Mental Health Services in Spanish Decline

According to a study published last month in the journal Psychiatric Services (https://ps.psychiatryonline.org/doi/10.1176/appi.ps.202100614), between 2014 and 2019, the proportion of US centers offering mental health treatment in Spanish declined by nearly 18%, resulting in a loss of 1,163 Spanish-speaking mental health centers. Using national data from all known specialty mental health treatment centers, the study also illustrated epidemiological trends for centers offering Spanish-language services. Between 2014 and 2019, the proportion of facilities offering Spanish-language services declined in 44 states, and this decline was most marked in states with the fastest-growing Latino populations. These numbers are particularly troubling considering that Latinos account for more than half of the total population growth in the US over the past ten years and that the total Latino population surpassed 60 million people in 2019.

“These population changes have precipitated new and evolving demands on the health care system, which are nuanced and driven by a range of factors,” the researchers explained, “including fluency in English and Spanish, immigration and documentation status, being first- or second-generation residents in the country, and exposure to trauma related to racism and discrimination.” According to an analysis (www.samhsa.gov/find-help/disorders) of the National Survey on Drug Use and Health, between 2015 and 2018, rates of serious mental illness in the Latino population increased by 60% (from 4.0 to 6.4%) among 18–25-year-olds and by 77% (from 2.2 to 3.9%) among 26–49-year-olds.

A similar trend between 2015 and 2018 has been observed for the prevalence of major depressive episodes among Latinos aged 12 to 49 years, which increased from 8.4 to 11.3%. In a study based on data from the Behavioral Risk Factor Surveillance System (https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2019.305337), 34% of Latino respondents reported at least one day of poor mental health in the past month (mean=3.6 days), and 11% reported frequent mental distress. However, despite the growing need for mental health care among Latino populations, utilization of mental health services remains low. The researchers suggest that culturally responsive care, incorporating an understanding of culture and language into clinical mental health practice, may be one strategy to increase treatment uptake in Latino populations.

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  1. The study also depicted epidemiological trends for facilities providing Spanish-language services using national data from all known specialist mental health treatment centers. Between 2014 and 2019, there was a decrease in the number of facilities providing services in Spanish in 44 states, and this decrease was most pronounced in the states with the fastest-rising Latino populations. These figures are especially alarming given that the number of Latinos in the US reached 60 million in 2019, and that they have contributed more than half of the country’s population growth over the past ten years.

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