Advocacy of a Community Psychiatrist

Original Post: NCPS (Northern California Psychiatric Society)

At the IMG Night, Dr. Gaw was asked to write about his experiences as an IMG.

This is how I contributed to the provision of health and mental health care for the Boston Chinese community.

I finished psychiatric residency at the University of Rochester, Strong Memorial Hospital in 1968, I thought I was well-prepared to conquer the psychiatric world — confident that I could treat just about any psychiatric challenge that came my way. After all, I found my mentors there, including Drs. John Romano, George Engel, and Otto Thaler. I felt they had equipped me with a first-rate training and experience. Yet it didn’t prepare me for the community challenges in Boston.

In 1969 during my fellowship with Gerald Kaplan at Harvard’s Laboratory of Community Psychiatry in Boston, my Rochester roommate, Dr. Frederick Li, an internist and cancer epidemiologist and later, the discoverer of the Li-Fraumeni Syndrome, and I were invited to join the Boston Chinese Community Health Project Task Force (Later, Evelyn Lee, MSW, also joined) to address the health challenges confronting the Chinatown community. It was a time of heightened community mental health movement. What could be more challenging to two young, idealistic Harvard professionals to devise ways to prevent the scourge of drug addiction from infesting the Chinese community, provide access to health and mental health care that the residents had long been denied, even as Boston Chinatown sits at the middle of several world- renowned medical centers: Tufts-New England Medical Center Hospital, Mass General Hospital, Beth Israel, and the Boston University Medical Center. The result of many long nights of community meetings convinced the Task Force that the best strategic way to bridge the cultural, linguistic, and economic barriers that stood between the health needs of the community and the resources of surrounding medical institutions was to establish a community-controlled neighborhood health center that pulled together bilingual and bi-cultural resources. During the 5- year planning period, we set up a Monday Evening Clinic at Tufts staffed with bilingual volunteer doctors, put up bilingual signs at the hospital, conducted community health screenings and collected health statistics, involved the participation of leadership at Boston City Hall and nearby hospitals, remodeled a donated community store-front space, and worked out the financial and insurance system so that culturally affordable, accessible, and acceptable services were made available. To overcome stigma about mental health care, mental health services were woven into an integrated primary care clinic with outreach into the community. I became their first mental health program director. Thus, the Boston South Cove Health Center was born — now a thriving multi-million dollars enterprise.