Making social work central to health care
UW School of Social Work alum Michael Light, who delivers endof-life care to Seattleâ€™s homeless population
A MESSAGE FROM THE DEAN
Social workers are essential first responders AND THE KEY TO COMMUNITY-BASED HEALTH CARE
s we prepared to publish this impact report back in the spring, the world changed in profound and unexpected ways. At the UW School of Social Work, we immediately instituted remote learning in response to the COVID-19 outbreak and launched a project to bring together social service agencies, our faculty and students, and volunteers to support vulnerable communities affected by the pandemic. As massive protests against racial injustice took hold in our city and around the country, we joined with the five other UW Health Sciences schools to launch an historic
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initiative to fight systemic racism—a chronic and deadly U.S. public health crisis. This coming academic year, the School community will devote itself to collective education and action that puts our institutional weight and social capital behind transformative anti-racist strategies and actions. Although most of this report was written before these extraordinary developments, its core messages resonate with the times: that “social care” (basic housing, health, financial security and essential social services) is an intrinsic component of effective health care, that integrated social and health care best promotes health and quality of life, and that access to care is too often a function of race, wealth and ZIP code rather than urgency of need. We can and must do better.
The need for social work expertise within the health care system has finally, albeit belatedly, been gaining national prominence. A 2019 study from the National Academies of Sciences, Engineering, and Medicine, called Integrating Social Needs into the Delivery of Health Care: Moving Upstream to Improve the Nationâ€™s Health, makes this argument in compelling ways and calls for bold institutional and policy changes. In this report, we document ways in which a communitybased approach to health care with robust upstream interventions and an interdisciplinary workforce leads to better outcomes. We highlight some of our Schoolâ€™s most innovative efforts to put social work and community-based prevention at the center of a new health care paradigm.
As our country grapples with the immediate and lingering effects of the pandemic and its impact on marginalized groups, our School will continue to push for systemic and structural changes that ensure health equity and the rightful place of social work within the health care system. We will also continue to share stories of how we are innovating and working with partners to discover solutions that have far-reaching impact in our community and throughout the nation and the world.
Eddie Uehara PROFESSOR AND BALLMER ENDOWED DEAN IN SOCIAL WORK
UW SCHOOL OF SOCIAL WORK
Breaking Ground TRANSFORMATIVE TEACHING Stephen T. Wilson named Washington state’s Social Work Educator of the Year
and accomplished teachers, Wilson was also honored with the School’s 2020 MSW Students’ Choice Teaching Award. Wilson is highly regarded for his ability to engage students’ empathy, connect theoretical knowledge to real-life experiences, enhance critical thinking skills through dialogue and reflection, and honor multiple learning styles. “My stance as a social worker is framed by thinking about social identities, positionality and one’s relationship to power,” says Wilson. “My goal is to make theory pop up for students and increase their ability to sit with and witness individuals, and sometimes communities, heal from pain.” Wilson’s professional interests include culturally responsive treatment, African American mental health and how children understand race. In addition to teaching and serving as a valued mentor, particularly to students of color, he has spent more than 30 years as a clinical social worker.
Stephen T. Wilson, a lecturer at the UW School of Social Work since 1998, was named the 2020 Washington State Social Work Educator of the Year by the National Association of Social Workers. Consistently rated as one of the School’s most effective
FOCUS ON MENTAL HEALTH FOR YAKAMA NATION YOUTH The School’s Indigenous Wellness Research Institute, partnering with the Yakama Nation, received a five-year, $1.65 million grant to improve access to treatment and support services for Native American youth and young adults experiencing severe emotional and behavioral challenges. IWRI is a leading Indigenous wellness research facility that marshals support from communities, tribes, academia and government to create innovative, culture-centered, interdisciplinary and collaborative research and educational projects. The grant will allow IWRI’s Healthy Transitions team to raise awareness of mental health issues, improve access to screening and detection, make more referrals to traumainformed treatment and provide better care coordination.
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A graduate of San Francisco State University, Wilson received his MSW from the UW School of Social Work in 1982 and a PhD in clinical social work from Smith College in 2017. In his doctoral dissertation, he examined the formation of racial and ethnic identity among individuals of color who were adopted into white families, and he offered a roadmap for helping such adoptees move through the stages of identity development.
The goal is to improve life trajectories for these youth, maximizing their potential to assume adult roles and responsibilities and increasing their chances to lead full and productive lives. Cynthia Pearson, a School research professor and IWRI’s director of research, is one of the principal investigators.
State of Washington YAKAMA ANCESTRAL LANDS
Mt. Rainier Yakima
Mt. Adams Vancouver
ON MULTIPLE FRONTS BUILDING INTERPROFESSIONAL EDUCATION FROM THE GROUND UP
The UW received $58 million from Washington state in 2019 toward construction of a modern, centrally located Health Sciences Education Building that will be shared among the six health science schools: dentistry, medicine, nursing, pharmacy, public health and social work. Created to intentionally foster collaborative teaching and learning among the six schools, the building is just one of a handful in the country created for this sole purpose. Groundbreaking is slated for 2020, with construction to be completed two years later. The new Health Sciences Education Building will give the School access to 98,000 gross square feet of classroom space—larger than the 84,000 GSF currently available in the social work building. The Miller Hull Partnership, a Seattlebased architectural firm, will design the building to incorporate flexible learning spaces, leverage modern technologies and generate an array of environments that can adapt to changing pedagogical needs.
