This episode is for anyone who's ever felt like therapy wasn't made for them, couldn't find a therapist who actually got it, or hit too many walls trying to access mental health care.

More info, resources & ways to connect - https://www.tacosfallapart.com/podcast-live-show/podcast-guests/gino-titus-luciano

Getting quality mental health care shouldn't depend on where you live or how much money you make. But it does. Licensed mental health counselor Gino Titus-Luciano joined me on Mental Health Monday to talk about what it takes to make therapy accessible to communities that get left behind.

Gino's path into mental health work started with a college professor who made psychology come alive. He kept taking her classes because they were fun and somewhere along the way it clicked. This wasn't just interesting material. It was work that mattered. After undergrad he spent time in behavioral health and youth justice before getting his graduate degree at Northwestern. That's where he had a moment that shifted everything.

He was joking with a friend about being "just a DEI student" when they stopped him cold. Why would you say that? Do you really believe you don't deserve to be there? The question stuck with him. He realized he'd internalized doubt about his own worth and that same doubt lives in so many people from marginalized communities. It became clear that fighting for equitable access to care wasn't just professional work. It was personal.

Now as founder and CEO of Hokuwa Mental Health and Wellness Group, Gino provides culturally responsive therapy across Hawaii, Nevada and South Carolina. He also teaches future counselors at Northwestern and serves as president of the Hawaii Counselors Association. In that role he's pushing for real policy changes like the recent telehealth bill that allows audio-only sessions. It sounds small but for people in rural areas without reliable internet or those who can't travel, a phone call can be the difference between getting help and going without.

The barriers to care are stacked high. Low-income communities often only have access to training clinics staffed by students. Insurance reimbursement rates are so low that many therapists won't accept Medicaid. The foundations of modern therapy come from a narrow perspective that doesn't always translate across cultures. Gino learned this firsthand teaching anger management in a prison where an inmate pointed out that expressing your feelings with words might work on the outside but inside it could get you hurt.

Culturally responsive care means doing your homework. It means being honest when you don't know something about a client's background. It means recognizing that advice that makes perfect sense in one context can be completely wrong in another. A therapist telling a 19-year-old from a multi-generational Filipino household to set hard boundaries with their parents might be missing the entire cultural reality of filial piety and community values.

Finding the right therapist is like finding the right shoe. You need the right fit for what you're doing. Some people could run a marathon in stilettos but most of us want something comfortable. It's okay to shop around. A bad first experience doesn't mean therapy doesn't work. It might just mean that particular therapist wasn't your person.

States are starting to make real changes, and that gives Gino hope. Hawaii just opened up provisional licensing so new graduates can start practicing and billing insurance right away. More providers means more access and that matters for communities that have been underserved for too long. The work moves forward even when it feels like we're taking steps backward.

Mental Health Care for Marginalized Groups with Gino Titus-Luciano