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DBHDS Virginia Department of
Behavioral Health and
Developmental Services
System Orientation and Critical
Concepts in Mental Health for
Medical Liaisons
Cecily Rodriguez.
Director, Office of Cultural & Linguistic Competency
March 2012
Page 2
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Learning Objectives
To review DBHDS as a system
To review local community services boards
To gain new terminology used in behavioral
health developmental services system
To understand possible roles of Liaisons in this
system.
To review some concepts in refugee mental
health
To become familiar with strategies and
interventions that may be useful in your work
Page 3
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
What is DBHDS?
DBHDS is Virginia’s public mental health, intellectual disability and substance abuse services system is comprised of 40 locally-run community service boards (CSBs) and 16 state operated facilities.
The CSBs and state facilities serve children and adults who have or who are at risk of mental illness, serious emotional disturbance, intellectual disability, or substance use disorders.
Page 4
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
State Run Facilities
Virginia’s state-run facilities provide
highly-structured, intensive services
and consist of:
•seven mental health facilities,
•five mental retardation training
centers,
•a psychiatric facility for children and
adolescents,
•a medical center,
•a psychiatric geriatric hospital and
•a center for behavioral rehabilitation
Page 5
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
DBHDS Training Centers
• Central Virginia Training
Center- Lynchburg, VA
• Northern Virginia
Training Center
• Southeastern Virginia
Training Center
• Southside Virginia
Training Center
• Southwestern Virginia
Training Center
Page 6
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Center Closings
• 2014
• Southside Virginia Training Center (SVTC) Closes
• 2015
• Northern Virginia Training Center (NVTC) Closes
• 2018
• Southwestern Virginia Training Center (SWVTC)
Closes
• 2020
• Central Virginia Training Center (CVTC) Closes
Page 7
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
DBHDS Mental Health Facilities
• Catawba Hospital
• Central State Hospital
• Eastern State Hospital
• Northern Virginia Mental Health Institute
• Piedmont Geriatric Hospital
• Southern Virginia Mental Health Institute
• Southwestern Virginia Mental Health Institute
• Western State Hospital
Page 8
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Other DBHDS State Run Facilities
• The Virginia Center for Behavioral Rehabilitation (VCBR) in Dinwiddie County and is a secure treatment facility for those sex offenders believed to present the greatest threat to the community
• Commonwealth Center For Children & Adolescents - The Commonwealth Center for Children & Adolescents is an acute care, mental health facility for youth under the age of 18 years
• Hiram Davis Medical Center- Medical facility for patients in the DBHDS system
Page 9
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Community Services Boards
A community services board (CSB) is the point of entry into the
publicly-funded system of services for mental health,
intellectual disability, and substance abuse. CSBs provide pre-
admission screening services 24-hours per day, 7 days per
week.
CSBs are typically operated by county or local governments and
there is one Behavioral Health Authority in the City of
Richmond.
CSBs are not part of DBHDS. While not part of the Department,
CSBs are key operational partners with the Department and its
state facilities in Virginia’s system of public mental health,
mental retardation, and substance abuse services.
Page 10
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Community Behavioral Health &
Developmental Services
Page 11
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Licensed Mental Health Providers
Specialized Services
Multicultural Human Services- Northern
Virginia Human Services
Cyndy Dailey, MPA,
703.533.3302, x197 (direct)
www.nvfs.org/mhs
Heritage Multicultural Programs & Services,
Inc
Alima Palmer, NCC; LPC; CSAC, Director,
Phone: 703 898-8760
heritageprogram.org/contactus.html
DBHDS licenses services providing treatment, training, support and habilitation:
to individuals who have mental illness, intellectual disabilities or substance abuse
disorders; to individuals receiving services under the Individual and Family
Developmental Disabilities Support Waiver; or to individuals receiving services in
residential facilities for individuals with brain injuries.