40 YEARS OF PREVENTION SCIENCE LEADERSHIP As the School of Social Work celebrated its 85th anniversary, one of its foremost research centers, the Social Development Research Group, marked 40 years of leading the national conversation on prevention science. Through high-profile research projects, its scientists and practitioners have developed evidence-based practices that promote healthy behaviors and encourage positive social development among diverse populations of young people. Currently led by Endowed Professor in Prevention and SDRG Director Kevin Haggerty, SDRG researchers have written 836 journal articles, manuscripts and book chapters and secured more than $125 million in grants and contracts over the years. The group’s innovative and highly successful Communities That Care system, a nationally known five-step change process using prevention science as a base, has been deployed in 17 states, promoting healthy development and reducing alcohol and tobacco use and delinquency among youth.
NEW APPOINTEE TO BOARD OF REGENTS BRINGS SOCIAL JUSTICE LENS Recent School of Social Work graduate Libby Gates MacPhee (MSW ’18) was appointed to a six-year term on the UW Board of Regents by Governor Jay Inslee, who cited her passion for education and her efforts to improve outcomes for students. MacPhee is no stranger to civic leadership. Over the years, she has served on dozens of nonprofit boards, from the Seattle Foundation to Seattle Children’s Hospital. She believes her experience as a UW student sheds light on “how the university’s mission is carried out, which will add to my perspective as a regent.” In addition to her regent duties, MacPhee is developing a collaborative counseling practice to provide mental health services to teens, young adults and families. She is also working to promote effective philanthropy to support key behavioral health needs in our community.
The design is informed by three guiding principles: build a diverse community, attract students and faculty from around the world and encourage collaborations that improve health.
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The current political climate, with its inflammatory partisan rhetoric and culturally charged divides, has a tremendous impact on immigrant health and well-being.
Technologies that collect information about the activities of older adults and transmit it to family members to view remotely have risks as well as benefits.
Most immigrants come to the United States to join family members, to work or to seek refuge from war, violence or natural disasters, but the road is far from easy.
Many elder advocates believe that installing Internet-connected devices in the home will allow people to age in place instead of having to move to an assisted living facility or nursing home.
“People focus so much on policies like the border wall or the DREAM Act,” says Assistant Professor Jane Lee, “but it’s more about the overall discourse that’s taking place. This is a vulnerable and marginalized population, and that climate creates fear and uncertainty.”
Although families may be acting with the best of intentions, this may do more harm than good, according to Assistant Professor Clara Berridge. Such surveillance can cause distress among those being monitored and create conflict within families, particularly when older adults perceive the technology as compromising their privacy and independence.
In her research, Lee interviewed more than 30 Latino immigrants, nearly two-thirds of them women, as well as another dozen people who work with immigrants in social service and community agencies in New York City. She heard numerous stories of discrimination and hostility, and many people she surveyed were fearful or felt hopeless, conditions that can lead to risky behaviors such as substance abuse or unprotected sex. Others were reluctant to seek medical care or adopt preventive behaviors. These stresses keep immigrants from integrating into society, says Lee, but health outcomes can be significantly improved when social and health services specifically target immigrants.
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With a $500,000 grant from the National Institute on Aging, Berridge is developing a first-of-its-kind tool to help adults with cognitive impairment and their families make better decisions about using technology to monitor activity in the home. “This tool will help guide families in balancing their perceived need for ongoing surveillance with an older adult’s dignity and wishes,” she says. Berridge is consulting with technology and aging experts to determine the most suitable features and options to include. Surveys targeting older adults will also identify common principles and preferences important to this population.
IN HEALTH EQUITY RESEARCH
Low birth weight is not only a risk factor in infant deaths but may also predict worse health and lower socioeconomic status throughout life and even across generations.
Injuries and violence disproportionately affect people of color, uninsured individuals, those with limited English-language proficiency and rural residents.
Associate Professor Melissa Martinson became interested in health disparities between developed nations when she was a social worker living in England. She wanted to know at what point these inequities first surface and whether they differ from country to country.
To ensure more customized prevention and post-injury interventions, information on health-equity variables such as primary language spoken, income level and longer-term post-discharge outcomes needs to be captured.
In one study, she compared links between income, education and low birth weight among babies born to mothers in the United States, the United Kingdom, Canada and Australia. The mothers had varying levels of education and were grouped into five income brackets. The results were surprising. “We expected there would be health differences between the highest and lowest income brackets,” says Martinson, “but in the U.S., it was not just the very rich and the poor whose health is tied to income. Infants at every step of the socioeconomic ladder were affected.” Martinson realizes it will take time to address the incidence of low birth weight in the United States, but her research should add an incentive to do so. “Whatever health disparities a woman has as a 50-year-old,” she says, “they’re partially laid out for her at birth in the United States, more than in other countries.”
“People don’t just come into the ER with a traumatic injury and that’s all,” says Sidney Miller Endowed Associate Professor Megan Moore. “They come in within the larger context of their social environments. By understanding these intersections and critical intervention points, we can better serve the patient.” With a $400,000 grant from the National Institute on Minority Health and Health Disparities, Moore is developing and testing a culturally resonant data instrument to collect better information on injuries, injury care and patient characteristics for state and national trauma registries. Moore is also co-director of outreach for an interdisciplinary team based at the Harborview Injury Prevention & Research Center in Seattle. With a $4.2 million grant from the Centers for Disease Control and Prevention, the research team is focusing on suicide prevention, opioid abuse, older adult falls and pediatric concussions in Washington state. UW SCHOOL OF SOCIAL WORK
Research in Action
How can Indigenous wisdom and practices be elevated? Waimānalo Health Center, nestled in the foothills of the majestic Ko’olau Mountains on O’ahu, Hawaii, offers health care services to residents along the island’s northeast coast; about half of its patients are Native Hawaiians. The health center’s team of providers has served the community for more than 25 years. Two years ago, Professor Michael Spencer, a Native Hawaiian and director of Native Hawaiian, Pacific Islander and Oceanic Affairs at the UW School of Social Work’s Indigenous Wellness Research Institute, launched a project in collaboration with the Waimānalo Health Center to study the impact of integrating Native Hawaiian healing practices (known as la’au lapa’au) into primary medical care. We sat down with him recently to learn more about this culturally grounded, community-based research project in which the researchers and community members are equal partners.
