‘Your mental health is important.’ We have heard this phrase all over social media outlets, but what exactly is mental health and why is it important? We define it as our overall well-being, like our emotional state, psychological state, and social life. These aspects of ourselves are impacted by the life events we experience over the course of our life. Being in a healthy mental state is important because it helps people cope with life stressors, be physically healthy, have positive relationships with others, and work productively.
Given its importance, mental health services have grown throughout the last decade, but many individuals are still not accessing them, nor are they being reached by organizations. In Santa Ana, the heart of Orange County, there is a disconnect between the abundance of mental/behavioral health services and residents actually utilizing those services. Although the city has the highest number of behavioral health services in the county (61 facilities), residents continue to have one of the highest rates of psychological distress compared to other county cities.
As two individuals who identify with the community, we believe it is important to know why mental health issues remain high despite service abundance. During our research, we found that for Latinx families with children, it depends on the caregiver’s beliefs about mental health, their perceptions that the child needs help, and the impact of the child’s mental health problems on the family. Importantly, individuals may not seek treatment because they do not recognize the symptoms of mental health conditions or because they may not want to talk about private home life issues. This may enhance the stigma because individuals may be afraid of being called ‘locos’ (crazy) and feel a sense of shame for needing services. In Santa Ana, residents may also face language barriers, which makes it difficult to communicate with providers who do not speak the same language or do not provide appropriate translating services.
During our research, we also learned that language as a barrier for this community is more complex. Barriers to accessing and using mental healthcare are not limited to the availability of services in Spanish, but also on the quality of these services. Individuals don’t ask for help even when help is available in their language and when they are able to access these resources, how come? One reason may be the lack of cultural competence on behalf of the practitioners and organizations.
There is research that supports the idea that clients are more likely to trust someone in the mental healthcare field whom they feel they can relate to. For Latinx individuals, this may mean they feel more comfortable trusting a Latinx practitioner who shares their cultural identity, can fluently communicate with them in Spanish, and can simplify clinical terminology during therapy in Spanish. In the mental health workforce, this is part of cultural competence. However, identifying as Latinx and speaking Spanish does not make a practitioner culturally competent by nature, this takes training.
In order to help close the health gap for the Spanish-speaking only community in Santa Ana, it is not enough to demand more mental health services in Spanish. Latinx-centered approaches and Latinx specific competencies are necessary. These frameworks allow a properly trained practitioner to understand Latinx individuals in their environment, which is crucial to understanding how to best serve this client. Services need to be provided in a culturally competent and sensitive way by fluently bilingual practitioners so that these clients are able to maximize their use of the mental health resources available in their area of residence. This means that practitioners need to be adequately trained in school by the time they graduate and enter the workforce. As Master of Social work students, we asked ourselves, how is our school preparing us as bilingual service providers? Are we capable of delivering the best possible service to our Latinx clients?
We both agreed that we are not. Our school needs to revise the curriculum to be more reflective of the current standards that guide social work. The National Association of Social Workers revised its code of ethics earlier this year to include cultural competence as an ethical standard. This demands that our university, and all educational institutions in the county training social workers, ensure its students are trained in cultural competence. Graduate students pay hundreds of thousands of dollars in tuition every year. Schools need to allocate funds to provide better training for bilingual students that serve the Latinx community in their internships and that will serve the Latinx community in their prospective jobs post-graduation. Although Spanish is the second-most spoken language in the United States, there is a shortage of fluent bilingual practitioners in the country. This can be in part because bilingual practitioners are not being trained to deliver services in Spanish. Our school does not place an emphasis on training bilingual clinicians to serve the Latinx community. The curriculum in the Adult Mental Health and Wellness program offers only one academic course that addresses this community specifically. It is an elective course that students are not required to take. This needs to change because the current education we are receiving is not in line with the guiding standards and values of our profession. Our ability to speak Spanish is not enough to establish culturally competent treatment.
Vanessa Lopez is a UC Berkeley alumna (2021) and is currently a graduate student at the USC Suzanne Dworak-Peck School of Social Work. She was born and raised in Santa Ana and currently resides in the community.
Sendy Ramirez is a UC Berkeley alumna (2005) and is currently a graduate student at the USC Suzanne Dworak-Peck School of Social Work. She has a beautiful 3 year-old daughter she enjoys reading to.
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