US mental health crisis may be harder for individuals with limited English proficiency

A recent survey from CNN showed that 90% of adults in the United States believe the country is in the middle of a mental health crisis.

This predicament seems particularly pronounced among children and adolescents — from 2016 to 2019, the number of children and adolescents diagnosed with anxiety rose by 27%, while depression levels increased by 24%. 

And just a couple of weeks ago a report from Centro SOL, a Baltimore-based agency promoting health equity for Latino populations, suggested that this crisis might be even worse for children and adolescents who are immigrants or have limited English proficiency (LEP). According to the report, many mental health clinicians in the state of Maryland are not providing language access services, making it more difficult for children and adolescents to receive the proper treatment.  

“Despite legal requirements that clinicians provide interpretation and translation when needed, children and adolescents in immigrant families in Maryland are at high risk for not receiving accessible mental healthcare,” the report reads.

Under the Civil Rights Act, institutions that receive federal assistance cannot discriminate against individuals based on their LEP. Moreover, Section 1557 of the Affordable Care Act requires healthcare providers to offer interpreting or translation services to patients with LEP — at no cost to the patient.

Although patients with LEP have federal protections mandating their right to language access services, the report questions whether or not this right is being met adequately in the state of Maryland, at least when it comes to mental healthcare. The report outlines a handful of case studies in which adolescents and children were effectively denied care for their mental health conditions. According to the report, some of these patients were placed on an unattended waitlist, while one Spanish-speaking patient was outright denied treatment because of her primary language. 

To better understand why this is happening, Centro SOL spoke with 25 clinicians in Maryland who reported a range of reasons, from long wait times for interpreting services to a lack of adequate funding. Additionally, while the Maryland Department of Health provides a list of language service providers for clinicians to work with, this list has reportedly not been updated since 2010.

Centro SOL made five recommendations to the state of Maryland and the Maryland Department of Health to remedy the current situation and ensure that patients’ needs are met. These include better educating patients and clinicians on the right to language services and adopting a system to monitor whether or not patients’ needs are being met. 

“Mental healthcare access depends on clinicians, patients, and family members speaking the same language,” the report reads. “Without the capacity to communicate effectively — with clinicians or staff who are either bilingual or through an interpreter — children and adolescents suffering from mental illness are at risk.”


Andrew Warner
Andrew Warner is a writer from Sacramento. He received his B.A. in linguistics and English from UCLA and is currently working toward an M.A. in applied linguistics at Columbia University. His writing has been published in Language Magazine, Sactown Magazine, and The Takeout.

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