Lack of bilingual services blocks access to mental health for Latinos, experts say

Although one in five Latino adults have a mental illness, only a third receive mental health services. One of the leading contributors to this is the lack of bilingual services.

Mental health in Southern California has become an alarming concern to experts as it has become the home to more than nine million Latino residents. It's estimated that 1.87 million Latino adults across Los Angeles, Riverside, San Bernardino, San Diego and Orange counties suffer from mental illness, with many not receiving the proper treatment, leading to a higher risk of unemployment, disability, suicide and other consequences.

Maria Bernal, who is a licensed and bilingual family therapist and a representative from the Camino Nuevo Adult Recovery Center in Santa Ana, said that language barriers in mental health can lead to misunderstandings in communication, misdiagnoses and even a lack of trust between clients and therapists.

Bernal believes stigma in mental health persists among Latinos because of the way the community views it. “There's a difference between generations and acculturation within the United States. People that are more culturally [aware], we find that they are more open to mental health services and attending to expressing feelings versus maybe a first generation,” Bernal said.

She also added that many times the community views mental illness as a weakness, especially when it comes to Latino men. “We still deal with a lot of machismo, where men aren’t supposed to express their feelings and their emotions,” she said. “At Camino Nuevo, we do have a men's group that is a safe place for them to come and process their feelings and talk about their emotions. We also identify and figure out ways to support them and create support amongst men.”

Even if Latino individuals were to seek treatment, the lack of bilingual care providers in California prevents them from getting the mental health care they need.

A study found that 31% of Latino immigrants can’t access mental health services because of the language barrier and according to the Department of Health and Human Services, Latinos have the highest uninsured rates of any ethnic group in the country, with 18.3% of the population uninsured compared to 5.4% of white people. 

Bernal said that Camino Nuevo is geared towards the low-income community. “We take in clients who have Medi-Cal, Medicare or no insurance. Sometimes the Latino population doesn't have the resources or the money for the services,” Bernal said. “Other times, you know, they may not seek treatment because maybe they're undocumented and they feel like if they reach out for help, there's going to be some repercussions for that. When in reality, you know, it's all confidential.”

She said that they currently have a language line that they can use to help with language barriers and it's a tool that is mandatory in the mental health field but warned that it’s not the same when it comes to mental health and being able to express feelings with somebody that speaks the language. This barrier also prevents individuals from fully expressing themselves and their experiences. 

According to U.S. Census data, almost 17 million Spanish speakers in the U.S. have limited proficiency in English. While healthcare organizations receiving federal funding are legally required to ensure these patients have access to care, many lack the resources to deliver it. 

As a result, studies on barriers faced by Latino patients show that, compared to English-proficient patients, individuals with limited English language receive fewer healthcare services, have greater mental health needs and get poorer-quality care.

Bernal said that until the Latino community changes their mindset about mental health, their will be a better improvement in the community's overall health.

“Mental health, especially with our Latino community, is that idea that you have to be strong and sometimes there's a huge emphasis on working hard. You work hard, you work hard and you don't have time and you can't fall apart,” she said. “What ends up happening unfortunately is that they tend to seek treatment when they are kind of falling apart and can't handle it anymore or sometimes they don't and it leads to other more serious problems.”

She also said that in order to destigmatize mental health in the Latino community, there’s a need to educate them about mental health and let them know that it’s okay to not always be strong, that it’s okay to reach out for help, and if you do, it doesn't mean you're crazy, o que estas loco.