Latinos face language barrier, cultural stigmas when seeking mental health treatment 01

Upper row from left to right: Scott Taylor (LCSW and Program Manager), Alex Ibarra, Joshua Jenksin (LCSW), and Derek Larsen (LMFT). Bottom row from left to right: Justin Fagnant (LCSW), Madison Schult (Care Team Assistant), Savannah Roll, Madeline Claude (MSWI), Rosa Reyes (Therapist), Elizabeth Feil (LCSW), Maria Tamayo (SSW). Not pictured: Merrill Yesslith (SSW). Monday, September 23, 2019, at Wasatch Mental Health in Provo. 

Wasatch Mental Health’s American Fork clinic didn’t think it had any clients who spoke Spanish. Then it hired someone who knew the language, and the people started rolling in.

“If we have it available, more people will be willing to come,” said Elizabeth Feil, a licensed clinical social worker and supervisor at Wasatch Mental Health’s Provo Family Clinic.

Latinos face a unique set of stresses and barriers to obtaining mental health treatment, along with a set of cultural stigmas that surround seeking help.

“It doesn’t matter who you are, it is frightening enough to come in for mental health services,” said Scott Taylor, a licensed clinical social worker and the program manager for Wasatch Mental Health’s Provo Family Clinic.

About 17% of Hispanics have a diagnosable mental, behavioral or emotional disorder, and 3.6% had serious thoughts about, made plans or attempted suicide, according to data from Mental Health America.

About one-third of Latino adults with a mental illness receive treatment each year, according to the National Alliance on Mental Illness, compared to the national average of 43%.

About 80% of Rosa Reyes’ caseload are Latino clients. Reyes, a licensed clinical social worker with Wasatch Mental Health, said that Latinos face strains from their financial situation, to immigration status to concerns about what their legal rights are. She said she’s seen clients express that they’re experiencing more stress since the beginning of the Trump administration.

Reyes said she’s had more clients talking about getting a power of attorney into place in the last couple of years.

“For a lot of time, you didn’t talk about it if you were undocumented,” Reyes said. “You didn’t say it. Now, more people are talking about it. There is more of a fear.”

Deportations, especially, can put stress on a family. Reyes said mothers have to work more and take on the role of a single parent after a father is deported, and some families lose touch after a family member is removed from the country.

“The mom will say, ‘my kids didn’t have any issues until their dad was deported,’” she said. “That is a huge change.”

The Provo clinic has evolved in the last few years to break down barriers for Latinos to come in for treatment. It has an annual training on cultural diversity, which includes stressing to providers that they should get to know clients on an individual level instead of making assumptions about how long their family has been in the country, what their immigration status is or which language they prefer to communicate in.

The clinic has added more Spanish-speaking staff and now has a Spanish-speaking front desk, case managers and providers. Signs and paperwork are available in both English and Spanish.

“I want them to feel comfortable,” Taylor said. “I want them to feel like they can come here.”

Every time it has an opening, it notes that Spanish-speaking candidates are preferred.

Taylor didn’t have the statistics, but previously knew that he didn’t have enough staff who spoke Spanish. Now, he estimates that about a third of the 3,000 to 4,000 clients his clinic annually sees are Latino.

“It is very rare that I go to the waiting room and there’s not somebody who speaks Spanish,” he said.

Before increasing its Spanish-speaking staff and enacting a policy change, bilingual employees were being pulled away from their jobs to translate.

“I was getting a lot more phone calls trying to schedule people rather than treating people,” Reyes said.

But although the clinic is seeing more Latina women and Latino children, it still faces a struggle in convincing Latino men they need to come in. Part of it is attributed to Latino men who work long hours and can’t afford to take a day off, while part of it has to do with the cultural expectations for men.

“I think there is more of ‘I need to be a strong man,’ more so than in typical American culture,” Feil said.

Latino men can also see the problems as their family’s, not theirs.

“Those who are aware they are hurting, they want some help,” said Alex Ibarra, a therapist at Wasatch Mental Health. “Those who do not want to accept that they could improve something, they feel like they send the wife and the children, that they don’t have to show up.”

Ibarra said Latino men also have the idea that they’re “crazy” if they seek help.

Part of it, he said, also comes down to their own history.

“It is a lack of awareness, and many times it is because, as far as I have seen, many of these men have had difficult childhood experiences,” Ibarra said. “They have had parents, sometimes fathers, who were very cruel to them, and so they kind of have used the same tools that they learned from their parents to use.”