Program on Immigrant Families and Unhoused Communities

Since 2009, Dr. Sullivan has practiced as a family nurse practitioner at Boston Health Care for the Homeless (BHCHP), providing primary care to immigrant and limited English proficient (LEP) patients in shelter-based clinics. In March of 2019 she helped launch Oasis, an immigrant health clinic at BHCHP  where immigrants experiencing homelessness are connected with interdisciplinary and multilingual health services. Dr. Sullivan also works as a clinical consultant with the Massachusetts League of Community Health Center’s farmworker health program. Between 2010-2017, she collaborated with Partners In Health in Chiapas, Mexico and Guatemala.

In collaboration with the Initiative on Health & Homelessness, Dr. Sullivan co-developed and co-teaches HPM 523: Homelessness and Health: Lessons from Health Care, Public Health, and Research.

Contributions to courses:

• ID 254: Political Epidemiology: Oppression and Resistance as Determinants of Health

• HMS Essentials of Medicine II: Immigration as a Structural Determinant of Health

• MPH 104: Social, Behavioral, and Structural Determinants of Health, From Data to Action: Immigrant Mental Health in Boston

The Partnership for Community Mental Health and Immigrant Well-being aims to examine the mental healthcare landscape in Massachusetts and learn from immigrant-led, culturally rooted, and community-based approaches to mental health. Traditional medical models of mental healthcare do not meet the current needs of immigrants in the U.S. Many barriers persist, including stigma (among both providers and community members), insufficient bilingual/bicultural behavioral health workforce, long wait times for visits, unclear therapeutic goals, and lack of experience with mental health services. In many regions, community mental health services are absent, and hospital-level psychiatric care is sparse, fostering a belief that treatment is only relevant for the most acutely ill. 

Public health can and should have a key role in addressing mental health and wellbeing among marginalized communities in the U.S. While a public health approach to mental health is not new, it is underutilized. Schools of public health are important places for innovation, learning, collaboration and research, especially in a setting where determinants of mental health are intertwined with structural factors limiting access to health insurance, employment and housing. Development of public health approaches tailored to immigrant communities are a way forward to foster community mental health. 

 A public health approach to mental healthcare requires us to: 
• Address social determinants of health and wellbeing; recognizing individuals are embedded in their current socio-economic contexts and carry the cumulative effects of trauma and harm 
• Employ a systems approach to understanding and addressing issues; acknowledging the complexity and interconnectedness of systems (health, education, housing, labor) and that solutions are going to surface through iterations of action and continuous learning.
• Consider alternative models of program and service delivery, elevating the innovations already taking place within communities and utilizing collective and community-centered approaches to care.
• Commit to health equity, prioritizing marginalized and underserved populations.

With generous support from the Hughes Holden Foundation, the Partnerships for Community Mental Health and Immigrant Well-being initiative is cohosted at the FXB Center for Health and Human Rights and the Office of Educational Programs, Field Education and Practice at Harvard T.H. Chan School of Public Health

Fostering learning

Develop a landscape review of community mental health supports for immigrant populations in Greater Boston. We are particularly interested in community-led resources that exist outside of traditional medical systems and foster accessibility regardless of insurance status.

Developing partnerships

Partner with existing community leaders with expertise and lived experience in mental health among immigrant communities.

Sharing knowledge and teaching

Offer public health students who are interested in immigrant mental health with paid practicums. These practicums will increase students’ exposure to immigrant mental health so that graduates enter into the public health profession with community-informed experience.