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Cultural Immersion
Rhonda Smalls
Wilmington University










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History: Mental illness has been around and prevalent in society for centuries. Without
the advance medical education and technology that we have in todays society many went
undiagnosed and untreated. In the beginning when mental illness began to be recognized some
believed illnesses were looked upon as a reaction from God for committing sins, while others
began to be alienated and frown upon, those who were different because society thought they
were possessed by demons.
In the 1960s new outlooks on treatment of mental illness began to be recognized and
handled differently. As stated in the text, new and much more effective medications to treat
serious mental disorders were introduced. (Hendrickson 2006, pg.3 ) With the newly introduced
medication many patients was released from the hospital setting and was able to be treated from
their homes while integrating their self in society. With patients as active members of society,
self growth became the main focal point in therapy sessions. Because of the switch in treatment
resources began to become limited which ultimately gets the attention of the state and federal
government. Federal and state governments responded by enacting community mental health
centers legislation that provided funds for community based mental health and substance abuse
treatment programs.(Hendrickson 2006 pg.3) This also sparked the creation of many National
Instutions and providing of funds for research to help guide the treatment efforts of mental
illness and substance abuse.
New professions and training for effective professionals came under way for now
publically know treatment options. As training and education of mental illness and substance
abuse began to become better understood by professionals and researchers it was beneficial for
patients that the treatments for the two become separate. The separation of the two will allow the
patients to get effective and successful treatment from professional trained specifically for their
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illness. It was evident that many patients suffered from both mental illness and substance abuse
but neither could be treated successfully in one anothers treatment facility.
With the release of the Diagnostic and Statistical Manual of Mental Disorders, 3
rd
edition
(DSMIII) it was written and research proven that individuals can suffer from more than one
illness at the same time. After the terminology was selected on what to call this new
phenomenon, treatment for those appropriately diagnosed became the next step on how to treat
them. After several options on treatments was suggested and tried the one the proven to have the
best outcome was the integrated service model. (Hendrickson, 2006 pg. 5) Hendrickson (2006),
states that the federal governments Substance Abuse and Mental Health Services Administration
(SAMHSA) report concluded that when dealing with co-occurring disorders the integrated
treatment was the treatment of choice. (pg.7) This lead to more training for those professionals
who lacked familiarity, in certain areas when it came to treating those effectively with co-
occurring disorders.
Mental disorders and substance abuse will always produce new finding in research and
treatment options because these are illnesses that constantly change. These are disorders that
have affected many. Its hard to live in todays world without knowing someone who suffer from
either a mental illness or substance abuse, and although it may only be one person that is
diagnosed many others suffer from that one. Unfortunately, with new illicit drugs constantly
created in todays society that sometimes create mental illness, I believe the demand for research
and treatments will steadily change in years to come. It is with great hope and faith that our
medical technology will be able to keep up and correctly diagnoses these upcoming and constant
changes.
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Direct Immersion Experience: If those who suffer from mental illnesses and/or addiction many
end up homeless. For this assignment I chose to visit the local soup kitchen, The Cathedral
Kitchen. I choose this particular place because I can interact with this culture informally. I have
learned that this culture do not like formalities. I tried to blend in with the others but with the
stares I received many knew I was not there for a meal. The staff allowed me to sit in the main
dining room with everyone. I noticed that many of the individuals knew one another. There was
some who appeared to be homeless and those who were just in need of a meal. I was able to
identify those with mental illness due to them talking to their self, blank stares, nervousness and
other actions they done to stand out from the rest. I was also able to identify the addicts, due to
their actions as well like constantly moving and eating in a hurry. Once the individual was done
their meal the just left the building if they did not want to wait around for second helpings.
Summary: I also learned that this facility does more than feed those who are hungry. At the
Cathedral Kitchen you can also see an eye doctor once a month, a dentist twice a week and a
family doctor once a week. Guest can also receive counseling for those dealing with or at risk of
getting HIV and/ or AIDS every Thursday provided by the AIDS Coalition of South Jersey. The
Cathedral Kitchen partnered with Project H.O.P.E in efforts to expand services offered to its
guests. Project H.O.P.E provided medical screenings and administered flu shots to 484 clients.
Also in their 14,872 square foot building CK has a bathroom with a shower and a laundry facility
that can be used by the homeless. (cathedralkitchen.org)
Name of Agency: Holistic Counseling Services, 4101 Route 42 Suite B. Turnersville, NJ
The agency is located in the business area on a major highway in Turnersville. Its
neighbors are stores like WAWA, Lowes Home Improvement Store, Target and lots of car
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dealerships. Access: From what I seen in the residential area located a little over a mile away
from the main highway it seems to be quaint and quiet. The agencys clients come from the
surrounding area but not particularly this close to the agency. The agency is located on a bus
route, however all of the clients drive to the agency for their convenience and the scheduling of
their appointment and for the fact the agency is only open for scheduled appointment.
Receptivity: The agency is small but it is quite inviting. In the lobby there are therapeutic
books and magazines, a television and a water fountain. The coloring is soft and relaxing, and
there are fliers of the agencys upcoming events.
Staff Training: the agency is small so most of the trainings and meeting is led by the
supervisor. There were no trainings during my internship. There were staff meetings that focused
on how to advertise the services to possibly get more clientele and marketing strategies to
promote their upcoming retreat. Funding: The agency gets funding by accepting most health
insurance and private pay. They also do fundraiser to help offset the cost for staff at retreats.
Staff Sensitivity: Staff is very sensitive to their clients they often ask about the clients family
and also follow up with clients who may have become ill or recently have surgery. They are
professional and respectful of the clients privacy as well as their personal information.
Agency programs and services: The agency offers a female group and marriage group
therapeutic counseling. These group counseling services was designed to help the clients
empower one another. The qualities of service are shown by the repeat attendance of its
members. I believe individuals repeatedly willingly show up because of the effectiveness of the
services they receive. They are typically schedule well in advance to allow time for clients to
confirm their attendance.
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The first NASW standard I chose was standard #3, Cross-cultural awareness. The agency
typically let the client set the tone of treatment. The therapy focus on the issues the clients are
currently having if it causes the therapist to address co-occurring issues she will do so at the
request of the client. The therapist does make referrals for clients to receive treatment outside of
her realm of knowledge.
The other NASW standard I chose was standard #8, professional education. The agency does not
require the staff to have education to better understand the population they serve. Most of the
staff are in college and the agency often host interns. But there is no staff that is permanent
besides the owner/therapist. I am sure for her licensure she participate in continuing education
courses and maybe that all who needs to be educationally qualified for the agency. I believe due
to the lack of education and knowledge of the culture the agency service is leaving the agency
with a high staff turnover rate and staffing problems.








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Reference:
www.NASW.com
www.cathedralkitchen.org
Hendrickson, Edward L., (2006) Designing, Implementing, and Managing Treatment
Services for individuals with Co-Ocurring Mental Health and Substance Use Disorders. Carruth,
Bruce F. (ed) The Evolution of Treatment Services for Co-Occurring Disorders (pgs.3-13)