeing youth (i.e. schools), should keep in mind when they’re trying to come up with solutions or programs to improve mental health among the youth they serve?

A lot — I can think of a lot of things. It’s a hard thing, because I know, school officials, people that are working in the school, they’re already taxed and probably need their own support.

What I would really encourage as a focus when I think about mental health as our community is creating more community spaces, where kids can be kids — you know, places and community centers, where they can recreate, play basketball, and be free to be adolescents, and, you know, sometimes make mistakes.

And then, also, I guess, maybe if they had more peer-to-peer training — I know that they’ve had some different programs where these prosocial peers become kind of specialists in different arenas where other kids can go to them and seek help and get answers to their questions. Basically, the more kids who know about mental health and how to help your own mental health and they’re spreading awareness amongst the kids, it’s going to be more efficient than you know having a school counselor come in and do social emotional learning yeah, having that trust, I suppose among people closer to your own age who you feel might understand your situation better than any others. Especially when you have more boys having more knowledge about mental health and making it an acceptable thing, making it a thing that is seen and aware, will just have a lot more buy-in from other boys, for example.

One of the BIC plan objectives is to “increase availability of behavioral health services in Chatham County schools through partnership with El Futuro.” According to your blurb on El Futuro’s website, you participated in an in-school mental health program targeting mental health for Latino students in Durham’s elementary schools. Can you tell me more about that program and how it worked?

We had wellness centers; Duke had official wellness clinics with a nurse practitioner in some of the schools, and then I would do mental health evaluations in the schools. That was a number of years ago, when I worked for the Center for Child & Family Health.

But I would basically help teachers identify kids that might be in need, and [I was] doing education about anxiety and talking to teachers, because a lot of times teachers, the only kids that get flagged are the kids with behavioral issues. And you know, those are usually boys with maybe ADHD, but so we miss a lot of anxiety issues until teenage years when kids start self-harming. Some of that was educating teachers to identify kids that might need a little bit of extra help, and then talking with parents. It was kind of really just being an extra [set of] eyes for kids, being able to understand the kids that might need help, and sometimes we would identify kids and their parents didn’t want the help, so that’s a whole other issue.

One of the things that I found difficult about that job was, especially with younger kids, if you don’t have parents involved, you’re really not able to affect much change. You can teach the kids some coping skills. But the way we work at El Futuro is family-centered, and so we never worked with kids in isolation. We’re always meeting with families and trying to create a change in the supportive structure and not expecting the kids to just, you know, do it all themselves because obviously, kids live with their families, and so, if we’re not addressing issues at the root, it’s much harder.

Now, of course, there are families that we can’t affect change, but from that standpoint, I will say that is one of the great barriers to mental health in schools. And then, you know, I have parents come in and say, “Well, you know, they’ve been in therapy in school for a long time, but they still are acting like this.” So, we need the parents to be involved, and I think that’s one thing that El Futuro tries to recognize and honor, trying to utilize the strong nature of family to see the importance of family involvement in mental health treatment.

As far as the school partnerships go, one of the issues across the nation is that this is a very difficult job as a therapist, and when you work in a nonprofit, and you do a difficult job, it can be quite taxing. So, it’s hard to do this work, and we are often met with staff staffing shortages; we cannot find enough bilingual people to do the work, so we’re always hiring therapists, and we will never be able to hire enough therapists.

I mean, fortunately, we don’t have as much turnover as some of the in-school programs, and I’ll attribute that to the nature of the difficult work that that is. It’s very hard to affect change in that setting. Despite this being difficult work, my heart is really with this community because it is so amazing to see just small changes and how they can affect the entire family system.

Anything else?

I guess I would encourage parents to really make mental health one of their priorities. People have the roof, they have the clothing — these are the things necessary to have kids, feed your kids. I would say mental health is right in there. That needs to be one of the things that we do as parents, and in order to do that, we also need to take care of our own mental health.

I also want to point people to our website. We have some parenting videos [in Spanish only] that are just help for all parents navigating different issues, and so I really want to encourage people to have a look at those. They’re really great resources to help people learn about specific issues.

Reporter Victoria Johnson can be reached at