UC Davis professor strives to close gaps in mental health care

09/18/2013 11:09 AM

09/18/2013 11:09 PM

Ever since he read Sigmund Freud while a curious youth attending a Jesuit institute of sciences in Guadalajara, Mexico, Dr. Sergio Aguilar-Gaxiola has been fascinated by the inner workings of the mind.

Combine that fascination with an affinity for people – his mother’s kitchen was like a bustling open house, often filled with town characters — and you have the makings of a man who’s considered a pioneering mental health professional.

And a busy one, at that.

Aguilar-Gaxiola is the UC Davis School of Medicine’s go-to academician for topics related to access to mental health care, particularly when it comes to the largely unmet needs of the Latino population. In the community of local and national — international, even — mental health professionals, Aguilar-Gaxiola is known as a tireless and especially eloquent leader on behalf of the underserved.

For example, after serving as principal investigator of the largest mental health study conducted in the United States on Mexican Americans, Aguilar-Gaxiola developed a model of service delivery that has increased access to mental health services for low-income, underserved, rural populations of California’s Central Valley.

Aguilar-Gaxiola attributes his dedication to social justice to his “incredibly formative experience growing up with the Jesuits. They helped shaped my values. They really left me with a lasting affirmation of moral values and humility.”

Formally, Aguilar-Gaxiola is professor of clinical internal medicine, the founding director of the UC Davis Center for Reducing Health Disparities, the director of the Community Engagement Program of the UC Davis Clinical Translational Science Center and co-director of the National Institute of Aging-funded Latino Aging Research and Resource Center. His curriculum vitae is 51 pages long.

Aguilar-Gaxiola also sits on dozens of university advisory and state government committees, including a couple for the state Mental Health Services Oversight and Accountability Commission. His projects include National Institute of Health-funded research and international work, including mental health studies of Latin American countries and consulting positions for the World Health Organization.

All that adds up to enough meetings to turn anyone into a dry, clinical academic, but Aguilar-Gaxiola is different. Those who know him say he takes care to convey enthusiasm, collaborate with others and connect with everyday people.

One of those people is Maria Hinojosa, CEO and president of the Futuro Media Group and anchor and executive producer of the long-running weekly NPR show “Latino USA.”

Hinojosa got to know Aguilar-Gaxiola through interviewing him for her radio program and serving with him on a recent UC Davis youth panel discussion on depression called Growing Up Latino and Surviving to 25.

“I deal with a lot of academics and the special thing that Sergio has is humanity,” said Hinojosa, a professor at DePaul University in Chicago. “He’s not afraid to show it and to be affectionate in the tone of voice he uses with people.

“There is something very warm about the way he speaks — slowly and deliberately; not in arrogance, but just making sure you are feeling the warmth,” she said.

Hinojosa calls this “the Mexican father in Sergio,” referring to a guiding, mentoring paternal figure.

“He’s an esteemed academician. He doesn’t have to add his extra level of caring about people, but that’s how he connects,” she said.

Aguilar-Gaxiola arrived at the UC Davis School of Medicine in 2006 after 15 years on the faculty of California State University, Fresno. Since then, he’s made a name for himself as an expert on bridging disparities in mental health care, especially for Latinos who struggle with cultural taboos against seeking help, stigma and, in the case of males, masculine views that may deny the existence of mental health problems.

According to his research findings, highlighted as part of the California Reducing Disparities Project in 2012, disparateness in mental health care for Latinos is “severe, persistent, and well-documented.” For starters, there aren’t nearly enough Spanish-speaking and culturally attuned mental health professionals to serve the population’s need, the findings indicate.

California has the most diverse population in the United States and the world, the Public Policy Institute of California has reported. Immigrants from more than 60 countries have settled in the Golden State, with Latinos as the majority. By 2012, 53 percent of California’s elementary school children were of Latino origin, the state Department of Education calculated.

Aguilar-Gaxiola says that, increasingly, community health workers may help fill the gap in services. Typically, volunteers known as “promotores” stroll through communities, sometimes going door-to-door to share healthy-living tips with Spanish speakers.

“Promotores have credibility, a good reputation. They’ve developed trust that is invaluable,” Aguilar-Gaxiola said. “They are in a great position to provide information to people so they can get healthier in their daily lives.”

The Legislature has been considering proposals to transform these largely volunteer positions into licensed and salaried jobs.

In what’s termed the “immigrant paradox,” research shows that newly arrived immigrants have better mental health than U.S.-born citizens of the same age. However, studies indicate that the longer immigrants reside in the United States, the more the protective social and cultural factors from their home countries wear off.

Thus, rates of mental disorders for Mexican immigrants increase according to the amount of time spent in the United States, research shows.

The most common mental health condition afflicting Latinos seems to be depression — a leading cause of disabilities. Aguilar-Gaxiola’s work shows that roughly three out of four Mexican-origin Latinos with diagnosable disorders remain untreated.

It is this “treatment gap” that Aguilar-Gaxiola, 59, constantly tries to bridge by participating in meetings, giving public speeches or speaking directly with troubled Latino youths.

Dr. Will Dere, senior vice president of Amgen, the biomedical giant based in Thousand Oaks, is an outside adviser to the Clinical and Translational Science Center at UC Davis, where Aguilar-Gaxiola leads the community outreach program. Dere notes that the UC Davis center received top marks and accreditation ahead of some other prominent national universities, which then turned to Aguilar-Gaxiola for advice.

“In addition to his technical knowledge, Sergio has the high IQ and other aspects of emotional intelligence,” Dere said. “He’s actually very self-aware, empathetic and has incredible social skills that enable him to interact with all kinds of people.”

Said Hinojosa, “What Sergio does, he is leading a pathway for others to follow.”

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