What started as one grant then expanded to include other mental health professional associations, including the American Nurses Association, American Psychology Association, and American Psychiatric Association. The Minority Fellowship Program became a place where racially diverse mental health professionals could go to get support to pursue doctoral and postdoctoral study.
Today, through funding from the U.S. Department of Health and Human Services' Substance Abuse & Mental Health Services Administration (SAMHSA), the American Nurses Association is able to offer the Minority Fellowship Program (MFP). It looks to encourage doctoral and post-doctoral training of minority nurses to help them become leaders in research, clinical practice, and academia. Fellows of the program have gone on to improve culturally competent mental health and substance abuse care across the United States.
"I think it's extremely important to give encouragement to go into doctoral study," says Willa Marlene Doswell, Ph.D., R.N., F.A.A.N., Chair of the MFP Advisory Committee and a member of the first class of fellows in 1975. Many minority nurses can't or don't know how to reach the inside track for research and publication at their home institutions, she says. The SAMHSA Minority Fellowship Program at the American Nurses Association provides the support they need to get ahead.
Over the years, the MFP has supported over 200 minority nurses while they look toward a doctoral education and beyond. Here are just a few of these inspiring nurses' stories.
A retired nurse from the Peace Corps convinced Marife she should pursue a career in nursing. She started by applying for the Associate Degree in Nursing program at a nearby community college. "I was placed on a wait list," she says. "It was taking too long, so I decided to try the L.P.N. route."
This strategy worked, as she was accepted right away. When she completed the program, Marife passed the NCLEX-PN exam. "Unlike my colleagues, I went straight into the B.S.N. program at Hawaii Pacific University instead of working as an LPN," she says. "It paid off! By the time I completed the B.S.N. program, most nursing certification started requiring a B.S.N. degree as a criterion."
After graduation, Marife went on to earn her Master of Science in Counseling Psychology at Chaminade University of Honolulu and a Master of Science in Nursing and doctorate in nursing at the University of Hawaii at Manoa. To complement her education, Marife was a member of the American Psychiatric Nurses Association and the Asian American Pacific Islander Nurses Association. Recently, she accepted a position at the University of Hawaii's School of Nursing and will be a full time assistant professor in the fall.
With expertise in counseling, mental health, case management and utilization management, health insurance, diabetes education, medical/surgical nursing, and oncology nursing, Marife works to create a healthier, more compassionate community. She is an RN Case Manager in the Emergency Department and Clinical Decision Unit at the Queen's Medical Center in Honolulu, Hawaii.
Marife is currently researching alcohol and substance abuse among patients with chronic illnesses. She started her work in substance abuse because she was tired of treating patients only for immediate problems. "We're always rushing to get the patients in for triage and rushing to get them discharged," she says. "I would like to fi nd a process to efficiently help them." Marife sees substance abuse as an array of addictions, not only alcohol and illicit drugs. "It is about a human being trapped in a revolving door with nowhere to go."
Her work has not only helped her grow academically, but as a nurse as well. Marife's diverse spectrum of patients has allowed her to learn when to be gentle and when to give tough love, but she says her job has taught her to be nonjudgmental and to treat people equally. "I take care of the patient who has insurance the same way I take care of the homeless patient with no insurance," she explains. Her greatest joy is seeing patients' smiling faces as they wave goodbye, thanking her and her colleagues for taking good care of them.
Giving advice to nurses interested in helping mental health and substance abuse patients, Marife says, "Always be true to yourself and treat your patients with respect and dignity. This population knows if you are sincere. They are most likely willing to open up and receive help and assistance if you are sincere."
Doris Hill has always enjoyed the sciences and working with a variety of people. She started out working at a bank, but after talking to people at her church who were in nursing, she realized it was the fi eld for her. When she and her husband relocated from the West Coast to the Midwest for his job, Doris saw the perfect opportunity to switch careers. She graduated from nursing school and began her work in the OR.
While working toward her B.S.N., Doris was encouraged by her professors to pursue a master's degree. Not only did she get her M.S.N., but she followed it up with a doctorate in nursing from the University of Minnesota in 2005. Of her studies, Doris says, "I really felt a lot of pull toward diverse populations, minority populations." Her dissertation was titled "Sense of Belonging as Connectedness to Selected Areas of Health and Traditional Practices in American Indians."
Doris has a long-standing commitment to the health of minority populations, especially American Indian and Latino patients. Overall, Doris says she'd "like to see a decrease in health disparities," and increased services for mental health patients and their families. She says nurses and other health care providers must learn and consider historical roots of trauma and the cultural needs of their patients. She stresses the importance of advocating and joining committees. "Take what you learn and use that to benefit the health of minority populations," she says. "Be a voice."