Family Stabilization Program
Commonwealth Catholic Charities
Patrick F. Taylor, M.Div., MSW
1512 Willow Lawn Dr., Richmond,
VA 23230
Ph: 804-545-5948
Email: [email protected]
Page 12
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
What We Do- System wide
CSBs offer varying combinations of
six core services:
• emergency services
(mandated)
• local inpatient services
• outpatient and case
management services
• day support services
• residential services
• prevention and early
intervention services
Page 13
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Language Matters: Talking About
Addiction and Recovery
Language plays a critical role in expression of the
meaning used
Old language
•Crazy, loco, addict, junky, users, substance
abusers, retarded, disabled, handicap
•Moral judgments
•Illness or value-laden opinion referring to the
person
•Identify a person by their action/disorder
•Embedded culture and psyche
New Language
•Based on new ideology of recovery
•People-first, not their disability
•Person with “a specific disorder”
•Self-identification http://store.samhsa.gov/product/Language-Matters-Talking-About-Addiction-and-
Recovery-CD-/SMA10-4504
Page 14
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Language Changes Attitudes and Lives
• Recovery is self-directed enabling individuals be able to self-talk (self-identify)
• Language can dispel stigma
• Overcome self-defeating thinking, statements, and beliefs
• Language shapes thinking, behavior and decision, then ultimately our lives
• Conveys hope and recovery
• Language can be positive or negative – how do you want to use your language?
Page 15
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
New Language, New Attitude
• Disabled
• Birth defect
• Blind or visually impaired
• Hard of hearing
• Deaf-mute, deaf-dumb
• Learning disabled
• Handicap(ped)
• Insane, lunatic, manic, crazy
• Retarded, feeble minded, idiot
• Person with a disability
• Person born with a disability
• Person who is blind
• Person who is hard of hearing
• Person who is deaf
• Person with a learning disability
• Disability
• Person with mental health disability
• Person with an intellectual disability
Page 16
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Mental Health
• Without mental health there is no health
• More than the absence of mental disorders – “a state of well-being in which the individual realizes his or
her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”
• Determined by socio-economic and environmental factors
World Health Organization. (2007). Mental health: Strengthening mental health promotion. Fact Sheet # 220.
Available URL: http://www.who.int/mediacentre/factsheets/fs220/en/
Page 17
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Mental Health Services- Important Terms
Recovery can be defined as a personal
process of tackling the adverse impact
of experiencing mental health
problems, despite their continuing or
long-term presence.
Self Determination has been defined as
a system that is “intended to allow
informed consumers to assess their
own needs . . . determine how and by
whom these needs should be met, and
monitor the quality of services they
receive”
Resiliency is the ability to adapt well to
stress, adversity, trauma or tragedy.
Page 18
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
SAMHSA’s Working Definition of Recovery
from Mental and Substance Use Disorders
• Recovery is a process of change through
which individuals improve their health and
wellness, lives a self-directed life, and strive
to reach their full potential
• Four dimensions of Recovery
– Health
– Home
– Purpose
– Community
Page 19
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Substance Abuse Services
In the Central Office- The Office of
Substance Abuse Services (OSAS)
plans, develops, directs, funds and
monitors the delivery of comprehensive
substance abuse services throughout
the Commonwealth.
In the Community Services Boards-
Provide a wide array of prevention
services to youth and family and crisis
services for people with substance use
disorders.
Private Providers- Wide variety of
residential and outpatient services
Page 20
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Important terms in substance use disorder….
Co-Occurring Disorders
The simultaneous presence of both mental illness and a substance abuse disorder in a single individual, known as “co-occurring disorders” (CODs), has become the focus of attention for many behavioral health researchers, clinicians and policymakers in recent years due to emerging evidence of the serious and challenging nature of these disorders.
Page 21
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Important terms in substance abuse….
Intensive Treatment Program
based upon motivational
principles and stages of
change theory. Treatment
recommendations based
upon assessment tools and
information gathered during
the structured clinical
interview. All clients receive
a combination of individual
and group therapy.
Page 22
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Office of Intellectual Disabilities- Important Terms
An intellectual disability is a disability
characterized by significant
limitations both in intellectual
functioning and in adaptive behavior
as expressed in conceptual, social,
and practical adaptive skills.
Person-Centered Planning is a
process-oriented approach to
empowering people with disability
labels. It focuses on the people and
their needs by putting them in
charge of defining the direction for
their lives, not on the systems that
may or may not be available to
serve them.
Page 23
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Intellectual Disability Services
This starts with Case Management Services and
includes:
• Determination of eligibility for Mental Retardation
Waiver Services
• Assistance in transitioning from state facility-
based services to local community-based
services
• Identifying and reaching out to potential
consumers
• Assessing needs and planning services
• Linking and assisting individuals in obtaining
needed services, supports, and resources
• Coordinating services with other providers
• Enhancing community integration
• Monitoring service delivery
• Advocating for people in response to their
changing needs
Page 24
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Infant & Toddler Connection of Virginia
For children from birth to 2 yrs. Provides supports and services
to infants and toddlers who are not developing as expected
or who have a medical condition that can delay normal
development.
