In a Wealthy County, Uninsured Patients Struggle with Grief and Trauma. This Therapist Helps Them Heal.

The father of three was finding it difficult to manage without his wife.
 
He and his children were grieving her recent death. But on top of that, she had been the one who did the cooking, who helped the kids get ready in the morning.
 
For marriage and family therapist Virginia Moreno, who treats people experiencing bereavement and trauma in Santa Barbara County, California, this wasn’t a problem that could be solved in the clinic. So she did what she so often does: She took extra steps to help her patient cope, in this case teaching the widowed father how to cook a few simple dishes, brush his daughter’s hair, and make the beds.
 
“You just go that extra mile, because there were three surviving children,” Moreno said. “We did all the survival skills.”
 
For nearly 14 years, Moreno has worked as a clinical therapist at the nonprofit Hospice of Santa Barbara, working with patients who have lost loved ones. The care she provides is often relatively short-term, focused on helping patients process their grief and build coping skills to help them continue on.
 
Now Moreno will be providing bereavement therapy at the Savie Clinic, a free clinic in north Santa Barbara County, in addition to her work for Hospice of Santa Barbara. There, she’ll work with as many as 50 patients confronting trauma or grief. The expansion of her work was funded through the Community Routes: Access to Mental Health Care program, a partnership with Teva Pharmaceuticals, the National Association of Free and Charitable Clinics, and Direct Relief. Savie Clinic received $150,000 over two years to expand their mental health services and outreach.

“It’s being able to provide a safe place for clients to share their stories, without judgment, without added stress,” she said. “You’re creating a safety net and [they know] that there’s someone who’s interested in walking this path with them.”
 
Moreno didn’t always plan on being a bereavement therapist. She went to college expecting to become a private investigator. But then she took a psychology class, and fell in love. She also saw a high need for mental health services in her Latino community, and was concerned about the stigma she saw community members holding toward psychology and mental health care.
 
“I thought, ‘Maybe if I look like them and talk like them, I can help them,’” she recalled. “I felt a yearning and a calling for that.”

Santa Barbara County is famous for its natural beauty and elaborate mansions, but the area is rife with inequity and income disparities, particularly in the northern part of the county, which has historically had little in the way of affordable health care.
 
That changed in 2022, when physician Ahmad Nooristani saw the extraordinary need for medical services in north Santa Barbara County, and founded Savie Clinic in the city of Lompoc, to provide free health care for uninsured patients.
 
Savie’s leaders first became aware of the urgent need for bereavement therapy in their community when a young patient died suddenly from an illness last year. As Savie’s staff worked to organize support for the boy’s family, they began to hear other stories of patients losing family members suddenly, whether from murder, suicide, car accidents, or natural causes.
 
“Hearing more of these stories made my hope to partner with Hospice increase,” said former Savie executive director Eryn Shugart, who is now a grant writer, in an email to Direct Relief.

Shugart said Moreno was a natural choice to provide the expanded services: “She is bilingual and bicultural, and 90% of our patients speak Spanish only. She is also an excellent and experienced clinician.”
 
For Moreno, it was an opportunity to bring an essential treatment to an underserved population.
“I was excited because I know that north county doesn’t get a lot of services,” she explained. “We don’t turn anyone away.”
 
But the care itself is familiar. “The subject is the same. It’s death and dying,” Moreno said. “This is what grief looks like…They’re brave enough to come in and fall apart, and then pull themselves together again.”

In Moreno’s experience, many members of Santa Barbara County’s Spanish-speaking population need mental health care, but they’re afraid of reaching out, and aware of the stigma. Part of her work is helping her patients understand and process the fear they’re feeling. “Whatever emotions you’re feeling, it’s normal,” she tells patients.
 
Ultimately, Moreno’s goal is to give the people who seek her help the tools they need to work through grief, trauma, and other emotional pain in their lives.
 
“They’re going to learn coping skills,” she said. “So when they get triggered, or they feel like the world is falling apart, they’re going to draw on their coping skills.”