Culturally appropriate mental health services are needed
Hilda Rosario-Escher, President and CEO of the Ibero-American Action League in Rochester, NY writes about the lack of access to culturally and linguistically competent mental health services that continues to afflict the Hispanic population, particularly in upstate New York. Hilda is seeking partners and supporters in her efforts to address this pervasive issue. If interested in working with Hilda on this, please contact her at Hilda.Escher@iaal.org.
Democrat and Chronicle: Web Essay: Culturally appropriate mental health services needed
Dec 27, 2012
I commend Gov. Andrew Cuomo for his firm stand on gun control as an effort to reduce violence in our country. In addition to gun control, we must also look at the untreated mental health problems that many communities of color face.
Research has documented that minorities in our country receive lower levels of mental health care. Those of us who work with these populations know they have tremendous difficulty accessing useful mental health services. There are a wide range of barriers to seeking mental health care that have been identified in the Latino mental health literature.
These barriers can be organized into provider barriers, barriers in the service system, community-level barriers, barriers in the social networks of people in the community, and person-centered barriers. The most important system level barriers include lack of health insurance, language barriers, discrimination from the system and lack of information about services (especially in Spanish). Community centered barriers include the stigma of mental illness. Person- centered barriers include lack of recognition of mental health problems and stigma of mental illness.
Stress from unemployment, poverty, evictions and home foreclosures hits communities of color very hard. Stress from constantly figuring out how to survive can wear down a person, and makes minority communities prone to develop mental health disorders.
Latinos have been identified as a high-risk group for depression, anxiety, and substance abuse. Studies have shown the prevalence of depression as high as 46 percent for Latino women and 19.6 percent for Latino men. In a major national study, Puerto Ricans compared to Cuban and Mexican-Americans had much higher rates of both symptoms of depression and a greater prevalence of major depressive episodes; especially for Puerto Ricans living in the mainland U.S. versus those living in Puerto Rico.
When our children exhibit behavioral problems, often parents don’t know what to do, where to go, or how to navigate the health system. We've learned that people are really invested in having a better understanding of their lives and mental health, if it can be communicated to them in a way that they can understand and trust. For example, studies suggest that once barriers of language and culture are removed (and to some extent insurance status), Puerto Ricans (and other Latino groups) seem to use similar amounts of mental health services as European Americans in the United States.
People experiencing mental health disorders usually get referred thorough their primary care physician, but often minorities do not have a primary care physician or their symptoms are not recognized. Minority serving agencies rarely have the financial resources to provide mental health outreach, education and services to fill this community gap in mental health services.
Between 2009-11, states cumulatively cut more than $1.8 billion from their budgets for mental health services, according to a 2011 report by the National Alliance on Mental Illness. Continued funding cuts to mental health services will mean that an ever-increasing number of disturbed individuals will be forced to cope on their own, and in their own way, and won’t receive the help they need and deserve.
As a society, we must put resources toward developing culturally appropriate mental health services, not just for ethnic or racial groups; but also, for all groups that hold more traditional cultural values and are less likely to follow mainstream care. Only then, will we see a decrease in the violence and victimization that we experience in all our communities.
Our state and federal governments must allocate mental health prevention and intervention resources for programs that work for all segments of our population. A mental health system weakened by shortsighted or misguided budget priorities is bound to make it even harder. Ibero-American Action League is eager to be a community partner with others interested in getting these educational and treatment services to people of color.
Hilda Rosario-Escher is President and CEO of the Ibero-American Action League.