• Focus on increasing the child’s participation in family and
community activities that are important to the family.
• Focus on helping the parents and other caregivers know
how to find ways to help the child learn during everyday
activities.
Each locality in Virginia has a “central point of entry,” which
connects children and their families to early intervention
supports and services.
Every child and family referred to the Infant & Toddler
Connection is provided a service coordinator who helps
guide them through the early intervention process.
Page 25
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Autism
• In 2009, the General Assembly
designated DBHDS as the lead agency
for Autism in Virginia.
• Provide policy, consultation, training,
and resource development to the
system.
• If under 3, everyone comes through
Part C (Infant & Toddler Connection)
• If over 3, everyone goes through the
school system.
• If over 21, everyone goes through the
CSB and/or Medicaid waiver
Page 26
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Terminologies Crosswalk
• Mental Health
Disorders
• Recovery
Model
• WRAP
• Safety Plan
• Intellectual
Disability
• Recovery,
Resilience,
Self-
Determination
• Person-
Centered
Planning
• Substance Use
Disorders
• Recovery
• RAP
• Relapse
Prevention
Plan
Page 27
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
THE LAW
Page 28
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Civil Rights Act of 1964
The Civil Rights Act of 1964 says that no person shall be excluded from participation in, be denied the benefits of, or be subjected to discrimination based on race, gender, ethnicity or national origin under any program or activity receiving Federal financial assistance."
Page 29
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Title VI
“Meaningful Access” Organizations are required to take
reasonable steps to ensure meaningful access to their programs and activities by LEP persons. The Guidance explains that the obligation to provide meaningful access is fact-dependent and starts with an individualized assessment that balances four factors:
1. Number or Proportion of LEP Individuals
2. Frequency of Contact With the Program
3. Nature and Importance of the Program
4. Resources Available
Page 30
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Social Security Act
• The Social Security Act prohibits
discrimination in the Maternal and Child
Health Services Block Grant. The Public
Health Service Act prohibits discrimination in
the Community Mental Health Services Block
Grant and Substance Abuse Prevention and
Treatment Block Grants. The Public Health
Service Act prohibits discrimination in the
Preventative Health and Health Services
Block Grants
Page 31
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Americans with Disabilities Act
• The ADA prohibits discrimination on the basis
of disability in employment, State and local
government, public accommodations,
commercial facilities, transportation, and
telecommunications.
• To be protected by the ADA, one must have a
disability or have a relationship or association
with an individual with a disability. An individual
with a disability is defined by the ADA as a
person who has a physical or mental
impairment that substantially limits one or more
major life activities, a person who has a history
or record of such an impairment, or a person
who is perceived by others as having such an
impairment.
Page 32
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Accreditation and Licensing
Joint Commission
“No longer considered to be simply a patient’s right,
effective communication is now accepted as an
essential component of quality care and patient
safety” http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalv
ersion727.pdf
CARF International
DBHDS Licensing
Virginia Board of Social Work, etc…
Page 33
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
What are Language Services?
• Individuals Right to Know
• Interpreting
• Translation
• Assistive Technology/Communication Tools
• Signage
• Way-finding
• Community Involvement
• Training
Page 34
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Northern Virginia- Links & Allies
ALEXANDRIA - http://alexandriava.gov/DCHS
Juliette Milushev, LPC, Supervisor MH/SA Residential Treatment Program,
Department of Community and Human Services, Center for Adult Services, 4480
King St., Alexandria, VA 22302
703 746 3411
ARLINGTON- http://www.arlingtonva.us/departments/Commissions/HumanServices/CSB/CSBMain.aspx
Robert Sharpe, Assistant Director, Department of Human Services, 2100
Washington Blvd, 4th Floor, Arlington, VA 22204
703-228-1762
FAIRFAX – http://www.fairfaxcounty.gov/csb/
Nhat Nguyen, MSW, Alcohol and Drug Youth Services Fairfax County, Substance
Abuse Counselor II, 10390 Democracy Lane, Fairfax, VA 22030
703-219-2562
Page 35
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Fredericksburg – Links & Allies
Rappahannock Area Community Service Board
600 Jackson Street
Fredericksburg, VA 22401
540-373-3223
Allies- Jane Yaun, Quality Assurance Coordinator and Corporate Compliance
Officer
(540) 373 – 3223 x3121
http://www.racsb.state.va.us/contact.htm
