Partner Spotlight: Makinie Fortino, Founder & President of DMHS

Earlier this year, Y-WE launched the Healing Justice Collective, a new initiative that connects current and past Y-WE participants to values-aligned mental health practitioners and covers the cost of these resources. In this series we are highlighting the partners and practitioners who make the Healing Justice Collective possible, starting with Makinie Fortino, Founder & President of DMHS (Deconstructing the Mental Health System). 

Listen to the audio recording from this interview:

Makinie Fortino, Founder & President of DMHS

Q: Tell us a little bit about you, your background, experiences, interests, whatever you want to share. 

A: Okay. Well, my name is Makinie Fortino. I am a licensed marriage and family therapist. I found out earlier this month that I actually just crossed into 11 years of providing mental health services. I’ve done all kinds of services with that. Some really cool stuff, some pretty disturbing things that I’ve done in home counseling, outpatient social services, vocational rehabilitation, college counseling, and college advising. I think that covers all of it, I’ve done a lot of work in mental health. [In terms of hobbies], I really like Korean dramas and Korean webtoon at this time. I just finished an anime called Legend of the Galactic Heroes. If you’re really into like war strategy in space, it’s very good.

Q: What is the origin story of DMHS? How long has it been around? 

A: So whenever I talk about DMHS, I’m mindful, because I think we have a lot of historic markers. And I don’t want a name to just be a historic marker. It also represents a societal issue. And so I first started thinking about DMHS, after the murder of George Floyd. But the thing that I want to add is 2022 actually saw an increase in police related murders. There were over 1000 people who were murdered at the hands of law enforcement since George Floyd. But that said, during that time, I was doing college counseling and advising for the state. And I had, I had already experienced a lot of examples of free mental health services. But I also felt limited at the same time, because I was only able to serve the students who walked through the doors for the college that I was working for. The other thing that was happening was I had a private practice, I’d had one since 2017. And I was full and people were reaching out for help at that time. And I also found for myself that I was experiencing racial trauma at the time, too. So I was having symptoms of PTSD, I was having nightmares, I was feeling startled whenever I saw law enforcement nearby. And so were my clients. And so were people who were reaching out to me for help. 

So I gathered a group of people. And I was like, “I have some ideas on what’s kind of going on in our mental health system, why we can’t reach people, why people still can’t find providers with all of the services out there. Can we just exchange some ideas and then come up with something?” And basically, at the end of the conversation, what they said was, “it sounds like you’re describing a nonprofit.” So it took me a little bit of time to get that together, and get it started. And that was basically the birth of Deconstructing the Mental Health System. 

The reason why I decided to go with deconstructing, as opposed to dismantling or decolonizing is because I have an LMFT at the end of my name. That is Licensed Marriage and Family Therapist. The issue with that – it’s a wonderful thing – but the issue with that is, I’m still part of the system. And I can still be a proponent of harm, if I’m not mindful of the work that I’m doing. So I called it deconstructing because when you’re deconstructing something, as opposed to dismantling, you’re looking at – if you’re thinking of a clock, opening up the clock and looking for whatever the issue is. So that’s what we’re doing with the mental health system. We are actively looking at where people fall through the cracks and why. And different ways that we can reach them faster, and that they can find people who they consider safe and relatable faster.

So the very first initiative that we had was the directory. And we wanted the directory to look a little bit different from others in the sense that we wanted people to, as soon as they clicked on the directory link, see somebody who looked like them. See somebody who identified with their ethnic group or their culture. So they wouldn’t have to sift through a list of names before they found what they were looking for. The other thing that we did was we wanted to make sure that people could find providers who either identified as queer, trans, people of color, or affirming. So again, they wouldn’t have to go through the listing to find a safe provider. 

And then finally, there are two other things that set us apart. We don’t just do individual listings, we do group practices. And we did that to cut down the time it would take for people to find a provider. So most of the group practices are in Washington State. And what that means for Washington State residents is that when they’re looking for someone who accepts Molina, Kaiser Permanente — they don’t have to look for one person, they can go to the group practice that probably accepts their insurance. Then, we advertise for cultural health and wellness practitioners as well. And again, the reason why we do that is we want to give the potential client the opportunity to find the healing that they want the way that they want it, whether they’re going through direct mental health, medical model services, or they’re going through yoga, Reiki, or coaching. 