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What sparked your interest in researching an integrative health care model? In 1996, when I received my PhD from the UW School of Social Work, I wanted to specialize in community-based participatory research among Native Hawaiians, but it was not feasible at the time. After spending more than 20 years at the University of Michigan, where I was a professor and then associate dean for educational programs, as well as working in the city of Detroit, I felt myself at a crossroads. In 2015, I took a two-year leave of absence and moved to O’ahu, where I studied, built relationships and learned about the needs of the Native Hawaiian community. Although many Native healing practices are experiencing a revival today, the majority have not been studied. Many people believe that Indigenous wisdom and practices are not consistent with the dominant narrative of medicine and science. I believe there’s a tremendous opportunity for researchers to study interventions that focus on integrating cultural practices that promote healing.
Tell us more about Waimānalo Health Center. The center was already doing a great job of serving the Native community, but its CEO, Mary Oneha, was committed to fully integrating Native healing as part of a model for patient-centered medical care. For Native Hawaiians, traditional ways are passed down by word of mouth; they are part of our ancestors’ sacred wisdom. My job was not to see if traditional medicine is effective but rather to study whether integrating traditional practices into Western medicine improved the patient experience and promoted healing. So I helped put together research questions to measure results.
MICHAEL SPENCER Presidential Term Professor Director of Native Hawaiian, Pacific Islander and Oceanic Affairs, Indigenous Wellness Research Institute
For decades, Native plant-based medicines were banned by law. People either practiced privately or stopped practicing entirely. In the 1970s, though, as the Civil Rights Movement gained momentum, the practice of using traditional medicines reemerged, and it continues to grow in popularity today.
in the Western model. Once patients recognize and adopt these healing practices, they begin to treasure their ancestral knowledge and strengthen their identity as Native Hawaiians. As we integrated traditional healing practices into the health center, we saw patient attendance and participation improve.
How was the Native population of Waimānalo integrated into the project?
The hands-on classes triggered a lot of memories. People told us, “My grandma used to grow that herb in our yard” or “I thought my auntie was crazy for making these concoctions.” But now they realize that Grandma had wisdom and Auntie had knowledge. Rather than seeing plant-based medicines as something from the past, they see a future in it and want to teach their children and their friends.
The first thing we did at the health center was to create a community advisory board made up of residents and staff members. We interviewed Native Hawaiian adults who are patients at the health center and Native Hawaiians not currently receiving services. We also included a range of health care providers and community elders, who were selected for their knowledge and wisdom. We videotaped our conversations with the elders, providing an oral record that will remain with the community for years to come. We want patients to be able to access both types of care at the health clinic—Western and Native—depending on the treatment plan. Since so much of our traditional healing is plant-based, the center taught classes where patients could learn how to make their own medicines at home using traditional plants and herbs. The classes were very popular!
It sounds as if cultural awareness improved health outcomes. Integrating traditional healing practices empowers the community and reinforces cultural connections. Native medicine has a strong spiritual component, which is seldom addressed
How did the clinic’s Western medical team react? The medical team was supportive and willing to work with patients who wanted to add traditional healing practices to their standard medical care. But before long, excitement among the doctors grew, and they were asking to learn more. They more readily accepted the traditional healer as an important member of the health care team when they realized patients were more likely to keep their appointments and increase their adherence to treatment plans. Despite best efforts over the past two decades, disenfranchised communities are still falling behind. We need to take culture and context seriously when working with Native communities in a health care setting. These communities have great wisdom and knowledge about what works. Through this project, we’ve witnessed a powerful connection between cultural expression and positive health outcomes.
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Research in Action
How can research make a lasting impact on health policy? There’s no better example of research informing health policy than the work of the Latino Center for Health, which is based at the UW School of Social Work and works in partnership with the UW schools of medicine and public health. Engaging with the community at the ground level is at the core of the center’s work to address the health needs of the Latino population in Washington state. In 2014, a group of Latino activists visited their elected officials in Olympia to let them know that the needs of Latinos in their districts were not being met. That on-the-ground approach paid off. Legislation to establish the Latino Center was passed that same year, with an initial two-year budget of $500,000. A second
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$500,000 appropriation was approved for the next biennium. The center is co-directed by the School’s Gino Aisenberg, an associate professor and expert in Latino mental health, and Leo Morales of the UW School of Medicine. In February 2019, responding to the urgency of the Latino Center’s work, the legislature doubled the appropriation. “We went in asking for $500,000 and were awarded $1 million,” says Aisenberg. “That amount will significantly increase our capacity.” Latinos are the largest racial/ethnic group in Washington and among the fastest growing. Between 1980 and 2018, the state’s Latino population grew from 1.9 percent to 13.1 percent, reaching nearly 1 million in 2018. Many are immigrants who face a host of social and health-related challenges, including lack of access to mental health providers, food insecurity and a scarcity of linguistically and culturally appropriate health care providers. Through its innovative, culturally responsive research and reliance on community partnerships, the Latino Center has become a critical resource for legislators, informing policy development and disseminating effective practices to promote health and well-being. The center’s staff seek community input
Latinos are the largest racial/ethnic group in Washington and among the fastest growing. Between 1980 and 2018, the state’s Latino population grew from 1.9 percent to 13.1 percent, reaching nearly 1 million in 2018.
