Mental Health Issues

Mental Health Issues

Social Work Policy: Benefit Administration and Provision Tessa is a 45-year-old, divorced, Filipina female who came to the Department of Human Services seeking assistance. I was asked to see her because she was denied services by the Division of Family Development. She is homeless and in need of mental health treatment for post-traumatic stress disorder (PTSD) but has no insurance or funds to pay for the services. She also reported that she has experienced domestic violence. Tessa reported that she was brought to this state from another state by an “underground network” for women who have experienced domestic violence and are still at risk for violence. Tessa stated that she was formerly married to a high-ranking officer in the military. The Division of Family Development denied her application because she refused to disclose her legal name and Social Security number. She fears that if her name is entered into any system, her ex-husband will locate her and kill her. Tessa carries a binder containing photographs of the injuries that she sustained during the final year of her marriage. The photos are graphic and depict severe facial bruising. There is medical documentation indicating that her orbital bone was fractured and both of her kneecaps were broken when her ex-husband struck her with a baseball bat. Her former husband was found guilty of domestic violence and ordered to undergo a substance abuse treatment program for his alcoholism. This program satisfied the requirements set forth by the military and Child Protective Services (CPS). Once the program was completed, Tessa was court ordered to bring Maria, her 5-year-old daughter, to him for visitation. Tessa began to see signs that her ex-husband was sexually abusing Maria during these unsupervised visits. She approached CPS with her concerns, but they found no evidence to substantiate this allegation. Under the visitation agreement, Tessa was not permitted to leave the state, but she ignored the order and moved to another state with Maria. She was subsequently located by the authorities, and the child was removed and returned to her home state. To her knowledge, Maria is now in the care of her paternal grandparents. Presently, Tessa is staying at the home of a member of a local church that is connected to the domestic violence network. She is unable to remain in this home indefinitely and has been told that she must find her own home and begin the process of establishing herself independently. Tessa is deeply saddened and worried about Maria’s safety. She has been advised to legally change her name and apply for a new Social Security number to protect her from future assaults by her ex-husband. This would also allow her to apply for benefits, but Tessa is unwilling to do this because she has been advised by her attorney that once her name has been changed, she must give up all contact and hope of reuniting with Maria. In our state, the computer system used by the Division of Family Development is designed to conceal the identities of women who have experienced intimate partner violence as a means to protect them. I advised Tessa of this and informed her that her legal name and Social Security number is a requirement for benefit approval. Tessa continues to refuse to share this information because she does not believe that the computer controls will limit access for a high-ranking military officer. In order to address her concerns, I contacted the office of the commissioner of the Department of Human Services to inquire whether the system is able to prevent access by a high- ranking military officer with connections to the government. I was told that this could not be guaranteed. I worked out an alternative solution with the state using a pseudonym until the issue of an identity change could be resolved for Tessa. Tessa received the cash benefits and housing grant, began mental health counseling, and found an apartment. She eventually was assigned a new identity with the understanding that she could not continue her search for Maria.

Working With Immigrants and Refugees: The Case of Luisa Luisa is a 36-year-old, married, Latino female who immigrated to the United States from Colombia. She speaks only Spanish, so a translator must be used for communication. She came to the United States on a visa, but remained beyond the allotted time. While in the United States, she met and married Hugo, who was in the country with documentation. Once Luisa married Hugo, she became pregnant with a daughter, who is now 3 years old. Luisa has a 10-year-old son named Juan in Colombia. Luisa has always had the desire to reunite with Juan and bring him to the United States to live with her. After her marriage and status change, she began the process of sponsoring Juan. She has been advised that in order for sponsorship to be achieved, she cannot receive welfare benefits because she needs to prove that she can support herself and her child. Luisa came to the local welfare agency after she and her daughter entered the domestic violence shelter. She reported that Hugo had a history of violence, which was exacerbated when he drank alcohol. Hugo had been drinking more frequently, and the episodes of violence had increased in severity. The domestic violence program requires all residents to apply for any available benefits in order to remain enrolled in their services. In one particular episode, Hugo almost fractured her orbital bones. She had extensive facial bruising and blood pooled in one eye. Luisa is quite fearful of Hugo. She is also financially dependent on him. She is reluctant to apply for benefits because she fears that this will compromise her ability to sponsor her son in Colombia. She is tearful and tells me that she cannot sacrifice her son’s opportunity to come to the United States. Luisa is socially isolated because she has no family in the United States, and Hugo has restricted her ability to socialize and establish friendships. However, she is a practicing Catholic and does belong to a church that offers bilingual services. Luisa began to discuss returning to Hugo because she felt that this was her only viable option. I advised her that under the new federal changes in immigration laws she might be allowed to apply for benefits and still sponsor her son because she is experiencing domestic violence. I explained that we would need to speak to an immigration lawyer to verify this, but it could possibly be an alternative to returning to Hugo. Luisa reported that she had given money to lawyers in the past who had been unhelpful. She was suspicious of the law’s ability to protect her. Hugo had also threatened to report her to the authorities, stating that he would tell them she only married him to remain in the country. Although this is not true, she feared that he would do this, and she would never see her daughter again. I offered to speak with someone at the domestic violence program and advocate that they allow her some time to research her options. I told Luisa that these were difficult decisions to make and that she would be supported in her decision. I told her that she knew what was best for her family. I offered to research the options that she might have under this new federal program. I also asked for permission to contact the priest at her church so that she might be able to review her situation with a religious leader in the community. Luisa agreed. Two weeks later, Luisa applied for services on behalf of her daughter and herself. She has decided not to return to Hugo.


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