Magazine article Psychotherapy Networker

The Middle-Class Express: Ramon Rojano's Mental Health System for the Poor

Magazine article Psychotherapy Networker

The Middle-Class Express: Ramon Rojano's Mental Health System for the Poor

Article excerpt

The Middle-Class Express

Ramon Rojano's mental health system for the poor

by Rob Waters

Ramon Rojano has a blunt message for today's therapists. Too many are shielding themselves from the world around them, and they risk irrelevance--or worse--if they don't change. "I think therapists are committing suicide," says the veteran family therapist. "We're disengaged from reality. We're not trying to make social change, participating in community meetings, or volunteering our time."

For Rojano, the direction the field needs to take is clear: therapists need to become active agents of social change. He knows that this involves plenty of challenges, but over the past two decades, meeting challenges has been his specialty. And according to him, if you really want to meet the big challenges, it helps to be audacious--maybe even a little crazy. "Carl Whitaker once told me that to be a good therapist, you've got to be delusional," he says. "And I'm very delusional."

Rojano doesn't bother with small delusions; he likes to tackle the big ones--like transforming the city of Hartford, where 47 percent of the people officially live in poverty, into a bastion of middle-class affluence. As the director of the city's Health and Human Services Department, commanding a budget of $32 million, he's made upward mobility for Hartford's less advantaged citizens his mission.

Rojano came to that position via an unusual career path. In the 1980s, he was, he jokes, a "big cheese" in his native Colombia, practicing psychiatry and family therapy with the country's elite. Then, on a family visit to Hartford, a friend of a friend--who just so happened to be the state commissioner of mental health--heard about Rojano and created a job for him as supervisor of community projects. Rojano moved his family to Hartford and has been embedded in the city ever since. When that first job ended and the friend-of-a-friend was gone, Rojano used his formidable networking and schmoozing skills to land a job as a family therapist in a Hartford child-guidance clinic, working with Latinos and African Americans. "I went from being a psychiatrist for the rich in Colombia to a social worker for the poor in the United States," he says.

He soon realized that using traditional psychotherapy techniques to address a family's psychological needs was pointless unless he could also help them address poverty, violence, and the  social and economic crises that were part of their daily lives. "I was finding a lot of issues I wasn't accustomed to in my training," he says. He asked for a full-time case manager to help him, he says, laughing at his own naivete. "My supervisor gave me one of those 'you're dreaming, wake up' looks." From that point on, if he thought a client needed help with social or economic issues, "I just went for it," he says. "If the issue was a job, I had to figure out how to get people jobs." Or transportation. Or housing.

One 8-year-old girl--he calls her Jennifer--who was referred to him for school phobia was so shy she didn't say a word for three sessions. He made a home visit and, over coffee with her parents, learned that gangs were active on the block and that police had conducted raids, chasing gang members down the street. Rojano realized that Jennifer wasn't school phobic, "she was scared that if she went to school, she wasn't going to find her parents in the house. …

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