Page 36
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Richmond Area- Links & Allies
Richmond Behavioral Health Authority - http://www.rbha.org/
Michael A. Tutt, Recruiting and Retention Coordinator
107 South Fifth Street, Richmond, VA 23219-3825
804.819.4099
Chesterfield- http://www.chesterfield.gov/content.aspx?id=3194
Cil Hurd Burke, Day Program Manager
6801 Lucy Corr Boulevard, Chesterfield, Virginia 23832
804.318.8819
Henrico-http://www.co.henrico.va.us/mhds/
Yvonne Russell, MA, Quality Assurance Manager
10299 Woodman Road, Glen Allen, VA 23060
(804) 727-8514
Page 37
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Hampton Roads – Links & Allies
Hampton Roads/Newport News- http://www.hnncsb.org/
Marcus L. King, Administrator, Staff Development and Training
757.788.0362 Direct Outside Line
Campus Extension 1362
M. Cecilia Terrones, BA. QMRP, IDDS Residential Supervisor,
HAMPTON House/HNNCSB
Page 38
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Roanoke Area Links & Allies
Blue Ridge- http://www.brbh.org/
Dina Hackley-Hunt
Manager, Training and Staff Development
Blue Ridge Behavioral Healthcare
3517 Brandon Avenue,Roanoke, VA 24018
540.982.1427, ext. 2129
Page 39
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Charlottesville Links
Region Ten- http://www.regionten.org/
• Region Ten Community Services Board is a large agency
that can be complicated to navigate. In order to help you
through the process, Region Ten has a department
dedicated to helping you understand the intake and entry
procedures. We will guide you in seeking services to fit your
needs. The Access and Intake process begins with a
simple phone call to (434)972-1800.
Page 40
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Understanding the Differences
• Important to distinguish between status
– Immigrant
– Refugee
– Precarious status
• Also helpful to distinguish between phases
– Pre-flight chaos
– Period of flight
– Refugee camps
– Final settlement
Khanlou, N. (2007). Young and new to Canada: Promoting the mental wellbeing of immigrant and refugee
female youth. International Journal of Mental Health & Addiction. (Online:
http://www.springerlink.com/content/7887281654x11468/)
Khanlou, N., & Guruge G. (2008). Chapter 10: Refugee youth, gender and identity: On the margins of mental
health promotion. In: Hajdukowski-Ahmed M, Khanlou N, & Moussa H (Editors) Not born a refugee woman:
Contesting identities, rethinking practices. Oxford/New York: Berghahn Books (Forced Migration Series).
Page 41
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
The Migration Experience
Multiple stresses that can
impact their mental well
being, including the loss
of cultural norms,
religious customs and
social support systems,
adjustments to a new
culture and changes in
identify and concept of
self.
Page 42
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Factors leading to increased stress
• The act of relocation
• Lack of social support
• Discrepancy between achievement and expectations
• Economic hardships
• Racial discrimination and harassment
• Lack of access to proper housing, medical care, and religious
practice
The goal for clinicians is to be attuned to the unique stresses and cultural aspects that affect immigrants and refugees in
order to best address the needs of this increasing and vulnerable population
Page 43
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Refugees and Mental Health
Context- Overseas
• WHO has established that
more than 50% of refugees
have mental health issues
• All resettled refugees
experience anxiety/stress
related to actual travel/re-
settling process
• Many refugees have
underlying trauma from
their migration experience
Page 44
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Refugees and Mental Health
Context -Overseas
• Most refugee source
countries do not have
formal mental health
systems
• Stigma and discrimination
associated with mental
health illness
• War, torture, witness of
violence and post traumatic
stress syndrome
www.issbc.org
Page 45
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Refugees and Mental Health
Context –in the US
• Racism as an additional
stressor contributing towards
mental health
• Re-traumatization may occur
during the resettlement
phase
• High incidence of depression
• Impact of delayed attention-
treatment
• Culture shock phenomena
www.issbc.org
Page 46
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Refugees and Mental Health
Context –in the US
• Heavy reliance on the medical
model of mental health
• Formal and informal mental
health systems and supports
exists with growing movement
towards more culturally
responsive services
• Increase recognition by formal
mental health system towards
the informal mental health work
undertaken by NGO’s
www.issbc.org
Page 47
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Concepts for Liaisons-
Culture Bound Syndromes
In medicine and medical anthropology,
a culture-bound syndrome, culture-
specific syndrome or folk illness is a
combination of psychiatric and
somatic symptoms that are considered
to be a recognizable disease only within
a specific society or culture.
