Psychological services for non-English speakers in the community

¶ … non-English speaking peoples in the Central Valley

In the multi-cultural area of Central Valley, California, there are many issues when dealing with the health care system, and one of the more problematic matters is that of the variety of populations served. For many citizens, English is a second language, which can cause problems in attempting to find health care or psychological services. While there are certainly services available for non-English speaking people in the area, more effort must be placed on providing services to a more diverse population.

This paper discusses the psychological services available in the Central Valley area for the diverse population of non-English speaking residents. Additionally, this paper will examine the positive aspects of these services. Finally, it will address possible future programs which could assist non-English speaking residents with obtaining psychological services.

There have been numerous improvements in the psychological services offered to non-English speaking residents in Central Valley, even in the last few years. According to the California Endowment, a non-profit organization committed to improving the health of Californians, multiple grants have been given to many organizations within the Central Valley, in an effort to expand psychological services offered in the area for non-English speaking residents. In 1999 alone, over $33 million was given to areas attempting to improve services (California Endowment Report, 2001).

One such grant was given to help establish the California Telehealth and Telemedicine Center, a subsidy of the California Health Foundation and Trust. Noting that many underserved and inner city residents were of non-English speaking origin, the Center was designed to assist those unable to seek alternative solutions for mental health issues. Based in Sacramento, the CTTC supports organizations that use communication technologies to reach isolated and non-English speaking patients who otherwise would not have access to psychological care. Now, rather than forcing these patients to seek out services offered in their languages, patients can call a centralized number, and speak with a representative in their native language. Services are offered through telepsychiatry, and are thus able to utilize mental health care providers throughout the state to assist residents virtually anywhere via telephones. Community care centers and local shelters, already overburdened by the high levels of patients in the area, can assist far more patients using the telepsychiatry option (California Endowment Report, 2001).

Another agency which assists in the mental health of the immigration population of the Central Valley is that of the American Society on Aging. The Society's Sacramento branch received a grant from the California Endowment in 2001 for $388,802 to increase the cultural abilities of the service providers in the area. This improvement included translators in Spanish, Chinese, Portuguese, Latin, Japanese, German, and other languages in an effort to assist low-income, high mental illness risk populations in the Central Valley Area (California Endowment Report, 2001).

Another resource being improved in the area is that of the California Foundation for Independent Living Center's Wellness Guide project. The project, designed to help individuals lead a mentally healthy lifestyle was, until 2000, only available in the English language. Realizing the much higher ratio of Spanish and Chinese speaking individuals in the Central Valley area, the Foundation now offers the project in alternate languages, including Spanish, Chinese, Japanese, Portuguese, and Vietnamese (California Endowment Report, 2001).

There are many agencies that have begun offering additional counseling services to non-English communities as well, in combination with regular health care topics. The Fresno Metropolitan Ministry has established the Immigrant Engagement project, which focuses, in part, on providing non-English speaking immigrant poor populations in Fresno information in their own native languages about taking an active role in their own health status. They offer information of area representatives for mental health care that offer services in a variety of languages (California Endowment Report, 2001).

Other organizations in the Central Valley area provide mental health services to specific language groups alone. For example, the Asian Pacific Psychological organization provides psychological services to disadvantaged refugee and immigrant families who would otherwise have no access to mental health services. While their main offices are in Alameda County, many Asian Pacific peoples choose to travel from the Valley, in order to obtain specialized care in their native language. With over 90% of their cliental requiring services in native Asian languages, the organization is one of the few of its kind in the state. Services provided include adult outpatient services such as counseling for acculturation stress, life situations, psychotherapy, and clinical case management, as well as medication treatment for the more mentally ill patients (CAADV, 2004).

Another such group is that of the Inter-Tribal Council of California, a non-profit organization operating state-wide to reduce violence in Native American families. The organization provides services to both English and non-English speaking clients. Their services include such mental health counseling as youth violence programs, adult counseling for abuse victims, and anger management for adult offenders. By working through five satellite offices, the agency is able to reach most areas in California, including the Central Valley (CAADV, 2004).

Changes throughout the Fresno area have been implemented due, in part, to changes in the Fresno County Mental Health Plan, which provides services for Medi-Cal beneficiaries. According to the changes in the provider manuals as of July, 2002, providers who work with Medi-Cal beneficiaries are now required to either be bilingual themselves, use a bilingual staff member, or to use interpreter services while directly servicing their patients. The MHP has also made a clear policy of discouraging the use of patient's family and friends as interpreters. In the event that a patient insists on using his or her own interpreter, the provider must have the patient sign a form, indicating this desire. The reasoning is that all providers are required to provide mental health services to non-English speaking residents, and are required to shoulder the costs of any interpreters necessary, in an effort to enable non-English speaking populations to access psychological services at the same affordable rate as others (Fresno County Mental health Plan, 2002).

Additionally, the revised plan notes another resource for non-English speaking populations, that of translator phone services such as LanguageLine and Cyracom. Providers may use such services to make appointments with patients, or to get more information from beneficiaries about mental health issues. The beneficiary, again, is not charged for the service, but the provider is responsible for telephone translator payments. This again provides necessary information to the patient without charging extra fees to the beneficiary (Fresno County Mental health Plan, 2002).

Still other changes to the mental health system have come from policy recommendations stemming from a two-year study conducted on the immigrant populations of Sacramento, those of the Mexican, Chinese, Vietnamese, Mien, and El Salvadorian immigrants (Smith, et al., 2004). The study showed that many in these groups, particularly in those of Hispanic decent, young people were more likely to attempt suicide. Additionally, the study showed that immigrants who speak little to no English have a much higher need for mental health services, yet rarely obtain the help they need. The researchers explained that, in addition to a lack of health care, a lack of bi-lingual staff in mental health centers in the Sacramento area resulted in higher levels of misdiagnosis, and unnecessary treatments. However, in those areas with a bi-lingual staff, incidents of this type were far lower (National Congress for Hispanic Mental Health, 2000).