Language barrier, lack of providers limit access to mental health services in the Hispanic community

2/24/2024

By Pat Hammond-Nashua Digital

Do you ever have days when you feel stressed, lonely or overwhelmed? You’re not alone.

It doesn’t matter if it’s your kids, your boss, or simply that nagging doubt that you’ll ever measure up. These feelings are normal. It’s how humans react when we don’t feel in control.

When it comes to mental health, most people think of the heavy hitters, like substance abuse, depression or suicide, but that’s only one end of the spectrum. Sometimes, everyday things like job stress, making dinner or going to the supermarket can send us into a downward spiral. And these feelings are amplified when you have language or cultural barriers. This is especially true when it comes to mental health services.

While we’ve all seen the headlines about the effects of the pandemic on mental health in general, there have been far fewer how it has affected specific populations, including Hispanics.

According to a 2021 report from the Centers for Disease Control, over 40% of Latino adults reported psychological stress, with almost 23% reporting suicidal thoughts. This is almost four times the rate of Blacks and non-Hispanic white adults.

Even worse, Hispanic adults were half as likely (12.6%) to seek mental health treatment than non-Hispanic white adults (24%). And even if they do decide to seek help, many don’t know how or where to find it.

Language barrier

Lisa Vasquez, a bilingual behavioral health specialist from the Nashua Division of Public Health and Community Services, says there aren’t enough culturally responsive mental health services in the Gate City or elsewhere in New Hampshire.

Spanish is the second most common language in the United States, with nearly 13% of people speaking Spanish at home — the fourth largest Spanish-speaking population in the world and the largest among countries where Spanish isn’t the official language.

You would think the sheer number of Spanish-speakers would mean that there is an abundance of services available in Spanish, but there isn’t. According to the American Psychological Association, only 5.5% of therapists in the United States speak Spanish, so it’s not surprising Nashua has so few Spanish-speaking therapists.

There’s another complication in providing mental health care to the Hispanic community of Nashua and other places in New Hampshire. In general, healthcare providers rely on interpreters to bridge any language gaps with non-English speakers, but because there is a perception of an even greater intimacy when it comes to mental health care, the process is made more difficult if communication takes place through a third person.

To help address the language barrier, both the city of Nashua and state of New Hampshire are providing Spanish-language resources for critical mental health services through the NH Rapid Response Access Point and 988 crisis hotline programs. The services are available to help anyone who is struggling with substance misuse or feels like they may be a danger to themselves. In addition to connecting people with services, a Rapid Response team can go directly to a caller’s location to provide support.

But such help only scratches the surface when it comes to meeting the need for mental health services in the Hispanic community, says Vasquez.

She says people “have to start thinking about mental health the way we do physical health.”

For instance, people seek medical care when they feel sick. If they have a cold that doesn’t get better after a few days, they go to the doctor. Mental health should be thought of in the same way, according to Vasquez.

Everyone has bad days, she adds, but when they become the norm, it’s OK to reach out for a therapist or other assistance that can help you develop strategies for handling the things that trigger you. For example, a therapist can help you learn techniques to reframe your thoughts, recognize triggers and develop a better response to them.

The Greater Nashua Mental Health Center is the most visible source of mental health resources in Nashua. They provide an extensive list of services for adults and children, including substance misuse recovery, individual and group therapy, psychiatric evaluation, medication management, and Nashua Drug Court treatment plans.

Their website offers content in a variety of languages, but it is unclear how many specific services are available in languages other than English. An online search showed a few employees speak Spanish, but the mental health center did not respond to requests for information about services offered in Spanish.

Public awareness

Rafael “Lelo” Almonte, owner of the La Fama 2 barbershop in Nashua’s French Hill neighborhood, says the language barrier is a prevalent problem for members of the Hispanic community in Nashua.

As a local business owner and father of seven, Almonte is a visible figure in the community. For many families, he is the go-to source to connect to services. “It’s hard for people who aren’t from here because they don’t know that services exist or how to find them,” he says.

According to Nashua activist Oscar Villacis, “the problem is we don’t have a consistent voice” and it’s hard to develop systemic trust when so many outreach programs rely on grant money.

It takes time to plan a program, hire the staff, and connect with the community, he says. Unlike a standard budget line item that is funded every year, grant-funded programs in the city and nonprofits can be temporary of their funding disappears.

While the city does its best to bring attention to health equity, it doesn’t provide mental health services. The city’s role is to connect the community to mental health and native language resources and“increasing knowledge of resources falls in our wheelhouse.” That starts with public awareness.

One part of the Nashua DPHCS public awareness campaign is the “Speaking our Minds” mental health podcast, which was launched in 2022. The podcast features episodes in five different languages (English, Spanish, Portuguese, Swahili and French) and gives voice to the “experiences and struggles of Hispanic and minority communities in New Hampshire.”

The podcast is seen as a vehicle for opening the dialogue about mental health issues. Now, in its second season, recent topics have included substance abuse recovery, autism, anxiety and ADHD.

Nashua DPHCS also partners with local businesses to bring services directly to Hispanics, but more outreach is needed. Almonte says that other agencies have to do a better job of reaching out to the community. He suggests low-cost options, such as Spanish-language newsletters or printed flyers that neighborhood shops can post in a window.

Another way to obtain Spanish-language mental health services is through telehealth, which is covered by many insurance plans. This means opens allows a person to go beyond Nashua or New Hampshire to Massachusetts and other states that have larger numbers of Spanish-speaking therapists.

Another option is support groups. The United Way’s 211nh.org website has a long list of virtual and in-person support groups around the state — including anxiety, depression, addiction, recovery, among many others. Instead of one-on-one counseling, a trained professional facilitates peer discussions and helps the group learn techniques to overcome challenges and connect with people who share similar problems.

Editor's note: For help with mental health or a substance abuse crisis, people can call or text 988 for the Suicide and Crisis Lifeline, 833-710-6477 for New Hampshire’s Rapid Response Access Point and 211 for the Granite United Way’s statewide information and referral service. 

Photos and credits:

Lisa Vasquez, left, a bilingual behavioral health specialist at the Nashua Division of Public Health and Community Services, is also the host and producer of the ‘Speaking Our Minds’ podcast, a mental health public awareness campaign aired in five different languages — Spanish, Portuguese, English, Swahili and French. Here, she talks with Rafael ‘Lelo’ Almonte during an episode of the podcast recorded at Almonte’s La Fama 2 barbershop in Nashua’s French Hill neighborhood. (Photo by Allegra Boverman)

Lisa Vasquez, behavioral health specialist at Nashua’a Division of Public Health and Community Services, says there aren’t enough culturally responsive mental health services in the Gate City or elsewhere in New Hampshire. (Photo by Allegra Boverman)

This article was produced in partnership with Nashua Digital and is being shared with the partners in the Granite State News Collaborative. For more information, visit collaborativenh.org .