At North Shore Child & Family Guidance Center, the vast majority of our clients are from Nassau County communities, but we recently had the opportunity to work with a young girl who came to Long Island from Haiti.
Thirteen-year old Anabelle traveled to the United States to receive life-saving surgery for an advanced stage of scoliosis at Shriners Hospital for Children in Philadelphia. Her condition was so serious that she would not have survived in Haiti. She was placed with a generous and loving host family that lived in Nassau County—far from home for a frightened and ailing teenager.
After about two weeks in the U.S., Anabelle became very withdrawn and refused to communicate with the family in any way. They weren’t sure how to help Anabelle, who didn’t speak English. The family was desperate to figure out a way to ease her fears and draw her out.
During this period the host family’s son, a recent college graduate, was working as a volunteer tutor at North Shore Child & Family Guidance Center’s Westbury office, known as the Leeds Place. He shared with his mom the broad scope of the work that we do with a very diverse population. She decided to call the director of the Leeds Place, Dr. Nellie Taylor-Walthrust, to brainstorm about what could be done to help Anabelle.
The discussion led to a plan that included one of our Haitian Creole-speaking outreach workers, Marmeline Martin, who has extensive experience working with special needs children and in training foster parents. Nellie asked the host mom if Marmeline could make a home visit to meet her and Anabelle. She was so happy and said, “Absolutely!” Then she asked, with a look of surprise on her face, “You make home visits?”
She was assured that we do, and added that seeing Anabelle in the home environment would be better, at least to start, than bringing her to an unfamiliar setting.
Marmeline readily agreed and made her way to the home where she met Anabelle who was sitting in her wheelchair, head bowed, with a somber look on her face. Marmeline asked if she could speak with Anabelle alone, and the family agreed it was fine.
At first, Anabelle would not speak to Marmeline. But in a short period of time, she opened up and revealed feeling homesick and alone, sharing that she wished to see her mother and the rest of her family back in Haiti. As Marmeline continued to speak to Anabelle in Creole, Anabelle began to brighten up, feeling reassured because she could be understood and feel comfortable enough to express her feelings. Marmeline asked if it would make her feel better if she came back to visit with her and she nodded in agreement.
Marmeline then met with the host mom to reassure her that Anabelle wasn’t in need of psychotherapy but was feeling low due to the separation from her family. She promised that she would continue her visits and that Anabelle was going to be fine.
On the next visit Marmeline brought some Haitian music to listen to that reminded Anabelle of being home. As the weekly visits continued, Anabelle began to smile and became more engaged with the family.
We reassured the host mom that she was caring for Anabelle in a loving manner and that what she needed to understand was that Anabelle’s adjustment to a new culture, environment and language was naturally frightening to the teen.
Cultural competency and the flexibility of home visits are key components of providing community-based mental health care, whether preventive care as in the case of Anabelle, or more intensive treatment for children with serious emotional disturbances.
As Nellie said, reflecting back, “It’s the small things that often make a world of difference.”
Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center (www.northshorechildguidance.org), which provides comprehensive mental health services for children from birth through 24 and their families.