GINO AISENBERG Associate Professor Co-Director, Latino Center for Health
in several ways, including through a community advisory board, community leaders and a series of strategy forums held across the state. That input helped identify a shortage of bilingual/bicultural service providers as a critical barrier to health equity. Once legislators were made aware of the issue, they approved an additional $150,000 to support a Latino physician supply study. The study will identify the number of Latino doctors in the state, their areas of specialty and their geographic locations. The data will be presented at a Latinx Health Symposium in September 2020 and will be used to inform the center’s policy recommendations for addressing the shortage. The center will also look into supporting the creation of a statewide Latino physicians association. Another study, supported by the center and with funding from the UW’s Population Health Initiative, examined health and safety concerns facing farmworkers in Skagit and Whatcom counties. In partnership with Community to Community Development (C2C), a women-led grassroots organization in Bellingham, Wash., the research team created a survey to identify key health and safety concerns among these workers, including pesticide use, availability of safety gear, heat-related illness, work-related injuries, and worker rights and social justice. Administering the survey was not straightforward, given the linguistic and geographic challenges and the migratory nature of the work. “People think that migrant workers are the same regardless of where they live,” says Aisenberg, “but workers in Skagit and Whatcom counties, where this project was based, are different
from those who live in the Yakima Valley. They are more migratory in nature, and many come from areas of Mexico or Central America where they speak the indigenous languages. Spanish is not often their first language.” C2C trained 12 promotoras to conduct the survey in English, Spanish and several indigenous languages, reaching 349 individuals. The findings, presented in early 2019 at a community forum attended by farmworkers and community leaders, identified pesticides, pests and water quality as the workers’ top environmental concerns.
“ We are not driving policy. The need is driving the policy. What we are doing is listening to the community, facilitating collaborative partnerships and contributing our research expertise.” This level of expertise and community engagement is what sets the Latino Center apart. “We are not driving policy,” explains Aisenberg. “The need is driving the policy. What we are doing is listening to the community, facilitating collaborative partnerships and contributing our research expertise. If we can continue to create high-impact research and articulate its value to the state legislature, we can continue to address the health needs of this community and move closer toward achieving health equity.”
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Research in Action
How do you shine a light on invisible stories? When Karen Fredriksen Goldsen began researching the health and aging of LGBTQ older adults more than 25 years ago, skeptics told her not to bother surveying that population. “I was told that no one would participate—that gay, lesbian, bisexual, transgender and queer people were too stigmatized, too closeted, too depressed, too whatever,” she later wrote. But she went ahead, sending out the first surveys with the help of community agencies.
since 1993, Fredriksen Goldsen is the principal investigator on Aging with Pride: National Health, Aging and Sexuality/Gender Study, the first national longitudinal research focused on LGBTQ adults age 50 and older. The landmark study, involving 2,450 participants and now in its 10th year, is funded by the National Institutes of Health (NIH) and its National Institute on Aging (NIA). The study also uses national, population-based data from the U.S. Centers for Disease Control and Prevention to compare the behaviors and health outcomes of LGBTQ older adults with those of heterosexual older adults, and it has identified notable health disparities between those populations. Aging with Pride has already yielded significant findings, including that social isolation among aging LGBTQ adults— particularly among the 55 percent who live alone—is a critical public health issue. The barriers they face in accessing health care, along with social stigma, harassment, biased treatment and lack of targeted support services, add to the challenges that all people potentially face as they age.
The response was stunning. “In the margins of returned surveys, we found handwritten notes from those who said their response to our survey was the first time they had told anyone that they were LGBTQ,” she recalled. “This was a population that wanted to tell its story.”
Fredriksen Goldsen and her colleagues are putting their data to use in creating and testing evidence-based programs to reduce isolation and enhance quality of life among LGBTQ older adults. They founded a nonprofit organization called Generations Aging with Pride (GenPRIDE) to carry out that work, which includes implementing enrichment and exercise classes, referrals to support organizations, and training for service providers on how to work effectively with LGBTQ older adults.
A leading expert on aging and health disparities in marginalized communities and a faculty member at the School of Social Work
Another offshoot of Aging with Pride is a five-year study that tests a new intervention for LGBTQ older adults living with
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KAREN FREDRIKSEN GOLDSEN Professor Director, Healthy Generations Hartford Center of Excellence
memory loss, including those with Alzheimer’s disease and other types of dementia and their informal caregivers. With funding from the NIH and the NIA and with Fredriksen Goldsen as principal investigator, Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action) will use trained coaches to test an individualized program that combines exercise and behavioral strategies in three cities: Seattle, San Francisco and Los Angeles. “Unique life experiences of LGBTQ older adults, including lifetime experiences of discrimination and victimization they may have encountered in health care settings, often result in difficulty accessing services, which can be especially challenging when memory loss and dementia enter the equation,” Fredriksen Goldsen says. As many as 5.7 million Americans have dementia. Aging with Pride found that LGBTQ older adults are at heightened risk of cognitive impairment and dementia because of the prevalence of depression, cardiovascular disease, HIV, smoking and social isolation in that population. With funding in place for the next five years of Aging with Pride, Fredriksen Goldsen and her colleagues are looking forward to even more stories and greater insights. “People really share a lot with us,” she says. “They have written in and said, ‘I don’t know why there’s not a place for me to put my name on this survey, because I really want to be visible.’” For her research, the NIH Sexual & Gender Minority Research Office awarded Fredriksen Goldsen its inaugural 2019 Distinguished Investigator Award, citing her commitment to multiple areas of research on sexual and gender minorities.