For her post-doctoral fellowship, Doris worked with her mentor, Dr. Barbara Elliott, at the University of Minnesota, Duluth, in the School of Medicine specializing in the health of ethnic minority populations, violence, and mental health. Doris says her fellowship has an impact on everything she does. It has given her an awareness of minority health issues, helped her get involved, and allowed her to make a larger impact. "It's such a great experience, it's hard to put into words," she says. She advocates the program's support, mentoring, networking, and focus on the "bigger picture"—expanding mental health from a local to a national level.
For future fellowship participants, she has a few words of advice. "It's such a positive experience. Enjoy it, learn all you can, and take advantage of the networking," she says. "When they leave the fellowship, they're given the skills and support to really impact those health disparities."
Robert Pope started as a hospital orderly, trying to work his way through the ranks. Then a colleague introduced him to a 20/20 program: work and school for 20 hours each, every week. Determined and serious about his studies, Robert was able to jumpstart his career in nursing.
Robert trained in gerontology at one of the largest hospitals in California and eventually delved into substance abuse and home-based patient care while working at a VA hospital. He noticed that a large population of the older veterans had histories of substance abuse. At one point, he had fi ve patients living in squalor, addicted to crack cocaine. "It appalled me. It shocked me," he says. "I didn't know that this existed at the time."
His experiences at the VA hospital led him to SAMHSA and substance abuse study. "I had taken my experience and my background and used those experiences to gain entry into areas not previously examined," he says. When he started his doctoral studies, Robert focused on the social processes surrounding illegal drug use among older African American men (his dissertation: "Older African Americans and Illicit Drug Use: A Qualitative Study").
Not only did the Minority Fellowship Program help him complete his doctoral work at the University of California, San Francisco (UCSF), but Robert is continuing his work as a post-doctoral fellow as well. He recently accepted a one-year SAMHSA post-doctoral fellowship studying perceived control and psychosocial/ physiological functioning in substance abusing older African Americans.
Outside the program, Robert has become internationally renowned for his work in substance abuse in older African Americans, presenting at conferences across the globe. The Journal of Transcultural Nursing recently published an article that Robert co-authored, "The Social Determinants of Substance Abuse in African American Baby Boomers: Effects of Family, Media Images, and Environment." Recently, he was appointed to serve on the Board of Directors of Mental Health America (MHA), in Alexandria, Virginia.
Robert says the MFP opened his eyes to many of the disparities minorities face working in health care, which he experienced firsthand. While attending his first class at UCSF, Robert looked around the auditorium. "The one glaring thing to me was there were no other African Americans," he says. "I was it." Robert felt a sense of isolation and loneliness. He struggled to relate to his peers. During one class, they discussed money-saving strategies that included decreasing spending on end-stage renal disease, which affects a large number of African Americans and other minorities. At another lecture, they talked about raising funds for osteoporosis, a disease that predominately affects older white women. These instances showed Robert the difficulties of being the only minority in a health science training program and motivated him to help try to change the health care landscape so minorities could see nursing and other health care professions as obtainable careers.
As a strong advocate for the MFP, Robert believes it's important to increase minority nurse numbers through mentoring and speaking out. He says the program has helped him immeasurably and is "an excellent model of success for minority students." He credits the program, Executive Consultant Dr. Faye Gary, Program Manager Janet Jackson, and their personal support for his success today.
Robert's advice for potential fellows? Don't be reluctant or hesitate. He was uncertain at fi rst, but a peer at UCSF convinced him to apply, and he hasn't looked back. Future candidates should not compare their accomplishments to the existing fellows' impressive résumés and feel they can't measure up, he says.
Currently, Robert promotes nursing among minorities and recruits across the country. For young people who want to pursue the program and nursing in general, he suggests not only applying for the MFP, but also reaching out to those who have already found success in their fields. He says fellows are ready and available to help–students just have to ask. Robert invites nurses in need of career guidance to contact him. He can be reached at firstname.lastname@example.org.
At three years old, Mayola knew that she wanted to get involved in health care from watching her mother, a Red Cross volunteer. "I always, always wanted to be a nurse," she says. "That's all I've ever wanted to do."
While at the University of Southern Indiana School of Nursing, Mayola completed a rotation in the mental health program and "fell in love with it." She remembers her instructor saying that the discipline was an area where nurses have to rely on their knowledge and compassion and not as much on machines. "It stuck with me," she says.
