DURHAM — Mental illness is never easy. But imagine facing depression or alcoholism in a place where you can barely communicate, where you are far from your family without much money to seek help.
This is where Karla Siu, 37, steps in. Siu is a counselor who heads the clinical programs for El Futuro, a nonprofit that offers mental health and substance abuse services to Spanish-speaking families at its offices in Durham, Carrboro and Siler City.
Many of El Futuro’s clients are recent immigrants and their children, a group whose transition to American society, often marked by poverty, can exacerbate existing conditions or make them more susceptible to crises. About half of El Futuro’s clients are children.
Siu, a Honduran immigrant and clinical social worker who earned her master’s degree at UNC-Chapel Hill, has seen hundreds of such clients over 10 years with El Futuro.
Luke Smith, the nonprofit’s director, says that Siu is a talented and experienced clinician. But he believes it is her warmth and devotion to the people she serves that make her work at El Futuro so valuable.
“You’re doing therapy with people who don’t have many resources and are living lives with a lot of stress and a lot of negative things coming at them, and then they or their children are struggling with mental illness,” Smith says. “It can be so defeating, but she is willing to jump into that fray and inspire people and lend them part of herself. Multiple times a day, she’s sharing pieces of herself like that.”
Siu says tries to imbue her clinical approach with “calor humano,” a human touch, understanding that her clients’ mental illness is often part of their migration experience. Sometimes, such as in cases of human trafficking, their problems are a direct result.
Siu notes that her own experience as an immigrant helps her forge strong connections with her clients.
“They have the same mental health problems that we all have – anxiety, depression, relationship conflict,” Sui says. “But you add that to a migration that might not be so smooth, when you’re going through separations and getting used to a whole new culture, all of that makes it more challenging.”
Bridging cultural differences
At each of the three El Futuro offices, a wall is filled with framed portraits of hands – part of the therapy process that acknowledges the nonprofit’s clients while letting them remain anonymous.
Smith says El Futuro was created to cater to a group of patients whose needs aren’t easily met at traditional mental health providers, where few counselors, or even their office staff, speak Spanish or are sensitive to cultural differences that may affect their treatment.
Siu is known for her expertise in serving families and particularly children, conducting play therapy, and assisting in recovery from traumatic experiences. In 2009, she co-authored a paper on cultural issues in treating Latino-Hispanic families with domestic violence issues, and she is a well-known speaker, both to clinicians and others who work on behalf of Latino immigrants.
One of her presentations focuses on how helpers can cope with “compassion fatigue” from the difficult work of caring with a loved one affected by mental illness.
Siu, who became a U.S. citizen last year, spent her youth following her father’s job as a telecommunications engineer to several countries. She grew up in Honduras and spent seven years in Japan. She came to the United States when she was 13 and lived in several cities.
She eventually chose James Madison University in Virginia for college. Starting college with an interest in letters, Siu studied Spanish literature in Spain.
But her attention soon turned to social issues, and when she returned to Virginia, she started working with immigrant children as a tutor at a public middle school. The work drew her in.
“Tutoring immigrant children, I realized that the bicultural side of me is one of the things that helped me reach people in a unique way,” she says.
Much of her career since has focused on Latino immigrants. She did a stint as a volunteer with Habitat for Humanity in Guatemala and worked with Latino families as a counselor in North Carolina and Florida before starting with El Futuro in 2006.
While she acknowledges that her immigrant experience is different from that of her clients, most of whom have far fewer resources and opportunities, she says parts of the experience are very much the same.
“There’s a lot that translates,” she says. “Issues of identity are a big thing that our clients deal with, and there’s the whole acculturation issue, how to become part of a new culture, and the nostalgia and wanting to go back home.”
When she joined El Futuro, it was only two years old and had only four employees. Now there are 20 people who serve more than 2,000 clients a year.
Patients come to them from doctors, schools, immigrant groups, the courts – and a lot from word of mouth.
Three years ago, Siu moved into a leadership role; she trains new counselors and still sees a limited number of patients a week. The group also helps its clients find other local social services.
She thought at first that she might move on in a few years, but she says she stuck with El Futuro because the people she works with make her job so rewarding. Even in their darkest hours, she says, they show an amazing resilience.
“There’s this deep sense of a higher purpose, a spirit of overcoming challenges that is inspiring to watch,” she says. “They’re very rewarding to work with even in the hardest of circumstances.”
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