Mobile mental health specialist Esther Kwak is adjusting to working from home while delivering urgent mental health services to Houston area students.
November 16, 2020
Esther Kwak (San Antonio ’10) is a mobile mental health specialist in Houston who works for Communities in Schools of Houston (CIS), a nonprofit that provides student support services including mental health and wellness. Kwak, who has a degree in psychology and a master’s in social work services, is a free, on-campus student social worker who works at 11 area campuses, ranging from elementary to high school.
Before the start of the school year, she spends weeks visiting schools to understand students’ unique mental health needs in each. She sets up safe, private meeting spaces for one-on-one therapy sessions. Then, once school is in session, she walks the hallways, becoming a familiar presence whom students can reach out to for help.
At least that’s how she used to work.
This school year, Kwak doesn’t know when she’ll walk those hallways again. But she does know that students, maybe more than ever, still need counseling, which means the way she works has to change. She’ll have to give up play therapy and offer everyone talk therapy, which is useful with high school students but less so, Kwak says, with a nervous fifth grader.
This isn’t the first time Kwak has dealt with a school shutdown. When Hurricane Harvey hit three years ago, “That was different. Harvey was crisis intervention,” a sprint to help students in shock as schools dried out. But now, depression and anxiety prevail as children spend days with less socialization and no idea when life might return to normal.
So how does a mobile mental health specialist serve students when a pandemic removes the mobile factor? Can she be effective when student and therapist meet for the first time through computer monitors? On a day in September, when Kwak and her team were prepping for the start of the school year, Kwak kept a diary of her time for One Day.
The steady snores of Turk and Ted, Kwak’s poodle and Shih Tzu mixes, are the first thing she hears when she wakes just ahead of sunrise. She needs fresh air ahead of a day of virtual meetings. Kwak laces up and heads out.
Typical Houston humidity and 80-degree weather meet Kwak on the trails of Terry Hershey Park. Her playlist: Colossians and Ephesians, as she works her way through the full audio Bible. “It’s been something I can connect to more, especially with everything that’s going on, through the pandemic and through social justice issues in our country.”
Beyond the trail, Kwak glimpses a stretch of homes getting post-Harvey renovations. “I don’t like thinking about Harvey so much just because my own home flooded,” she says, but she’s reassured to see “how we’ve moved forward.”
Back home, she makes her daily morning treat: a tumbler full of coffee with a vanilla protein shake to get through the day.
“Hello?” Kwak says. She can’t see a face on her monitor, but a name on the screen signals that someone should be on the other end of this Microsoft Teams meeting. “My Wi-Fi isn’t good here.” The voice on the other end shuffles around to find a stronger signal.
For the next 10 minutes, it’s the most painfully relatable reality of virtual office spaces. Long silences are interrupted with the occasional, “Can you hear me better?”
This is the messy middle that Kwak and her team have to figure out now before students enter the mix. Kwak’s team normally uses Zoom. “This is the first time we’re using a new video platform. We had to find a version that was HIPPA (Health Insurance Portability and Accountability Act) compliant, and that allowed for confidentiality for students and families. We’re trying to figure out how it works, but navigating it has been a challenge,” Kwak says.
Everyone eventually makes it onto the call, including a CIS student support manager at a West Houston high school. This is the person who will recommend students needing counseling to Kwak.
As the group tries to make sense of students’ virtual and in-person schedules, Kwak asks, “When would the best time be to work with students?” Not a lot can be decided on this call, with schedules still unknown and assistance needed from the school district technology help desk.
This high school staff is the fourth of 11 school teams Kwak has met with recently. “I am hopeful,” Kwak says. “Schools will have to adjust as they go, as they figure out what works and what doesn’t work.”
Tumbler beside her, Kwak gets comfortable at her desk and dives into a 70-page report from the Migration Policy Institute titled “Immigration Enforcement and the Mental Health of Latino High School Students.” The institute examined how living in fear of deportation impacts students’ mental health.
Kwak reads that more than half the students surveyed (including from Houston) reported symptoms of mental health conditions at levels high enough to warrant treatment. Two-thirds met the clinical threshold that would warrant treatment for anxiety, 58% for post-traumatic stress disorder, and more than half for depression.
“The reality is the idea and the fear of deportation, in and of itself, is enough to really cause mental health symptoms,” Kwak says. “There has to be systemic change in addition to providing mental health services” to students.
Kwak wouldn’t have called herself a handywoman before the pandemic, but she takes a short break to work on a shower drain issue. “These things wouldn’t normally bother me, but I’m home all day.” This will “hopefully make my work-from-home experience” feel smoother.
Kwak’s next check-in is with a new high school partner. Previously, to work with a mobile social worker, a school had to have space on campus for Kwak to meet privately with students. The school she’s meeting with today didn’t have that room but going virtual eliminates the barrier.
“This campus has been waiting and wanting and desiring mental health support. And this was a campus that I really wanted to work with last year, but we just weren’t able to,” Kwak says. “There are some plus sides to being virtual. But there is still a lot to work out. We’re going to have to try to build relationships for the first time with many students who we’ve never actually met before.”
When she commuted across Houston from one campus to the next, sitting in traffic, Kwak often opted for a fast lunch out. Now she’s saving money and connecting to her Korean traditions by prepping at home: today, rice, bulgogi, and side dishes (banchan): sautéed potatoes and carrots and spicy cucumber kimchi salad.
Kwak has her last school check-in of the day, this one with one of three elementary schools she’ll work with this school year. This call’s topic: syncing family contacts with the school.
“Like every other school, we’re kind of in a position where we have to wait and see what schools have done to reach out to students and families,” Kwak says. It’s hard to predict how many students will show up for therapy.
“There are some plus sides to being virtual. But there is still a lot to work out. We’re going to have to try to build relationships for the first time with many students who we’ve never actually met before.”
Kwak spends an hour attending part of a required training for a youth counselor: how to respond to human trafficking victims in a trauma-informed way. “The city of Houston is one of the highest human trafficking locations across the country,” she says.
Training done, Kwak spends the rest of the day on planning and trouble-shooting emails. She is hoping to be as effective as she can this school year, given heightened student needs. “I really do believe that everyone is really trying the best they can in this moment,” she says.
Less commuting these days means more time for Kwak to visit her parents at their new home. When she walks in, dust covers the walls, and there isn’t any furniture (or a functioning sink). Her family has lived in the house for several months, but the pandemic delayed renovations.
Kwak’s parents, who came to the United States from South Korea in the 80s, don’t get upset about the delays. It’s like camping, but indoors, they joke. Kwak grabs a packing box and sits with her family in the garage as they enjoy a microwave-prepped Korean dinner (no stove yet): kimchi stew, rice, and seaweed. Kwak slips into the language she grew up speaking.
“My parents asked my brother and me when we were young to only speak Korean at home. We’ve grown up speaking Korean together as a family,” Kwak says.
Kwak watches Ted, her poodle mix, chase and fail to catch lizards on their walk. Back home, to the comforting sounds of her snoring dogs, she thinks about the Bible chapters she’ll hear on tomorrow’s walk and what’s coming from her next day’s school check-ins.