Mental Health in the Mountains: Systems Change to Support Latino Communities
Written by Hannah Groves of Trailhead Institute, made possible by the shared knowledge, expertise and work of Mari Plaza-Munet, former Regional Health Connector (RHC) in Region 12 and the partnership of West Mountain Regional Health Alliance.
Mari Plaza-Munet has been a connector of people and systems for her entire career, which spans over two decades. “I’ve been a Regional Health Connector for 25 years”, she jokes, describing her previous personal and professional roles that have a clear, common theme: bridging communities, providers and organizations with education, legal services, housing support, and other social services. A through-line of Mari’s life work has been her human-centered, holistic, and cultural approach, of which her work serving the Latino* communities of Eagle, Garfield, Pitkin, and Summit counties (RHC Region 12) is just one example.
*A note on language: The terms Latino and Latina will be used as this is how community members who were part of the project referred to themselves and their community. However, we also want to recognize and honor individuals who may not identify with these gendered terms and may identify more closely with Latinx or other language.
“I have not stopped addressing mental health since 2020. It’s been about three years that I have been non-stop working, supporting, creating a bridge, collaborating, and bringing people together to talk about mental health in the Latino community.” -Mari Plaza-Munet, Former Region 12 RHC
Investigating the Landscape of Latino Mental Health
During her tenure as an RHC with West Mountain Regional Health Alliance (WMRHA), Mari led a project investigating the landscape of Latino mental health in the mountain region she serves, specifically focusing on Latina mothers’ experiences and needs related to mental and behavioral health. The findings and recommendations were published in a report in March 2023.
The exploration was part of a longer-term effort prioritizing the Latino community and their behavioral health needs in the region. WMRHA has been engaged in these efforts since 2020. Upon identifying that mental health is a significant challenge for people who live in Region 12, and in particular, the Latino communities of the area. For the last three years, WMRHA and local partners have been collaboratively addressing this identified gap through targeted media campaigns (including social media) to combat stigma and highlight available services. They also began regularly convening local mental health providers to improve services for the Latino community, based on feedback from the media campaigns.
These efforts, and the follow-up action and conversations, have led WMRHA and local service providers to focus on Latina mothers’ experiences and needs as well as improve connections between mental health providers and the community. This is where Mari’s personal approach and role as an RHC was critical. As a Latina herself, Mari brought her cultural knowledge as well as her love and compassion for other people to the project.
“We had conversations with human beings because that’s what I wanted. I didn’t want to have ‘yes’ or ‘no’ quantitative research. I wanted to make it qualitative. I wanted to really hear from people what they needed. So, it was all related to COVID but we also asked questions about, ‘How are you feeling?’ and ‘How are you doing?'” -Mari Plaza-Munet, Former Region 12 RHC
Supporting the ‘Axis’
It was a strategic decision to focus on the Latina mother for this phase of the work. Within Region 12, five key groups within the Latino community were identified with distinct needs related to their mental health: elders, adults, children, University/college students, and young people ages 14-18. Each of these groups have their own perspectives and experiences on mental health, and Mari emphasized that these needs are distinct and must be considered separately. Mari notes that the Latina mother was chosen as a priority population because “…the mother impacts the entire family system, and is seen as a guide to the rest of the family… she’s the axis”. Mari explains that focusing on Latina mothers allows local service providers to maximize their reach with their efforts, as mothers typically interact with and influence many other people within the Latino family system, initiating a ripple effect.
To be able to improve the mental health support and services available to Latina mothers, it was first necessary to talk with the mothers themselves and see what their experiences have been and what they might need. This is where Mari’s approach was particularly successful in gaining trust and building rapport with the mothers who agreed to be interviewed about this topic.
“It was simple because I like people, no matter where they are. It doesn’t matter who they are. I have a kinship with human beings, because I approach personal and professional life with that lens – with compassion.” -Mari Plaza-Munet, Former Region 12 RHC
Community is Essential
Mari models and advocates for a few simple principals when working with community members in any capacity. Her recommendations are an important call and reminder to all in the public health and healthcare community to honor the experiences and humanity of everyone, every single time, which includes our interactions with our colleagues and partners.
“If we approach interviews, convenings, and conversations with colleagues and communities with kindness – where we are kind to each other, we are kind to another human being – and we respect that we don’t know where people are coming from, that we all have different reasons and experiences that make us to do and be who we are… that is an open door. I see people as unique and valuable. I respect their wisdom. I honor their time. And all of these ingredients – honoring their time, honoring their wisdom, and coming to them with a sense of neutral kindness and respect – that is an open door, and that is what I recommend to everybody who needs to create a community council or they need the community to tell them how well they are doing.” -Mari Plaza-Munet, Former Region 12 RHC
This recommendation is especially important when discussing topics such as mental health, which has significant stigma associated with it for many communities. Mari knows as a Latina and through her conversations with community members and colleagues that there are specific fears and stigma about mental health within the Latino community in Region 12. Despite this, Region 12’s Latina mothers shared their strengths and hopes for themselves, their families, and their community. Check out the report to learn more about their insights, recommendations, and ways they are holistically supporting their own wellness.