So that was kind of the first piece and then from there, we just kind of kept thinking about, you know, how else what other pieces of information can we put together. So we have an “Orgs We Like” page that has over 50 organizations. And that includes organizations that do mental health, that do wellness, that help people learn how to farm, that help people who are experiencing homelessness. And all of these organizations that we have listed on that page, were either created by or operated by people of color. And then the other thing that we have is a “Get Help and Resources” page, which has over 100 links, and prioritizes Black people, indigenous people, and people of color, the needs of everybody in those groups first before anybody else. So we started there, and then we kind of expanded to direct services as of October of 2022.

Q: What’s the makeup of the organization? Who’s doing this with you? How did you get those people on board with you?

A: Ah, so we were very intentional when we were creating it to make sure that it was operated, managed by, any services that were provided by people who identified as the groups of people that we also serve. And so we do have a few queer/trans people of color on our board. And everybody on the board also identifies as people of color. As far as the execution of services, I’m the main person doing most of that. But what I would say is, when it comes to direct services, I’m not the only person doing that. So we have about 20 people who have signed on to be providers for our free therapy and wellness program. And the cool thing about that is that we’re not a group practice, we’re a collective. And so each person runs their practice the way that they see fit. And that works out really well for clients. Because when they find what they’re looking for, they don’t have to go through us. We’re not telling them how they receive services. It’s really up to the client and the provider that they choose.

Q: Can you expand on the values that guide your practice and this organization? 

A: One of the reasons why I decided to create this nonprofit was because I knew that if I were to continue working for somebody else, if I were to continue just doing a private practice, I would just be an individual helping one person at a time. And so collective efforts, collectivism is one value that sort of guides every initiative in this process. Even if it looks like one person is doing the creating, there’s a number of voices in the background who are giving feedback about the way it should look. We also reach out to the community for feedback. So all of the forms, all the public facing forms, like the application, for example, was built with community feedback of “here’s the questions that we want to be asked, here’s what’s appropriate, when you’re asking a question to somebody who identifies as queer. Here’s what you should be asking when it comes to youth, or not asking.”

Another value is right in the name: deconstructing. We’re always thinking about populations that are left behind. So people who don’t have insurance, people who receive social services, people who are on Medicare and Medicaid, are all less likely to engage in mental health services, because mental health services aren’t usually marketed to them. So we go out of our way, even when we’re doing outreach to make sure that we’re reaching out to orgs that serve those populations, so they’re the ones in line first. So we can serve them first.

Another value is volunteerism. So our free therapy and wellness program is never closed. Because we always have a few people who are open to volunteering and accepting clients. And at the same time, we do have partners like Y-WE. And so we’re really excited to say that since October of 2022, we have not had to close our doors. And so I think sustainability is another value that we have, we’re always thinking of how can we keep this going? How can we build on it? How can we reach more potential clients? How can we get them to get the help that they need faster? Because they’ve been waiting long enough. And I think, another value that we have, we really do try to operate outside of systems. So we do have providers that accept insurance, but if we can pay them, so that they can provide the services faster, so that they’re not giving client information to organizations that are just collecting data. We want the information to be for the client and the provider and that’s it. Cutting out the red tape as fast as possible, that’s really what we want to do. And reach the people that have been ignored for too long.

Q: We talked a little bit about the free therapy program. What’s the inspiration behind that and what has it been like to build it? 

A: I’ve worked for organizations that have provided free services for a long time. One of my first jobs after graduating with my Marriage and Family Therapy degree was doing in-home counseling. And that was something that was paid by the state. The organization that I worked for allowed for people to receive “intensive family preservation services.” So up to three sessions a week for free. That was back in 2013. And so in each job that I was working in, there was always this element of cutting the cost for the client. Now there were issues within that, right, sometimes it was court mandated. Sometimes the client had to jump through a lot of hoops. And when I say fill out a stack of paperwork, I’m talking 20 to 30 page intake form, just to be seen. So I was watching that and kind of paying attention to what worked and what didn’t in each organization that I worked for. And just kind of filing it in the back of my head. “One day, if I ever get to do this, here are the things that I’m not going to do, and here are the things that I will do.” The idea of free therapy, for me, has been sort of brewing in my head for a while. And I was waiting to find the right group of people to pull in for it. And that kind of leads to how it started. 

