Why Culturally Matched Care Matters

Interview by Shakima Tozay

The Parent Education Resilience Collaborative (PERC) is PS-WA’s newest parent support program. This program focuses not just on the role of being a parent, it includes the whole person and incorporates specialized peer support and wellness and mental health strategies to increase parent resilience.  To learn more, here is my interview with Latonia Westerfield, a Parent Resilience Specialist with the PERC Program.

Please introduce yourself

My name is Latonia Westerfield, I work at Perinatal Support WA for a program called PERC, which stands for Parent Education and Resilience Collaborative. In that program, I am in the role of a Parent Resilient Specialist. What that looks like is getting people culturally matched peer services to support wellness strategies and to talk about mental wellbeing. I provide them with resources for different services, care such as helping them find a therapist, helping them get child care and all the things that may be impacting their life.  I am also a community Midwife and I do work with families in that area. I typically serve black and brown families in both roles. 

How did you get involved with PS-WA and the PERC Program?

For the past year, I’ve been finishing up my Midwifery education; in January I was ending my work at a local clinic in Seattle and I was looking for a job. A community member shared this opportunity with me and I looked it over. As a community Midwife we do serve and counsel people (although we are not therapists) about mental health in the perinatal period and how it affects pregnancy and labor and birth in the postpartum. We are on the look out for families that need extra support and extra services.  I have some skills in that arena and I was interested to be able to serve families in a different capacity in terms of mental wellness. I applied for the job and I got it! 

I was really excited about doing the work because it also provides me with the opportunity to sharpen my skills in that area. PS-WA also provides lots of training for providers of all different sorts and care providers so I’ve gotten a lot of training around postpartum depression and anxiety and all of the ways that people experience mood shifts in pregnancy or loss or whatever it is they may be experiencing.

What is your role; What services do you offer?

I am a parent and I also experienced postpartum anxiety after my 3rd daughter. I have 5 kids. It was a really hard situation to navigate, not just because I had 3 kids, but because when I went to get help, I was told that I had 3 kids and this is something that happens with 1 child. Then I felt like something was wrong with me because I couldn’t handle being a mom. I’ve navigated the mental healthcare system as a patient and person who needs services. That is what I bring as a peer and I am a parent and I also know what it’s like to be sitting in a space when you are not sure what’s wrong and you’re not sure what to do about it and who to talk to about it. That is what I offer parents, that perspective, that lived experience as a peer.

The scope of what I offer is a space to be held and to be witnessed.  I truly believe That is what folks need when having challenges as a parent, struggling or facing difficulties in terms of their mood. That looks like really listening to parents, understanding what they are going through and providing and offering them options such as wellness strategies to talk about how they would like support. A lot of parents are like, “I wish I could get more sleep”, a lot of parents are like “I wish I had more time to work on my identity outside of being a parent”.  We just really talk about the areas of their life they would like to shift and see improvement on. I also offer resources. I am not a therapist, but if someone is coming into the PERC program and are interested in therapy, we do have a clinical therapy program that I can refer folks to. When that program isn’t full. Because right now we only have one black therapist and she gets full pretty quick. I help folks find other options that are culturally significant to them. We talk a lot about what does therapy look like? What kind of characteristics are you looking for in a therapist? I also help people navigate lots of systems if they need resources, housing, child care, whatever it may be. I have access to lots of community resources so they don’t have to navigate those systems while also navigating being a parent that is experiencing a mood disorder. I do those initial steps for them so they don’t have to navigate it on their own. I am also available via text, meet virtually for sessions. Like a community member who is there for you when you need support.

What can you tell us about the community you serve?

Mostly, I serve Black families since I started working with PERC. I can tell that so many of the families that come into care already have a sense of what it is that they need and have so much resiliency. Black folks come from historically resilient communities because they need to be. Folks show up and are like, this is what is happening in my life, this is what’s happening in my family, this is what’s happening in my community and this is what I’ve asked people for or what I’ve told people and I haven’t gotten what I need. 

I am realizing a lot that Black parents that come into this care and program aren’t being heard by medical doctors, therapists or are not getting matched with appropriate therapists and are having barriers to getting the care that they need. When what they really need is culturally and community matched services or somebody to witness for them and reflect back that is a valid thing that you are experiencing and that it is ok that it doesn’t look like, what it looks like when folks expect these things to be happening for people who have resources to access mental health services or to demystify the fact that there is lots of stigma in Black communities about therapy and psychiatric care and about medication and really just about talking about mental health. Those pieces are what I’ve noticed come up for the parents I’m working with. 

What do you think are the most important issues facing the community you serve?

So many, particularly in the work that I am doing around mental health I think Biggest/most important issue people are facing is that fact that there is such a huge lack of peer supporters. There is not a lot of aunties, grandmas, moms, and play cousins who are accessible particularly during the pandemic, people have been cutoff.  I think that people’s go-to tends to be “you need to talk to a professional”. I really think the First line of defense should always be the community because that is who it has always been.  There is a program in California that specifically trains hair dressers to identify postpartum mood disorders because in the black community, when you go get your hair done you are talking about things going on in your life and you’re getting community therapy. That is such a huge piece that Black folks have always utilized that we are missing from inside the system. They bypass community support and I feel like that is where we get the first care and the best care and the most protection and it also helps to demystify the stigma. 

We are not having those conversations in our community anymore also. It just seems important that we need the community support aspect. We need uncles, we need grandmas, we need aunties, we need everybody to be looking out for new parents. It’s different coming from your grandma, your auntie, your uncle, or your hair dresser or someone in your community that you trust as opposed to a doctor who is like “you need therapy, you need to see a psychiatrist, you need medication” when that is not the whole picture of what is going on. The other side of it is that the community tends to have mistrust of medical healthcare systems because of the harm that has happened in our communities.

