Elma settled in Silver Spring, Maryland in 2003 having fled an abusive relationship in her home country of Guatemala. After two miscarriages that resulted from violent beatings at the hands of her husband, Elma knew that she had to get away. She chose to come to the United States because of the opportunities it offered to build a new life and earn enough money to support her mother and two daughters back home in Guatemala.
Elma worked tirelessly for seven years cleaning construction debris out of recently built houses, and on weekends she had a second job cleaning carpets. These jobs did not offer any benefits, and so Elma had to pay for the high cost of private health care out of her limited salary, until one day she went to the Emergency Room with a severe hemorrhage. Elma had lost a great deal of blood and had advanced anemia. She was admitted to the hospital where she received multiple blood transfusions. When she was well enough to return home, the hospital referred her to a clinic participating in Montgomery Cares, a public-private partnership that provides primary and preventive care to low-income, uninsured adults in Montgomery County.
Finally Elma had found some relief from the hefty medical bills that had been eating away at the remittances she was able to send to her family; but, her health was still a problem, and it was about to get much worse.
In 2009, Elma suffered a severe leg injury at work. The accident prevented her from continuing at her job, and without a steady income, she could not save enough money to send back to Guatemala. Elma became desperately depressed; she slept all the time and stopped taking care of herself. After being told she would not be able to work, Elma became suicidal. “If I can’t work” she thought to herself, “If I can’t help my family, it would be better to die.” She went to the bank of a river, took off her shoes, and prepared to drown herself. Thankfully she did not go through with it. Instead she told her doctor about what she was feeling and was quickly referred to the Montgomery Cares Behavioral Health Program.
The Montgomery Cares Behavioral Health Program began in 2005 in response to the high prevalence of depression and anxiety disorders among Montgomery Cares patients. The program embeds behavioral health care teams at primary care clinics and they work with primary care providers to identify, diagnose, and treat patients with common behavioral health concerns.
Elma began to meet regularly with a behavioral health care manager. At first she was cautious, but her care manager helped Elma realize that holding on to her story was causing her harm. Elma slowly began to open up and share her story. She started taking anti-depressants and other medication to help her cope with PTSD. She was also referred to other County programs that provide assistance with food and clothing.
Now, Elma is able to stay focused on the positive things in her life. She is concentrating on healing both physically and emotionally, and is now able to walk unassisted; she hopes to be able to work again soon. “I’m grateful to everyone who has helped me. I’m grateful to God. I feel good.”
Looking back on her experience Elma wants other patients—especially women—to know that there are services to help them get through tough times and that they should not be afraid or ashamed to ask for help, “We’re not crazy,” she says “we’re learning to survive.”