Page 48
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
WHEN WORDS CAN’T DESCRIBE THE PAIN
• Country / culture Somatic idiom
• India/Pakistan ‘sinking heart’, ‘feeling hot’, ‘gas’
• Nigeria ‘heat in the head’, ‘biting sensation all over the
• body’, ‘heaviness sensation in the head’
• Mexican Americans ‘brain ache’, ‘brain exploding’, ‘uncontrollable’
• Chinese ‘shenjing shuairuo’ – neurasthenia
• Dubai ‘sadri dayeq alayya’ – ‘my chest feels tight’
• ‘taabana’ – ‘I am tired, fatigued’
• ‘jesmi metkasser’ – ‘broken body’
• United Arab Emirates‘the heart is poisoning me’
• ‘as if there is hot water over my back’
• ‘something is blocking my throat
Page 49
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Culture Bound Syndromes
Page 50
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Concepts for Liaisons-
Using Interpreters
• Interpreters should be
considered a part of the
therapeutic or counseling
setting
• Interpreters have to be
fluent in both languages,
• Specifically trained and
experienced
• Interpreters’ roles need to
be clear to all involved
Page 51
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Concepts for Liaisons-
Using Interpreters
• Be aware of how
positioning might
influence the encounter
• Basic understanding of
psychological symptoms,
therapy, therapeutic
relationships and the
methods that may be
used
• Meaning of specific
medical/psychological
terminology
Page 52
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Concepts for Liaisons-
Using Interpreters
• There should be no private
contact between
interpreter and patient
(includes not giving
number to patient)
• Pre/Post therapy session
briefings
• At first session,
introductions with roles
and expectations
explained
Page 53
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Concepts for Liaisons-
Using Interpreters
• Interpretation should be in
first-person, and as literal as
possible
• Everything said in the room is
interpreted
• If terms used in translation
lead to misunderstanding they
should be clarified through
retranslation
• Interpreters may interrupt to
ask a clarifying question
Page 54
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Secondary/Vicarious Trauma
Process of change that
happens because you care
about other people who
have been hurt, and feel
committed or responsible to
help them. Over time this
process can lead to
changes in your
psychological, physical and
spiritual well-being
Page 55
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Secondary/Vicarious Trauma
• Coping and managing vicarious trauma by taking care of yourself: Escape, Rest, and Play
• Transforming vicarious trauma by identifying ways to nurture a sense of meaning and hope
– Connect (or reconnect) with sources of meaning, purpose, hope and perspective in your life
– ABC’s to Recover from Vicarious Trauma: Awareness, Balance, and Connection
• http://headington-institute.org/Portals/32/resources/spiritual-self-care.pdf
Page 56
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Food for Thought
“For more than a generation now, we in the
West have aggressively spread our modern
knowledge of mental illness around the world.“
We have done this in the name of science,
believing that our approaches reveal the
biological basis of psychic suffering and dispel
pre-scientific myths and harmful stigma.
There is now good evidence to suggest that in
the process of teaching the rest of the world to
think like us, we’ve been exporting our
Western “symptom repertoire” as well. That is,
we’ve been changing not only the treatments
but also the expression of mental illness in
other cultures.”
Page 57
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
Resources
• WHO-
http://www.who.int/hac/techguidance/pht/mental_health_refugees/en/
• World Federation for Mental Health-
http://www.wfmh.org/index.html
• Mental Health Clinical Tools- http://ethnomed.org/clinical/mental-
health
• UNHCR- http://www.unhcr.org/3bc6eac74.html
• Minnesota Dept. of Health-
http://www.health.state.mn.us/divs/idepc/refugee/guide/10mentalheal
th.html
• JAMA- http://jama.ama-assn.org/content/294/5/646.full
• Community Mental Health Journal-
http://www.etsu.edu/coe/excellence/statecustody/pdf/cmhj%20immigr
ants%20and%20refugees%20article.pdf
• Refugee Health TAC-http://www.refugeehealthta.org/physical-
mental-health/mental-health/
Page 58
DBHDS Virginia Department of
Behavioral Health and
Developmental Services
For more information contact me
Cecily Rodriguez
Director, Office of Cultural & Linguistic Competency
Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services
804.786.5872
http://www.DBHDS.virginia.gov/OHRDM-CLC.htm
