There are more than 300 MFP alumni throughout the nation that provide culturally competent and linguistically appropriate direct care. The MFP alumni also educate, conduct research, provide healthcare services and develop health policy in urban and rural clinical settings, community and outreach programs, and academia with the intent of eliminating mental health and substance use disparities and enhancing well-being among all people, including ethnic minority populations. Each month the MFP will showcase one alumnus’ amazing nursing journey and how their MFP experience helped them pursue their dream.
Featured Alumna of the Minority Fellowship Program-Youth
Avi Wofsy, MSN, RN
Avi Wofsy, MSN, RN is a graduate of the University of California San Francisco Master of Science Program. Her background is in psychology and adolescent risk behavior research. Avi’s experience includes substance dependence research in the emergency medicine department of a Level 1 trauma center, an HIV clinic that serves clients in the American South, and clinical training at San Francisco General Hospital and Trauma Center. Her research interests include harm reduction models, emergency services recidivism, and mental health care access issues.
Avi’s previous rotations were at a mental health clinic and a public school district in Northern California. She works with the Richmond Area Multi-Services (RAMS) that offers individual and family therapy, case management, medication support, vocational training and employment services, problem gambling counseling, and residential care. RAMS is part of the Asian & Pacific Islander Mental Health Collaborative (APIMHC). Avi is also a member of the American Nurses Association and the Alpha Eta chapter of Sigma Theta Tau International.
Avi Wofsy responds to questions regarding her interest in nursing and the nuances of providing psychiatric care for Asian American populations.
Q: What motivated you to enter the field of psychiatric health care?
Wofsy: When I was in college, I worked for the university's housing department as a resident assistant. I lived in campus housing among other students. Much of this job was supporting students as they navigated becoming young adults with new responsibilities. I saw students experience depression, anxiety, substance dependence, and a few first psychotic breaks. I saw significant gaps in the mental health care system, even on a well-resourced college campus. I enjoyed my work and decided to pursue mental health as a career.
Q: Tell us about your work with RAMS
Wofsy: As a psychiatric-mental health nurse practitioner (PMHNP), I offer culturally-respectful services for our clients. The psychiatry team and I offer psychiatric assessment, diagnosis, referrals, psychiatric crisis management, psycho-education, and health education. I work with a multi-disciplinary team that includes therapists, case managers, and peer counselors. We work with a client base that includes large immigrant, first-generation American, and refugee populations with unique needs. I feel very privileged to be part of our clients' lives and to work with a team of people who are so committed to community-based mental health and recognize the importance of diverse providers.
Q: What are some of the major issues/challenges facing young Asian Americans with regard to access to psychiatric health care services?
Wofsy: So much of young adulthood revolves around building your own identity. For all young people, balancing the expectations of others and their own goals can be a challenge. When providing care, I try to come from a place of humility and be open to learning about my patients and their experiences as individuals.
Q: How would you explain the need to have targeted, culturally sensitive psychiatric care for Asian American communities?
Wofsy: Culture is extremely complex. Asia is a huge continent, and it is important to remember it is not a homogeneous monolith. There are significant differences among Asian cultures, even within smaller geographic areas. The best thing to do is listen to your patient, be attuned to their needs, and let them guide you. No two cultures are exactly alike and no two patients are exactly alike.
Never make assumptions.
In broader terms, there is considerable stigma related to mental health and psychiatric care in many communities, which is a huge hurdle in terms of seeking timely care. I've learned a lot from my patients about aspects of health and privacy, and how they are impacted by culture. If a patient feels like you respect them, it really helps build a better (and ultimately more productive) patient-provider relationship.
Q: What would you say are the unique needs of recent immigrant communities including refugees? Do they face issues of stigma from within their own communities regarding psychiatric care and how do you go about resolving these?
Wofsy: In the community where I work, there is a significant recent immigrant and refugee population. For some, immigration may come with a huge feeling of loss. Many clients face trauma (including inter-generational trauma), physical displacement, isolation, language barriers, and must also learn to quickly navigate a complex and unfamiliar healthcare system. In my own community, mental health is not something people talk about. It takes a lot of courage to seek care, so it is important to always be a source of support for your client.
Q: Tell us more about your research interests and how they are shaping or informing your work as a psychiatric nurse practitioner?
Wofsy: My main interest is in emergency psychiatric services recidivism. The psychiatric ER system in San Francisco is overburdened, which negatively affects patient care and increases provider burnout. I am interested in how community mental health can reduce recidivism by catching symptoms before a patient reaches a crisis point, and then offering ongoing care.
Q: Is there sufficient support for the work that you (and RAMS) do? Are there needs that are not being met and why is it important to fulfill these needs?
Wofsy: Our clinic has a very collegial atmosphere. I feel supported by my colleagues, and I especially appreciate working with our therapists. Many of our therapists have worked here for years and have really gotten to know our clients and their families. They offer a way to build rapport and that helps patients trust me more. I feel very privileged that patients let me be a part of their lives.
Q: Is there anything else that you would like to add – including next steps for your career and research?
Wofsy: Representation is very important. Mental health is not a very diverse field, and that can be really intimidating to people who are even considering this field as a career. I was very lucky to have amazing preceptors when I was in NP school. Training an NP is very time consuming and a lot of work; I am really grateful so many people invested in me. I really feel it is important for me to pay that forward, so I hope to be a preceptor in a few years.