Fabian feared he was on the verge of a heart attack. And he was only 16 years old.

At times, his heart beat so fiercely that he thought it might burst. His breathing was labored and he felt dizzy and faint.

And so, accompanied by his mother, he came to the Covenant Community Care (CCC) clinic located inside the Southwest Counseling Solutions (SWCS) facility on Waterman Street in southwest Detroit.

CCC provides primary health care to the poor, the uninsured and the underinsured. About a hundred patients a week come to the clinic. CCC is partnering with SWCS to provide integrated healthcare that attends to both the medical and mental health needs of residents in the community.

Dr. Scott Stryd at CCC saw Fabian and quickly realized that Fabian was having panic attacks. Fabian’s symptoms expressed difficult psychological and emotional issues that he was struggling to deal with. Dr. Stryd referred Fabian to Liliana Hilbrecht, Integrated Services Coordinator at SWCS.

“One of the great things about the integrated healthcare model here is that the access to mental health services is immediate,” says Dr. Stryd. “If we didn’t have this model and partnership, I would have had to refer Fabian to an outside community mental health agency, and it could have been months before he saw someone. But Liliana saw him right away and helped improve his health even before he left the clinic.”

Talking to Fabian, Liliana learned that the teenager was under tremendous stress. He was a full-time high school student also working two jobs. Fabian had to work in order to help support the family. His father, who was an undocumented immigrant, had been seized by authorities and then deported. His twin brother, who like Fabian was born in America, suffers from cerebral palsy. Fabian also has a 10-year old brother who is a citizen. Fabian’s mother and his older brother are facing deportation.

“When I explained to Fabian that he was having panic attacks, it was a revelation to him and he immediately began to feel better,” Liliana says. “The understanding itself had therapeutic value. Through this initial session and followup visits, Fabian was able to effectively change his thinking and his lifestyle.”

“The stress is still there,” Fabian says, “but I am dealing with it in a healthier way and the attacks have gone away.”

Fabian continues to receive counseling with Liliana once a month. He says that he used to keep his worries to himself, but has learned through his sessions to talk about them and seek advice. “They’re not trapped in my head anymore,” Fabian says. “I let them out and try to let them go.”

Liliana and the other counselors who work with her in the integrated services program provide intensive and bilingual therapy. Most clients are seen only once, but that one session often makes a significant difference, particularly when the issues relate to stressful life situations. In addition to counseling about stress management, Liliana links clients with community resources to help them deal with the situations, like unemployment, foreclosure, lack of food, and other problems.

For clients with serious mental illness, Liliana refers them to therapists at SWCS and other community mental health agencies.

“I love the challenge of this work and the opportunity to help people immediately,” Liliana says. “We have great communication and teamwork with the doctors and staff at Covenant. We’re all deeply committed to this integrated healthcare model because we know it’s best for those we serve.”