Peter Yee, LMSW, Assistant Executive Director for Behavioral Health Services, Hamilton Madison House (HMH) and NASW-NYC Board Member; and Jessica Tynan, LMSW, ESL and Special Projects Coordinator, HMH

Hamilton-Madison House (HMH) provides a wide array of culturally and linguistically sensitive programs including early childhood education, youth and teen programs, adult education classes, mental health services and senior programs. Services for the elderly include four senior service centers and an adult day services program. Mental health services offer an outpatient clinic, continuing day treatment, psychosocial club, and a supportive housing facility.

History of Serving Asian Communities

Hamilton-Madison House, established in 1898, is a voluntary, non-profit settlement house dedicated to improving the quality of life of residents in Manhattan’s Two Bridges/Chinatown area. For 108 years, hundreds of thousands of people have taken part in life altering programs.

Today, Hamilton-Madison House serves 16,000 people a year ranging from infancy to old age. The consumers reflect the ethnic make-up of its evolving community. The 2005 demographic breakdown was 78% Asian, 10% Latino, 8% African American and 4% Caucasian.

In January 1983, the Chinatown Alcoholism Project, the first of its kind in the nation, began community education, outreach counseling, information, referrals and networking.

At the present time, HMH operates the largest outpatient mental health services for Asian Americans outside of Hawaii and California. The client population consists of Chinese, Korean, Japanese, Vietnamese and Cambodian consumers. Clinicians speak as many as ten languages/dialects to provide culturally competent services.

HMH opened a supportive housing facility in Queens in 1994. It is the only one of its kind specializing in permanent housing for Asian American mental health patients. The Asian Psychosocial Clubhouse/Sunrise Club opened in September 2003, also in Queens, to provide an environment in which Asians struggling with mental illness can find the support and opportunity to learn the life and vocational skills to become self-sufficient.

Over 6,500 Asian seniors obtain services at Hamilton-Madison House’s four locations: City Hall Senior Center, Helen Harris Residence Senior Services, Knickerbocker Village Naturally Occurring Retirement Community, and Smith Houses Senior Center.

Challenges in Providing Social Work Services

The Asian population is far from being a monolithic group. For instance, a Chinese individual could come from Beijing, Shanghai, Hong Kong or a rural farming community. These varied geographic and socioeconomic realities have implications for the provision of treatment. HMH serves individuals speaking a variety of different languages. Documents available only in English must be translated into different languages. An example of HMH has overcome this challenge can be seen at the Psychosocial Club in Queens. During presentations, audience members are given earphones for real time translation of the presentation into Korean, Cantonese and Mandarin.

The stigma of mental illness for Asians often means that consumers wait until their symptoms are quite severe before seeking help. This can clearly be observed in HMH Asian outpatient clinics where over 80% of consumers are chronic patients, in comparison to only 25% in our non-Asian clinics. Treatment and recovery is often longer and more difficult for Asians.

The biggest challenge in providing services is the shortage of licensed Asian mental health professionals. Social work is not a profession traditionally endorsed by Asian families, who often steer their children toward more lucrative careers.

Asian social workers may experience language difficulties when taking the licensing examination. HMH also has often resorted to recruitment of Asian nationals to fill vacancies. This practice may result in additional operating costs since the agency must sponsor staff who are not U.S. residents.

Working with a multi-Asian staff can be challenging because the Asian countries that staff members come from were at war with each other just a generation ago.

In spite of challenges, Hamilton-Madison House is deeply committed to the community and strives to ensure that area residents are treated with the support and respect that they deserve.

To view a video of Hamilton-Madison House’s history and current programs, please visit our website at: www.hmh100.com.