City of Seattle funds GenPRIDE Center for LGBTQ Older Adults Karen Fredriksen Goldsen and her team are applying their findings to community interventions that are making a difference in the lives of aging adults who may be marginalized because of their sexual orientation and/or gender identity. Most recently, Fredriksen Goldsen secured funding from the City of Seattle to support the GenPRIDE Center, which creates community for LGBTQ individuals who are at risk of social isolation, and to develop the state’s first-ever LGBTQ-affirming affordable senior housing project on Seattle’s Capitol Hill. The 125-unit building is slated to break ground in 2020 or 2021 and be completed in 2023. GenPRIDE will be the primary service provider. “These LGBTQ seniors are largely invisible and immensely underserved,” says Fredriksen Goldsen. “The new affordable housing will provide a vibrant hub for the LGBTQ community and ensure all seniors living in the Capitol Hill area have a place they can call home.”
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Bringing Health Care
to People Experiencing Homelessness WHERE THEY LIVEâ€” ON THE STREETS OF SEATTLE
Access to routine health care is daunting enough, but what happens when a homeless person faces a life-threatening disease that requires intensive or end-of-life care?
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he traditional models of palliative care are often inadequate for serving homeless individuals, says School of Social Work alum Michael Light (MSW ’13). Most people prefer to die at home surrounded by family. This is also true for the homeless population, but their “home” might be a tent or a car, and fractured family relationships may have left them emotionally isolated. Since 2016, Light has been part of the three-person Healthcare for the Homeless Palliative Care Team, based at Harborview Medical Center, where he serves alongside a nurse and a nurse practitioner. The team is the first of its kind in the country and one of only a handful in the world. “What’s novel about our approach is that we meet people where they are, whether that’s on the streets or in a public shelter,” says Light, who spends half his time on the outreach team and the other half in Harborview’s emergency department. “This intimacy provides context about who they are and how they live, and that is a significant factor in helping them access appropriate care.” Homeless people are more likely to develop chronic illness, experience high rates of mental illness and substance abuse, and face frequent exposure to violence. With no regular access to soap and water and often staying in crowded shelters, they are at extreme risk for the spread of deadly diseases, such as COVID-19.
Light is originally from Benicia, Calif. His family later moved to Bellingham, Wash., where he received certifications as a massage therapist and a nursing assistant and then earned a bachelor’s degree at Western Washington University. While looking for ways to become more involved with hospice, Light realized that his massage skills could be beneficial for people receiving end-of-life care. “I visited people in their homes and came to appreciate that level of intimacy,” he explains. “That familiarity occurs with the outpatient services I provide today. I’m coming into their space, wherever that is, whether it’s in a car or under the freeway. What’s important is relationship building and honoring their dignity.”
Average life expectancy for a homeless individual is 42 to 55 years, compared with 78 years for the general population. In Harborview’s emergency department, Light provides trauma-informed psychosocial services to 20 patients a day. “As medical social workers,” he says, “we take the lead in helping victims of sexual assault, identifying legal next of kin, providing mental health triage, coordinating follow-up care and supporting loved ones when patients die.”
Light is pursuing a Master of Public Health in Global Health at UW, teaches advanced health and mental health practice at the School, and guest lectures in the School’s The Harborview team provides what’s known Carol LaMare Scholars Program. He has received several UW fellowships focused on as complex care coordination. This might global service as well as a Bonderman travel include accompanying a homeless person fellowship, which allowed him to explore to an oncology appointment, co-managing the effects of colonization and the power of pain control with a primary care provider or partnering with case managers to provide human resilience. “People everywhere find ways to respond to injustice,” he says. “Their advance care planning. actions inspire me to become more effective in promoting social justice in global health.” The palliative care team follows about 25 people at any given time; in 2018, they Light also provides technical consultation served 116 individuals. Although vital, and research assistance to introduce the program is critically understaffed, medical social work services to Cambodia, given Seattle’s current homeless spending five months there over several population of about 11,200.
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visits to Phnom Penh. His work is part of the successful 15-year partnership between the School and Cambodia’s Royal University of Phnom Penh (see sidebar). “Shaping global health from a social justice framework is a valuable learning experience,” he says. “When you’re working across cultures, responding to cultural adaptations, it’s important to think about the context and the collective needs of the population you’re serving.” Although Phnom Penh and Seattle are 7,500 miles apart, they share some similar health inequities. “Cambodia has very vulnerable populations with limited resources, but so too do the homeless in Seattle,” he says. “I tell people you don’t need to travel to do global health work. Just come downtown with me.” Although Light did not set out to follow a career in palliative care, he views it as an incredible opportunity. “People often ask me if the work is depressing, but I don’t find it so,” he says. “I think it’s very meaningful. The hardest part is seeing the challenges the homeless face every day. Part of my job is to partner with them in their frustrations and make sure they don’t fall through the cracks.”
Michael Light (right) with the other members of the palliative care team: Tony Boxwell (left), an advanced registered nurse practitioner, and Joe Hufford (center), a registered nurse.