The report has also identified additional gaps and opportunities that service providers, organizations, and the community can continue to address to support Latino mental health over the next few years, some of which has already began. Because of WMRHA and the RHC role, organizations have been working together for years to collaboratively address mental health and continue to find new ways to work together to support individuals and families in the region. For example, Mari noted that a few Latino-serving organizations are starting to incorporate mental health support into their services where they hadn’t before. This is the essential work of the Regional Health Connector – working with community, identifying gaps, and supporting collaboration of organizations to better serve local needs.
Naming the Need for Long-Term Funding
Mari stresses that long-term funding is critical to continuing to address gaps in care for the Latino community and their mental health needs in her region. Addressing mental health requires years of collaborative effort addressing multiple factors that contribute to mental wellness. One aspect of this emphasized by Mari is that changing behaviors – whether among providers, individuals, or community organizations – takes a very long time. It also takes coordinated effort and collaboration between individuals, groups, and organizations. Many current funding streams do not support learning and progress over adequate periods of time or the coordination and relation-ship building required of systems change work, which is why the RHC role is so important. RHCs, including Mari, focus on the conditions of systems change.
This includes changing and promoting policies, practices and resource flows that support health and opportunity; changing the context of communities by improving connections, building relationships, and investigating power dynamics; and working to challenge “status quo” mental models to bridge gaps in care and support. It takes structural, relational, and transformational change within public health, healthcare, and social service systems to support individual behavior change over time. Using Mari’s project as an example, she changed systems by amplifying the Latina mothers’ experiences and needs to providers and service organizations, who could then incorporate that information into their communication and resource flows to fundamentally change the way they work together and how they provide services to the Latino communities of Region 12. For additional resources and examples on RHC’s systems change work, please reach out to your local RHC or RHC Program Staff.
In addition to sustained funding and continued systems change efforts, Mari expressed the importance of the RHC program structure. Currently, the program’s backbone support is comprised of Trailhead Institute (RHC Program Office), CU Anschutz Department of Family Medicine and Colorado Health Institute. All these partners provide support for the program behind the scenes, including evaluation, advocacy, and grant-writing to secure sustainable funding.
Capacity Building Through Program Support
Throughout her time as RHC, Mari often talked about how the RHC role, supported by Trailhead Institute and partners, has been a powerful avenue for her work. As previously stated, Mari has been working as an “unofficial” RHC before holding the title, but appreciates that Trailhead, CU Anschutz Department of Family Medicine, and CHI (all three founding collaborative partners of the program) brought meaning and importance to the connector and convener role. Additionally, the funding secured by these partners have continued to allow for flexibility and local control, meaning the RHC can appropriately respond to what’s going on in the community. Through this model, Mari felt empowered and that there is ample freedom for growth as well as training, resources, and coaching upon request in order to best fulfill her role as RHC. One impactful aspect of the program and how its implemented, is that RHCs can bring their unique passions, lived/living experience, and community connections to their work. RHCs are resourced through their relationships and expertise to address a multitude to existing and emerging social needs, health issues, or topics of interest – a key aspect of the role that supported Munet Plaza in bringing her own approaches and expertise to Region 12’s needs.
Plenitud
Mari’s advocacy for Latino communities’ health doesn’t stop at her RHC role or with the Latina mothers’ mental health project. When she’s not working in Region 12 as the RHC, she has been creating a train-the-trainer curriculum for holistic wellness. The program is called Plenitud.
I love the word ‘Plenitude’. Plenitude is to feel good, to feel well – inner and outer. To feel grateful, at peace, content. This is a project where I want to bring human beings together in a process of three months with the right pacing and frequency… I teach them how to breath and the different kinds of breathing that you can use, and teach them to direct energy to places in the body so that you can calm yourself, or so that you can actually breathe… These are things that human beings have been doing for centuries. -Mari Plaza-Munet, Former Region 12 RHC
Plenitud is yet another way in which Mari expresses her love and support for Latino communities, and is enacting change at the systems level, as well as with individuals. Mari is actively seeking funding to get this program off the ground!
Mari moved on from her official role as RHC to new opportunities in June 2023, but she will continue with her holistic and human-centered approach to public health and mental health because that’s who she is, and has always been! Listening to and healing communities through connection isn’t something that needs a title, and every RHC uses similar approaches in their work. The RHC program is made up of individuals like Mari, with true care, compassion, and humility at the heart of their work.
With Gratitude To
West Mountain Regional Health Alliance
This work would not be possible without the partnership and collaboration of West Mountain Regional Health Alliance as the host organization for the Regional Health Connector position in Region 12. The mission of WMRHA is to build an integrated healthcare system to achieve optimal health for all people who live in the West Mountain region.