For 24 years, Mayola has been working in various clinical settings with a focus on psychiatric/ mental health nursing. She completed her dissertation, "Predictors of Depressive Symptoms and Obesity in African American Women Transitioning from Welfare to Work," at the University of Tennessee Health Science Center in Memphis. Mayola is also the first known nurse to earn both a Ph.D. and a D.N.P.
Of her patients, Mayola says they "are some of the most vulnerable." Mental health care requires a very different mindset from physical health, and many people don't want to be around mental health patients. "They're the forgotten population," she says. "But they're still people and they still deserve care."
Mental health care is a difficult field, she explains, and nurses must call upon all their faculties when aiding those with psychological concerns. (Mayola prefers the word "concern" over "illness" because of the stigma associated with the latter.) "You have to have compassion," she says. You are working with patients that may never get better, and many times it's an uphill battle against chronic progressive diseases. It is hard to leave her practice at the end of the day, and it sometimes occupies her thoughts into the evenings. However, Mayola stresses that the skills involved in mental health nursing are not unique to the practice; they're transferable and needed across all health care disciplines.
Despite the hardships, there are many benefits to working in mental health. "I am thankful that I have the opportunity to serve these people," she says. "I think that it has made me a better person." Mayola cares deeply about her patients' welfare and says they truly make a contribution to society. "Every day that I go to practice, I ask God to guide me and help me practice safely," she says, "and I try to give it all that I can."
Regarding the MFP, Mayola is in reverence. "I wouldn't be where I am if it weren't for that program and Dr. Faye Gary and Janet Jackson," she says. Of Dr. Gary, Mayola says, "She truly believes that her fellows will make a difference." Dr. Gary pushes the fellows, knowing they will contribute to nursing science and research.
The MFP provides the foundation fellows need, and Mayola recommends that those passionate about mental health apply for the program–just be ready to articulate and demonstrate your enthusiasm for helping those with serious and persistent mental illnesses.
When she was in high school, Rosa Gonzalez-Guarda went on a service mission to the Dominican Republic. There she saw very poor communities, with limited education and health care resources. "The thing that struck me most," she says, "were the great disparities [between the United States and the Dominican Republic] that existed in terms of health."
When she left high school for Georgetown University in Washington, D.C., Rosa wasn't exactly certain of what she wanted to study. She thought about nutrition, but there weren't many programs available at the time, so she decided on nursing and a minor in international health so she could be more exposed to public health issues.
After earning her B.S.N., Rosa began working with communities in the United States. "I realized I saw the same disparities that struck me abroad existed here." She refocused her studies on local issues, especially intimate partner violence (IPV), domestic violence, substance abuse, and risky sexual behavior.
Rosa decided to pursue master's degrees in public health and nursing (M.P.H. and M.S.N.) at Johns Hopkins University in Baltimore, Maryland. She worked with world renowned researcher Jackie Campbell, who specializes in domestic violence and has published more than 150 articles and seven books on the subject. They developed a violence prevention program at a predominantly African American inner-city middle school. It was a wonderful experience for Rosa, as she learned more about IPV. It was then that she decided to focus on domestic violence among Hispanics.
For her doctoral study at the University of Miami, Rosa drew from three different disciplines: nursing, epidemiology, and psychology. Her dissertation focused on the intersection of substance abuse, IPV, and risky sexual behavior among Hispanic women, and she developed a model for understanding and addressing the co-occurrence of these conditions. "In reality, when you look at a lot of the factors that lead to these conditions, they're the same thing," she says. Rather than focusing and treating a single ailment, Rosa believes that such issues should be treated together. There are many changes she'd like to see, especially the categorical way the health system is funded.
Rosa says the MFP and its fellows improve communities through research and granting more opportunities for nurses. She believes they can also help with the nursing shortage. The lack of nursing faculty, who tend to need Ph.D.s to teach, has forced nursing schools to turn away students. With the program, more nurses can earn their Ph.D. on the way to becoming professors.
Rosa suggests potential candidates think about the things they'd like to research as a doctoral candidate and build a career trajectory around them. She explains that being a nurse researcher doesn't mean being isolated from patients, sitting at a desk crunching numbers. Research nurses can really make a difference in the field. And her last piece of advice for potential MFP candidates? "Stay true to the communities that you are trying to serve."
As nurses look toward the future and an aging American population, the opportunities to make an impact in the mental health and substance abuse field will continue to expand. The MFP affords minority nurses the chance to participate in that growth. When asked what advice she has for candidates considering the MFP, Willa Marlene Doswell says, "They should apply! [The SAMHSA Minority Fellowship Program at the American Nurses Association] opens up doors and it opens up opportunities to help the minority community." For more information on SAMHSA's Minority Fellowship Program at the American Nurses Association, visit the MFP online at www.emfp.org.