We had the directory, we had listed over 200 people. And so I was like, “what do I do next? We need to keep building, we need to keep pulling people in, reaching people faster.” And so at the time, I had been studying and getting my hours to become an approved supervisor. So I became an approved supervisor. And I was working with Dr. Kim, who is a Black supervisor. And when I say supervisor, what I mean is, in order to become fully licensed in the mental health field, you have to get 2000 hours and you’re supervised by somebody by an approved supervisor. So the two of us got together. And I was like, “hey, I’ve got this idea. I want to provide free therapy services, but we don’t have any money. How do we do something for free in a way that is sustainable and equitable?” And so we came up with the idea of making it a volunteer service, and then recruiting people who were looking for hours so they can get their license. So one of the people that I reached out to was working with 253 Therapy, which is a Black owned group practice. And so I chatted with Phebe [the founder], and I was like, “hey, there’s somebody who’s interested in providing services in exchange for supervision. And we think that this would be a good idea, because then we’ll be able to help people who can’t afford mental health services while providing supervision hours, and then saving both the client and the supervisee money.” So it was really cool to kind of see that get started up. And there were only four of us when we started. And basically, since then, we got some funding, we’ve partnered with orgs. And it’s grown to 20 people. So we’ve maintained the volunteer exchange, but we’ve also been able to pay our volunteers as well.

Q: Can you tell me about the community partnerships that you’ve made in this process? 

A: For sustainability, but also so we can reach different populations, we were connected with Y-WE, and you do some amazing work with youth. But one of the things that kind of came up in conversation was that you weren’t providing direct mental health or wellness services. And so that is really what a lot of our partnerships have been so far, with the exception of 253 Therapy, it’s been, “how do we serve the clients that you have while providing supervision to those who are associate level looking to become fully licensed, and also needing to cut the cost of supervision?” Yeah, that is basically the premise of our partnerships at this time, and what we seek to expand in other partnerships as well.

Q: Why youth centered care in particular? What about that was energizing to you? And why is it important?

A: There has been, since 2020, an increase in youth who are dying by suicide, and youth who are reporting feeling isolated, experiencing symptoms of depression, and experiencing symptoms of anxiety. And at the same time, I think society is at a loss of what to do about it. And so I’m really passionate about the idea of our providers making space to work with youth in a way that youth feel like they’re not being told what to do. They’re not being told how to heal, they’re just being given a space where they can fully express what they missed out on in 2020. They missed out on graduations, they missed out on proms. Some of them had already struggled with school shootings, they’re dealing with the threat of that, not to mention just what’s happening hormonally and mentally as you’re developing as a young person and as an adult. And so I think what I really love about these partnerships is just being able to work on addressing that. So we can educate them about coping skills, so we can help them understand that some of the reactions that they’re having are completely normal considering what they’ve had to go through, what they’re having to live with, and what what as society were telling them that they have to just put up with and be okay with. They shouldn’t. 

Q: What drew you to the work that Y-WE is doing with the Healing Justice Collective? And what has our connection been like for you?

A: I like the passion that you have for the youth that you’re working with. I really like the summer writing program that you have as well. Writing, like expressive writing, is really good for mental health and anxiety management, just from a mental health perspective, that’s really great that you do that. And you already do make space for youth who are experiencing mental health disturbance. What I like about the Healing Justice Collective is that there’s more than one org that is doing this, which is something that we already acknowledged with our directory and the orgs that we like. So I feel like we sort of align as far as we send the youth to the place and the provider that they prefer, that they would probably work best with. And then the orgs that are in the Healing Justice Collective as well share similar values. And so I really liked the idea of, “what if we were all full? But then the other orgs that are there aren’t.” So then there’s really no pause of services for your youth as well. Yeah, I’m all about collectives, I feel like that’s really how all of us should be operating with our orgs, getting together because we don’t all do the same things. We don’t all serve the same clients. And so the more of us, the merrier. 

Q: What has been the most joyous part of your work?

A: Just realizing the contrast between me doing private practice in 2020, or sort of just having this as an idea, but not seeing what it looked like, versus May of 2023. You know, I hold monthly meetings with our providers, and so we’re not an org that just farms clients out to providers, I know who the providers are. And I get to talk with them and learn about their services. And so when you’re sending the youth, I’m thinking of the conversations that I’ve had with these providers, and I’m connecting them with providers that care just as much as we do, that see us in a very similar way, and that I know that they’re not going to cause harm to them when they work with them. And I’m really excited to see what this looks like, even 12 months from now, because it looks completely different already. I feel like I’m not in isolation anymore. I’m sort of embedded in this collective. And there’s so many people who are passionate. And it’s nice to be able to get together with people and listen to them talk about what they’re doing, and also connect with you as well.

Q: What have your learnings been? What keeps you going?

A: I think I get feedback from people about different parts of the process, and I guess I’m speaking more from a management position, but I get a lot of feedback on the referral process and on the tracking process. I learned about accounting, like they’re just different things that you wouldn’t really think about before starting a nonprofit that just sort of pop up out of nowhere and you have to address it and learn it on the fly.

