By Raul A. Reyes

Decades ago, Angela Diaz was nearly a high school dropout. Despite having good grades, the young immigrant from the Dominican Republic spent days at home, refusing to leave the house.

Then she stopped by the Mt. Sinai Adolescent Health Center in New York City.

“They helped me understand what I was going through, and they treated me for depression,” Diaz said. “They encouraged me and got me to go back to school and graduate.”

For Diaz, the visit proved life-changing. She went on to Columbia University and Harvard University. She became a doctor ­— and since 1989 she's been the director of the same center that helped get her life back on track.

The facility, which celebrates its 50th anniversary this year, was established in 1968 as the city's first primary health program to address the specific needs of teenagers. It sees about 12,000 patients a year from the New York, New Jersey and Connecticut region. Located on Manhattan’s Upper East Side, it's near the diverse neighborhood of East Harlem.

The center offers physical and mental health services, from primary health care to counseling to family planning.

“We provide everything from mental to dental,” Diaz said. “You can get glasses here, or a physical. We have programs for HIV protection, for parenting, and to help transgender youth; we obtain medications for our clients when they need them, or even give them MetroCards.”

Cost is not an issue; services are free if patients don't have access to insurance or Medicaid. The Center is funded by government grants and reimbursements, as well as public and private donors.

Dr. Angela Diaz of Mt. Sinai Adolescent Health Center has studied at Columbia and Harvard University.Raul A. Reyes

More importantly, its mission has not changed since the days when Diaz was there as a patient. Its focus is on youth; it sees patients up to age 22 and its services are confidential.

"This is a teen center,” Diaz said. "Our teens tell me they come here because they feel welcome, respected, connected – and not judged.”

Serving a much-needed community

Across the country, many Hispanics do not receive culturally competent health services. Yet there is a need for centers like this, especially for young people. While in 2014 Latinos were under a quarter (23 percent) of U.S. youth between the ages of 10 and 19, by 2050 Latinos will be about a third (31 percent) of the nation's pre-teens and teens.

In addition, Hispanics generally lag other groups in accessing mental health care.

A former patient, Selena Padilla, said that when she first sought counseling for depression, she had to convince her mother that it wasn't about her parenting and it wasn't her fault.

“I was coming from a Latino background, and there’s this attitude that you’re fine, there’s nothing wrong with you. My mom felt like she failed as a parent because I needed help," said Padilla.

Padilla found a sense of community and support at the Center, and recently returned for an internship. She now plans to attend college.

Beyond care, fostering more Latino doctors

Diaz knew she wanted to become a doctor from a young age. After a childhood accident landed her in the hospital, she became fascinated with doctors and medicine.

“I’ve been saying I wanted to be a doctor since I was four," she said. But Diaz grew up in extreme poverty; in the U.S., her parents were factory workers.

She credits the mentoring she received at the Center with helping her see the possibilities in the medical field.

A 2015 study found that Hispanics comprised only about five percent of practicing U.S. physicians. And UCLA researchers have found that as the Latino population has grown, the percentage of Latino doctors relative to the population has declined.

“We are very concerned with the lack of diversity in the medical field,” said Dr. Elena Rios, president and CEO of the National Hispanic Medical Association. Many of the country’s doctors, she explained, are the sons and daughters of doctors, or they come from a solidly upper middle-class background. “Latinos don’t have that pipeline yet; our path is harder because there is no one in front of us.”

Rios said that the need for more Latino doctors will become even more acute as increasing numbers of Hispanics receive health insurance under the Affordable Care Act and state expansions of Medicaid.

Yet the years of study required to become a physician, as well as the costs involved, can pose obstacles to potential Latino physicians. Training to be a doctor usually requires a college degree, four years in medical school, at least three years as a resident, and possibly more time to focus on a specialty.

According to the Association of American Medical Colleges, in 2016-2017 the average cost of attendance for one year at a public medical school was $34,592 for in-state students and $58,668 for out-of-state students. Tuition and fees at private schools average well over $50,000 a year.

Dr. Hector Vazquez used to go to the Center as a teenager with his then-girlfriend. “We felt comfortable going there, it was like a safe haven for us,” he said.

Dr. Hector Vazquez speaks at the Mt Sinai Adolescent Health Center anniversary celebration in New York on Oct. 30, 2018.Bruce Gilbert

Though he initially went to the Center for checkups, Vazquez said that staff members helped him prepare for the college application process. For him, this made a big difference, since he had not been exposed to this kind of guidance before.

"When you never see people who look like you doing something, you don’t think you can do it," said Vazquez. "If your parents didn’t go to college, the expectations aren’t there for you to go to college. You need a safety net in order to succeed.”

As a medical student, Vazquez came back to the Center on rotations and reflected on the impact of his earlier experiences there. “What they are doing is, in a way, revolutionary.”

Through their work with young clients, Angela Diaz and the staff of the Center hope to continue to effect healthy outcomes and productive lives.

Working at the Center that once saved her gives Diaz empathy into the lives of her young clients.

“In all the time I’ve been at this clinic, I have never, not one day, felt burned out. That’s because I see the change,” Diaz said. “Every person who comes here, their life gets a little better. Even if we contribute a little to their development, that makes a huge difference. It is amazing how well they do.”

“I see myself in these kids,” she added. “I know these kids have talent and potential, and with a little bit of help, they can succeed.”

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