BRINGING A GLOBAL PERSPECTIVE
TO LOCAL HEALTH CARE
“Whether it’s a hospital in Phnom Penh or a trauma center in Seattle, learning to provide health care that’s responsive to cultural context has transformed my approach to medical social work,” says Michael Light. Beginning in 2012, when he was an MSW student, Light spent five months in Cambodia over several visits, much of that time supporting Partnering for Health, a joint effort between the School of Social Work and the Royal University of Phnom Penh. Partnering for Health focuses on integrating social work into medical care at two government-run hospitals in the capital city of Phnom Penh. Under the guidance of partnership director and School of Social Work professor Tracy Harachi, Light co-led the project’s development and evaluation phase, identifying program activities and implementation strategies. In a country that is one of the world’s poorest and is still struggling to overcome decades of civil war, genocide and colonization, Light had to look more deeply into practice models and intervention tools that would meet the unique needs of the Cambodian population.
th, UW School of Medicine; From Left: Dr. Richard Vei t; of Social Work; Michael Ligh ool Sch UW i, Tracy Harach ‘06) H MP ‘04; W (MS and Lesley Steinman
“You don’t have to get on a plane to understand what global health care workers deal with every day.” “On both a professional and personal level, my work in Cambodia was one of the most meaningful experiences of my life. The inspiration and knowledge I received from my Cambodian colleagues inform my work in Seattle on a daily basis. You don’t have to get on a plane to understand what global health care workers deal with every day.” Independence Monument in Phnom Penh commemorates the end of French colonial rule in 1953.
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FOREFRONT IN THE
SCHOOLS Bridging the mental health gap to end the epidemic of youth suicide
s a chemical dependency counselor in an East King County high school, Phoebe Terhaar was part of a community that was rocked by a student suicide in successive years. “The loss—it’s hard to put into words,” Terhaar recalls. “For a collective community to feel the shame, and the guilt, is a horrible feeling. There’s a sense of, ‘What are we doing wrong?’ ’’ Around that time, Terhaar became aware of House Bill 1336, which required schools in Washington state to include suicide prevention measures and mental health awareness in their safety plans. Her school signed on the very next year to participate in a new program offered by Forefront Suicide Prevention, a center of excellence based at the UW School of Social Work. Forefront had played a pivotal role in the passage of HB 1336, the first such suicide prevention legislation in the country.
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Seattleâ€™s Roosevelt High School was in the inaugural cohort of the Forefront in the Schools program, which guides schools through an intensive three-year process of community transformation.
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The program, called Forefront in the Schools, brought 13 King County high schools into its inaugural cohort. Each school signed on to an intensive three-year process of community transformation that would involve students, parents, staff and community stakeholders. Year one of the program focuses on creating a suicide prevention and intervention plan—or revising an existing plan—and establishing links to local behavioral health services. In year two, schools implement teacher-led training and peer-to-peer training of students in how to recognize and respond to signs of emotional distress. Year three focuses on integrating suicide prevention efforts into a school’s overall support framework, including mental health education and social-emotional curricula for the entire school community. At every step, a Forefront in the Schools coach provides support, guidance, training and materials. Twice a year, Forefront brings together teams from all of the cohort schools to review program components, engage in professional development, share experiences, discuss challenges and learn from one another. “It wasn’t until this program that I experienced firsthand how a culture can shift from the ground up within a school,” says Terhaar. “It’s because of this comprehensive model. It’s not a onepronged approach—it involves the entire school community. It was really extraordinary.” When the Forefront in the Schools coach, Lauren Davis, left the program in 2016 to launch a successful run for the state house
of representatives, Terhaar jumped at the chance to apply for the position. “This topic really has my heart,” she says. She has been leading Forefront in the Schools since the second cohort entered the program in 2017. Terhaar speaks passionately about what makes Forefront in the Schools unique among suicide prevention programs in schools. Importantly, it’s not an off-the-shelf, one-and-done program. “We are working upstream to address mental health issues and supports, and to prevent tragic loss of life,” she says. The program gives every member of the school community a role to play in suicide prevention and mental health support—not just school counselors. Staff learn how to recognize signs that a student might be dealing with depression or anxiety, rather than assuming that a student is lazy or apathetic. Counselors are given additional training in screening and intervention, and links to community services are strengthened. The program fosters student engagement, which is critical to shifting norms to promote help-seeking and increase a sense of connection and belonging. Parents are also trained to spot warning signs and minimize access to lethal means within the home. One challenge for many schools that want to join the program is lack of money. That’s where private philanthropy has been critical, not only in helping to launch the program but also to sustaining it.
Lucas Snavely (left) and Mica Weiland, co-presidents of Roosevelt’s student-run Suicide Prevention Team, which has nearly 50 members. The team gives presentations on suicide prevention and mental health in classrooms throughout the school, with a goal of reaching 100% of the students each year.
2020 IMPACT REPORT
Forefront in the Schools at a Glance
20,790 Teachers, staff, parents and students trained
High schools served
From left: Kristina Rodgers, principal of Roosevelt High School; school nurse Amanda Schwartz; and Phoebe Terhaar, program manager of Forefront in the Schools.
The Apex Foundation, a major supporter of the program, covered all costs for the first cohort of 13 schools. The second and third cohorts have 16 and eight schools, respectively. They include public, independent, parochial and tribal schools from counties across the state, including King, Pierce, Mason, Island, Okanogan, Stevens and Chelan. The foundation recently renewed its support with a substantial gift designed to sustain the program into the future. “We are thrilled to continue to support the important work that Forefront is doing in schools and in our community,” says Apex Foundation Executive Director Aurélie McKinstry. “We are especially excited about looking at a more holistic and upstream approach to preventing suicides.” Terhaar says that many schools—particularly those whose teaching and counseling staffs are already overburdened—feel overwhelmed and unprepared in the face of rising rates of mental illness and suicide among young people. “They want to know: ‘Who’s helping us?’” she says. “Every community has the potential to turn things around. Once people are getting more of what they need, they can become part of the solution.”
