Social Work teaches that societal issues, like mental health concerns, substance abuse and some health conditions, are all connected. Graduate College of Social Work Associate Professor Luis Torres discusses an innovative program called SMART Cougars, which takes aim at HIV/AIDS transmissions in minority young people.
Torres has a class exercise to illustrate the complexity of societal problems. He writes the name of a social issue on the board (like child abuse) and asks students to suggest causes. The white board soon becomes cluttered with responses. He then randomly circles one of their responses and asks for its cause. Invariably, responses lead back to the original social problem posed, showing the interconnectedness of social issues.
Among ongoing research at the Graduate College of Social Work are studies on health disparities and the conditions that may lead to them. In the past year, the college has submitted more than 17 major proposals for research, totaling $3,665,535.
Torres is lead investigator for SMART Cougars (Substance Use, Mental Health and HIV/AIDS Risk Assessment and Testing), a program that addresses HIV/AIDS education among young minorities.
Q. How are social issues connected?
A. It’s an interesting question and at the end of the day an academic one. Do you develop a substance abuse problem first and then develop a mental illness or health issue, or is it the other way around? For every case, the pathway is different. Social work believes what you are experiencing as an individual is couched in a broader context of your family, community and society. The important point is to recognize it’s all interconnected.
Q. How does SMART Cougars address that?
A. Latinos and African-Americans are impacted disproportionately by HIV/AIDS. HIV testing is frequently delayed due to access to care, affordability or treatments that are not responsive to culture or an individual’s context. Latinos have one of the highest rates of premature termination of any kind of treatment. One of the reasons is that treatment may not resonate with who they are. Latinos and African-Americans account for 57 percent of the metropolitan area population, but represent 82 percent of new HIV diagnoses and 73 percent of people living with HIV. SMART Cougars began in January 2015 with a goal of preventing and reducing HIV/AIDS transmission among minority youth. It provides free rapid testing, and free counseling and screening for mental health or substance abuse issues. Participants learn these conditions are connected and how to reduce their risks. In the first three months, more than 250 people have participated.
Q. Stigma also must be a challenge.
A. HIV is still a tremendously stigmatized condition, even though we’ve crossed an interesting threshold. HIV/AIDS is now talked about as a chronic, managed condition. We’ve reached a point where, with early identification and proper treatment, people can live normal life spans. But the sense of urgency seems to be gone, and we let our guard down. As a result, when you look at data, young adults, particularly Hispanics and African-Americans 18-24, are still among the groups disproportionately impacted by HIV. This is the group SMART Cougars targets.
Q. Who funds the project?
A. We are funded for three years by the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA wanted to bring together minority-serving institutions and minority, community-based organizations to prevent transmission of HIV/AIDS and development of mental health and substance abuse issues in minority groups ages 18-24. They particularly wanted to serve Latino and African-American populations. We are working with the Third Ward organization Change Happens! and Houston Area Community Services to deliver individual and group interventions on campus and in the surrounding community. Minority young adults in our target group can get an HIV test and participate in an intervention that incorporates screenings for mental health and substance abuse and risk factors for HIV/AIDS. They walk away with a clear plan of how to reduce their risk.
Q. Where is SMART Cougars?
A. “We have rotating booths all over campus. We have space in the Wellness Center, and we are all over social media. We want young people to know that any of us can be impacted by mental health issues, substance abuse, HIV and other STDs depending on our risk factors. We explain how to talk about HIV/AIDS, things like condom negotiation, because young people don’t know how to bring up a conversation about safe sex. The project is doing what it’s supposed to do, which is raise awareness and give young people tools to protect themselves and others.”
Q. What projects at the college address other health disparities, such as substance abuse and mental health?
A. We received a 5-year, $1.25 million grant from the National Institute on Drug Abuse to study older Mexican-American injection heroin users and younger Mexican-American non-injection heroin users. Heroin use is back on the rise, and we need new tools to combat it. Additionally, we are involved in a three-state study on the effectiveness of recovery high schools as part of the continuum of care for adolescents with alcohol or drug use disorders. Houston has two recovery high schools and multiple adolescent treatment facilities.
Q. How does social work approach these issues differently than other disciplines?
A. One key paradigm of social work practice is ‘person in environment.’ We don’t just treat a person with symptoms, but within their broader context. The approach recognizes systems are interconnected. The second is an emphasis on strengths. Social work doesn’t just see deficits, symptoms, malaise in a community. We see strength, and we ask, ‘How can we build on that strength to address the challenges?’