What keeps me going is I really love hearing back from clients. And so I send out a survey every quarter and there are clients who are responding with things like “this organization, being connected with a provider and finally getting a yes has saved my life.” And when I read stuff like that, I’m just like, “that’s why I’m here.” That’s why this organization is here. That’s why this collective exists. Sometimes I say this and I hope it doesn’t sound like I’m minimizing it or speaking too highly of it. But what I’m hearing from people is that their lives have changed as a result of being connected with someone that they do not have to explain their pain to.

Q: What are your hopes for the future of this programming? From an abundance mindset, if money wasn’t a thing, if your capacity wasn’t a burden, what are your hopes for the program? 

A: Wraparound care. So for example, a youth comes through Y-WE and is referred to DMHS, and we have connections to organizations that could provide medical services, or perinatal services, or wellness. We do have wellness providers, but what about weekly or monthly yoga? It would be so cool to have not just partnerships, but a collective that we can refer to and every client has the opportunity to heal fully, to process their their experience of being in their body and in their brain, from mental health, to wellness, to spiritual to everything. It would be so cool to be connected to as many organizations as we can, and then refer each and every client to all of them as needed.

Q: What does healing mean to you? And how do you know that healing is happening?

A: I was working with somebody recently, who didn’t recognize that they were already in the process of healing. And so when I started working with them, they were describing, “I’ve tried everything, nothing is working. And I have XYZ diagnoses.” And in the work that I do, my theoretical orientation is systems theory. But then I also add in racial trauma and womanism. And in the work that I’m doing with this person, is helping them realize that they have been for a very long time, fighting to be an individual in many of the systems that they were in, that had value. Because the way that they were socialized not just by society, but by their parents and by their family members, was that their life did not matter. And that there was nothing that they could do that would ever make it matter.

And so the work that I have been doing with them is helping them realize, you’re not doing nothing, you are very capable. And your very existence is a value in and of itself. And watching this person come to the realization of the power that they have, of the changes that they have already made in their life. And putting almost a shield up, so that they wouldn’t internalize the stuff that they’re receiving from society and from their families, I think is part of the healing process. Having their own ideas about how they feel, and being able to identify what they’re feeling and where in their body is part of healing. And then, at the end of the most recent conversation, they said, I look forward to cultivating joy. And I was just like, I almost cried, I almost cried in that session. I’m not saying therapists should or shouldn’t cry, but that one really touched me because this person is on their way. And so I think, you know, part of the answer is that healing is a process that has to be recognized. Because if it’s not, it’s really easy to diagnose. Really easy to pathologize, and really easy to minimize. And so I don’t do any of that stuff in my work. 

Q: In a dream world, what does youth liberation look like to you? 

A: Gosh, I’m thinking about parents not hitting their kids. I’m thinking of kids being able to sit at the table with adults, if they want to. Autonomy being validated. You don’t have to sit on your uncle’s lap, you don’t have to hug that person. Gosh, basically them recognizing that they are their own person, and they don’t have to wait until 18 to be seen as such. Part of youth liberation is the absence of violence.

Q: Is there anything else you want to share, anything else you want readers to know, a call to action?

A: If you provide mental health and wellness services, we are always looking for more providers, especially those who are open to volunteering. I am all about us being paid but there, for me, is also a passion in the idea of giving freely as well, like a both and. Pay you if and when we can pay you, and also, if you are passionate about giving back and most of us are already doing it, why not do it with the collective? Join us. And also, you know, if you choose not to, we would love to have your information in our directory. Because basically, the more people in the directory, the more options for potential clients. And if you can get our directory onto your website, again, more access for potential clients.

Q: For people who are not in the Social Work arena and just want to support your work, how can they do that? 

A: One thing I noticed is I feel like in 2020, the passion for mental health and Black mental health BIPOC mental health was very high. And I think the thing that I would really like to say for people who are looking to support is do not forget. It didn’t go away, and in some ways it got worse. Because the threat of COVID has “reduced,” but it’s still out there. I feel like people are sort of reemerging from their homes and trying to reintegrate and, and suffering with that, especially with what’s still going on with violence that’s happening. So it didn’t go away. So I would say if you do choose to support us, either sharing our information or supporting us financially, do it consistently. Do it monthly, even if it’s $15, $20, $30, however much you decide, commit to a monthly because the issue is not going anywhere right now.

Y-WE’s mission is to cultivate the power of diverse young women to be creative leaders and courageous changemakers, through transformative programs within a collaborative community of belonging. Learn more about the Healing Justice Collective and how you can support this work.

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