PANDEMIC UPDATE: In May, Forefront received a substantial gift from Pivotal Adventures, an incubation and investment company created by philanthropist Melinda Gates. The grant is funding the transition to remote training for Forefront in the Schools and other Forefront services and programs.
COLLABORATING FOR IMPACT Forefront collaborates across disciplines at the UW, applying the latest science to evaluate impact. Key partners include Professor James Mazza, UW School of Education; Professor Elaine Walsh, UW School of Nursing; Clinical Psychologist Christopher DeCou, UW Medicine; and Research Scientist Martie Skinner, School of Social Work’s Social Development Research Group.
Washington counties represented
Referrals made to outside counseling resources
Safety plans initiated
Youth and Suicide in Washington State • Suicide is the second leading cause of death among teens age 15 to 19.
• According to a 2018 survey,
16% of 8th graders, 18% of 10th graders, and 18% of 12th graders reported making a suicide plan.
• The suicide rate among young people age 10 to 24 increased by 27% from 2016 to 2017.
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A DONOR DISCOVERS THE EXPONENTIAL IMPACT OF INVESTING IN SOCIAL WORK
ike many philanthropists, Seán O’Leary turned his attention to giving for the social good after a long career in business. Dismayed by the growing anti-immigrant sentiment in our country and the persistence of racism and social injustice, he began considering how his giving might contribute to the changes he hoped to see. “At my age, it’s not like I can go out and have so much time to be able to change the world,” says O’Leary, a UW graduate who spent a long career in the salmon industry. “But if I can contribute to the people who can make that difference, then it’s double, triple, one hundred times one man’s power to do something.” O’Leary joined the UW Foundation board in 2017 as the board representative for the School of Social Work. And he went from knowing virtually nothing about social work to becoming a passionate evangelist for the School’s research and programs. “My perception of social work was what you get in the newspaper: people going around and checking on poor people to see if they need any assistance,” he says, noting that news outlets tend to mention social work only when public agencies fail vulnerable children. But O’Leary’s eyes were quickly opened after meeting with Dean Eddie Uehara and later with faculty and students. “I met Eddie, and I can say I walked out of there and my mind was blown from the difference between a preconceived notion of what a social work school would be to what she was explaining they do,” he recalls. He learned about the pivotal role that Partners for Our Children is playing in reforming child and family services in our state. He spoke with the pioneering prevention science researchers in the Social Development Research Group. He heard the leaders of the Indigenous Wellness Research Institute describe their collaborations with Native communities to address health and mental health challenges. And he learned about Karen Fredriksen Goldsen’s groundbreaking research on the unique challenges faced by older LGBTQ adults. “The courage of these people to go out and face the problems that most of us try to avoid in our communities is beyond belief,” he says. “The value that this school provides to this community is immeasurable.”
2020 IMPACT REPORT
O’Leary has directed his giving toward student scholarships at the School as well as specific programs. Most recently, he contributed to the Doctoral Excellence Fund, a new fund to support PhD fellowships. He sees this as a crucial investment in the School. “Like any good investment, you really want to have top-quality people involved in the organization to attract more top-quality people,” he says. “If you’re going to prepare students to go out and deal with these problems in the world, you’ve got to have the top level of talent to be able to teach them and lead them.” His conversations with students, particularly low-income students of color, have also given him deeper insight into the kinds of social barriers he never had to face. “I am so impressed by the students’ courage, which this school harnesses for their personal development and for our community’s progress.” O’Leary, who was on the JV basketball team at the UW and then played professionally in Switzerland for two years before returning to finish his BA in English, worked as a salmon trader in Alaska after graduating and later co-founded a company that produced frozen and canned salmon products.
“I am so impressed by the students’ courage, which this school harnesses for their personal development and for our community’s progress.” Now that he is no longer engaged in a day-to-day business role, O’Leary is thriving in his philanthropic activities, which include co-chairing the School’s campaign to raise $70 million as part of the university’s Be Boundless campaign. As of May 2020, the School had raised more than $73.4 million. O’Leary continues to meet with the School’s scholars and students so he can better understand their work and convey its impact to other donors and potential supporters. “It is such a joy to listen to people present what they’re doing and talk about what they’re working on,” he says. “It’s continually blowing me away.”
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HOW ONE COUPLE GREW A SCHOLARSHIP FUND
Boundless Giving The University of Washington’s fundraising campaign, Be Boundless — For Washington, For the World, is in its final months, and the School has exceeded its ambitious goal. As of May 2020, we had raised more than $73.4 million, exceeding our $70 million campaign target—the largest on record for a school of social work at a public university.