What brought you to this work?

I have been doing birth work officially for almost 6 years now. I just see so many needs. and I think community midwives historically have not just helped people in the prenatal period, labor and birth and in the postpartum. Historically black midwives in the South have been community and showed up for families in so many ways. As I support folks during their pregnancy and when they were having their babies, I was seeing how they weren’t being held in different spaces. 

I attended hospital births too as a Doula and when folks needed to transfer to the hospital before COVID we would go with them and you would see all the harm that would happen, particularly to Black, Indigenous POC families when they are giving birth in hospital systems. In my community, we were noticing these things, so we were standing in that place and that’s an important role to fill and also a really hard role to fill when there is so little of us doing the work. I am a big advocate of not burning out community advocacy workers, birth workers. It’s important to get into a service or program that has infrastructure built in already and to bring my lived experience to it. PS-WA is a huge resource that can help me, help my community so that the few of us out here are not burning ourselves out.

What do you enjoy most about what you do? What motivates you to continue to do this work? 

What I enjoy most about what I do is witnessing people recognize that they already have these skills and these tools inside of them and in their community. It’s just like watching a light bulb turn on. That connection of being like, I know how to take care of myself and take care of my family and I know how to look into my community to tap into, inherent resources, inherent skills and inherent wisdom that is already there… It is really powerful for people to feel in their power about their health and their mental wellbeing. 

What is the significance of culturally matched services? 

Mostly, being a black person is not a monolith experience and just because you are matched with a black person does not mean that you will get the same experience because we are different people. But there is something different about me, as a Black mom sitting down with another Black mom and just being like unspoken, “I see you”. It’s different. I’ve worked with lots of different families, but it is a different recognition… I’m not going to have to explain a lot of things about who I am and what I am experiencing because there is already so much unspoken foundation from just being from the same community… I feel the biggest piece is we don’t have to say, it’s already out there so you can get into the work easier as opposed to having to explain what it means to be a black mom and experiencing these things if I were to be matched with a White peer Resilient Specialist. There is also a different way of advocacy and unspoken things that exist in systems such as microaggression, anti-black racism. That may be missed by folks who don’t experience that on a daily basis. The other side of that is there can be a tendency to be an “over ally”, and may make the situation worse or bigger because they’re not really sure how to navigate advocating for yourself because advocating for yourself looks like not saying anything and not putting up a fight. It’s about navigating systems in a way that fits you as a marginalized person or person who has historically had to be more resilient. When you are doing that with a person who comes from your community, you just get it. You get better support. It’s more relaxed. A lot of my families say it’s like talking to a friend.

What are some tools and resources that inform the work that you do with clients?

The PERC program designed this tool called wellness goals and we shifted to be called Wellness Wheels. We listen to parents and hone in on areas they are trying to work on it can be sleep, spirituality, nutrition. They write them in these connecting circles. I like it because it gives people the opportunity to see that your mood is 100% connected to what you’re eating, how you’re sleeping, who’s your community support. Families really like using this tool because it is a visual representation of where am I lacking and how can I better ask for support now that I know what I need is for somebody to come over and hold the baby so I can get a nap. It gives people a more holistic perspective about what strategies work for your mental wellness. People tend to see things that are happening in their life in an isolated way. When we use this tool, they can see how all of these parts of themselves are working together and when one part is lacking it tends to affect all the other parts. But when that part or couple of parts that’s lacking get the proper attention and focus that they need everything improves. Families really like that tool. We laminate it so people can write on it with dry erase markers. It can change and keep shifting and be whatever they need it to be.  It gives people small tangible goals for a day or a week. It can be overwhelming for parents to break those things down.  I use a lot of talk tools, talking to people about boundaries for new parents. They get support, but it’s not actually the support they need. 

We also have a POD exercise so we talk about getting other people in your community involved to support you. We talk about tapping into the community in specific ways…it really expands their idea of their support in their family and in their community. They draw a circle and in the circle is them and whoever they want to put in the circle with them, it’s usually their baby and their partner. On the edge of the circles, they write down the names of their go-to people and things they need and just keep expanding it out. In that exercise I also talk about red, green and yellow lights with people. Red light people will activate us and just escalate the situation. Then there is a yellow light person, so If I don’t have access to my green light person, someone who will show up for me and hold space for me, sometimes it’s ok to talk to that yellow light person. It really helps parents not have to deal with extra anxiety from people who they get activated from talking about their experience. It’s not helpful.

Is there anything else you would like people to know?

I would really like people to know, particularly BIPOC, that there is nothing wrong talking about what you are feeling and experiencing. It doesn’t mean you are weak and not resilient.

About the Interviewer: Kima Tozay is a Licensed Clinical Social Worker, Certified Grief Counseling Specialist, and a bereaved mom who is dedicated to supporting and advocating for families impacted by infertility and pregnancy and infant loss. She supervises licensed military social workers, home visitors for the Navy birth to three program and DV advocates as a military Social Work Supervisor. As an advocate for maternal mental health, Kima and a team of other bereaved mothers, was instrumental in getting Certificate of Birth Resulting in Stillbirth legislation passed in Washington State. She is on the Board of Directors of Return to Zero Hope, a non-profit organization where she also facilitates support groups for Women of Color. Kima is also Secretary of PSI Washington State Chapter and a member of the Perinatal Mental Health Taskforce.