Spurred by a passion for education and a commitment to political activism and social justice, Daniel LaFond (MSW ’68) and his wife, Clare, are continuing to open doors for social work students who are in financial need or are veterans, ex-felons or recovering addicts. In 2016, the couple established the Daniel J. & Clare LaFond Endowed Fellowship; over the years, they have contributed increasingly large amounts to the fund. The endowment provides fellowships to one undergraduate and one graduate student each year; a third fellowship is earmarked for an undergraduate in geriatric social work at the School’s Healthy Generations Hartford Center of Excellence. Both Daniel and Clare worked in higher education for many years. Daniel taught at Bellevue Community College for 32 years, and Clare was the marketing and communications officer at the UW Center for Commercialization, which earned a top spot in a global ranking of university business incubators. Daniel grew up in Olympia in a family with 12 children. He was a chaplain’s yeoman in the U.S. Navy Reserve and, after receiving his MSW, counseled prisoners and was a caseworker in the child welfare system. In 1971, he became chair of the Social/Human Services program at BCC. In 1981, he assumed leadership of BCC’s Human Development and Counseling Center. The LaFonds’ initial contribution formed a strong foundation for future giving. Today their gifts provide a steady stream of scholarships and fellowships that enable more students to complete their degrees and make an impact in the field.
DONATED AS OF MAY 2020
“Our campaign’s success is due in great measure to the leadership and hard work of our campaign committee: Co-chairs Lynn Behar and Seán O’Leary and committee members Anne Deacon Anderson, Trinese Clark, Norman Johnson, Janice Sabin and Amnon Schoenfeld,” says Dean Eddie Uehara. “We are deeply grateful to all our donors for their commitment to transforming the student experience, serving the public good and deepening social impact.” Lynn Behar (MSW ’86, PhD ’99) continues to be a tireless supporter of oncology social work education. Since 2005, she and her husband, Howard, have generously funded scholarships in oncology social work and an endowed professorship. Most recently, they expanded their support to create a state-of-the-art center for integrative oncology and palliative care social work. “This support will help ensure that a new generation of social work practitioners is prepared to lead, innovate and serve,” says Behar. UW alumnus Seán O’Leary, shown at right with his wife, Jill Snyder (and profiled on page 22), serves on several other boards, including the UW Foundation Board. “This spring, UW Provost Mark Richards announced a new initiative to support PhD students that included a $2 million matching fund, O’Leary immediately stepped up. He became the first UW donor to pledge funds for this important program to support the School’s doctoral students. “I’m so grateful I can help our PhD students take their places in their communities as outstanding scholars and researchers,” says O’Leary.
To make a gift, go to socialwork.uw.edu/giving-opportunities 24
2020 IMPACT REPORT
Diversified Revenue The School of Social Work’s record of sustained fiscal health is the result of revenue-projection planning tied to the development of diverse public-private partnerships with philanthropic groups and government agencies. This strategic and deliberative process fueled revenue growth of more than 56 percent during the last decade. 8% 18%
MAJOR REVENUE SOURCES FY19 33%
4 1% Externally Funded Research $31.6M _______________________________________________ 33% TRAINING AND INNOVATION AWARDS $25.3M _______________________________________________ 18% UW Educational and Operational Revenue $14.4M _______________________________________________ 8% Philanthropic Contributions and Gift Interest $6.2M _______________________________________________ $77.5M
Scholarship Growth One of our top fundraising priorities is student scholarships. In the six years from FY14 to FY19, the School more than doubled annual student scholarship and stipend support from $1.7 million to $3.9 million; increased the total number of student awards, which now average $9,700 per student annually; and boosted private philanthropic support from $500,000 to $1 million annually.
SUPPORT FROM DONORS AND PUBLIC PARTNERSHIPS FY14–FY19
HOW NEW LEADERSHIP ELEVATES A CULTURE OF INNOVATION The School of Social Work ranks among the top in the nation for publication rates, research funding and scientific inquiry. Over the years, our faculty and researchers have compiled a stellar record of scholarly productivity and collaboration, both regionally and nationally. To stay innovative, the School is committed to fostering a climate that enables researchers to think about the next big idea, contribute to theoretical and methodological developments in the field, and take calculated risks that may lead to substantive change in diverse communities. David Takeuchi, associate dean for faculty excellence, working in tandem with Rona Levy, associate dean for research, plays a key role in this critical undertaking. Takeuchi and Levy will continue the School’s tradition of high-impact scholarship, staying on the lookout for ways to enable faculty, researchers and doctoral students to establish new research programs, enhance their career trajectories and creatively expand into new areas of scholarship. “The Dean and the leadership team embrace a culture that supports incremental as well as transformational research that is imaginative and innovative,” says Takeuchi. “I look forward to helping refine a vision for the future of research that highlights the unique contributions of our School, our city, and the Pacific Northwest and its culture of innovation.”
$4,000,000 $3,500,000 $3,000,000 $2,500,000 $2,000,000 $1,500,000 $1,000,000 $500,000 $0 2013-14
n Public Partnerships
n Donors UW SCHOOL OF SOCIAL WORK
Social work in a time of pandemic On March 9, less than two months after the first U.S. case of COVID-19 was reported in Washington state, the UW shifted entirely to remote learning; a statewide stay-athome order was announced just two weeks later. Social workers have always been skilled at identifying urgent needs as they emerge, bringing evidence-based services to people where they are and working with communities and partners to achieve the greatest possible impact. This has been especially evident during the COVID-19 outbreak. As part of the School’s pivot to remote learning, we launched Project Connect to bring virtual social services to vulnerable communities while providing “learning while serving” opportunities for our students. Fifteen projects launched in the first month alone, with partners ranging from local tribes to hospitals, social service providers and state agencies. The diverse groups served include Native elders, families with children in foster care, and incarcerated individuals. Our faculty and students have responded by applying their ingenuity, technology know-how, policy acumen and the latest research to create rapid-response solutions that are making a real difference in people’s lives and can serve as models for social innovation in future societal crises.
2020 IMPACT REPORT
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Box 354900, Seattle WA 98195-4900 / socialwork.uw.edu
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Making social work central to health care.