Finding a mental health provider can be a fairly complicated process. The pandemic has exacerbated the need for many. Yet some people may not have the means or information available to them in their native language to access this information. For this episode of Carolina Curious, we answer this question from listener Camila Pulgar Guzmán: What does the landscape for mental health aid look like for bilingual Spanish-speaking immigrants in North Carolina?
"I'm an immigrant from Chile. I was born and raised in Chile, but I lived in North Carolina for about 15 years," explains Pulgar Guzmán.
Pulgar Guzmán is not a disinterested party regarding the issue. She's a licensed therapist based in Winston-Salem who works closely with the Latino community. In the field, she often sees a lack of bilingual providers for the rapidly growing community in the state, which she says is worrisome.
"Our community also doesn't know where to look for them, or they're not accessible to them in way," she says. "Because our community is so isolated, as you probably know, especially here in Winston-Salem, they're very isolated. So it's hard for them sometimes to know where to ask for help."
Various resources for the Latino community show different data on exactly how many Spanish-speaking therapists are in an area. For example, the website Latinx Therapy shows in North Carolina there are 11 therapists who speak Spanish. None of those listed are in Winston-Salem. Pulgar Guzmán created a list on her own website Salud Mental Health, where she lists 14 Spanish-speaking therapists and mental health resources in the city, some in churches.
In terms of statewide resources, the North Carolina Department of Health and Human Services has Hope4NC, a 24/7 hotline that can help Spanish speakers who might be experiencing emotional distress. It also partnered with local organizations, and there are general wellness resources in Spanish available as well on its website.
Deputy Secretary and Chief Health Equity Officer for North Carolina's Department of Health and Human and Services Debra Farrington says there's still a lot to be done, especially for young people.
"In the cases of the Latino community, we have a number of organizations who provide these community health workers who are responsible for connecting people to medical care and to social support," Farrington explains. "88% of Latino youth have unmet mental health needs. And that compares to 76% of white youth and 77% of Black youth. So we're seeing a higher percentage of Latino youth who have unmet mental health needs."
Milton Cepeda is the only bilingual school psychologist in the Winston-Salem/Forsyth County Schools system. He says that there's an overall lack of mental health providers in the state, and this also includes schools. The National Association of School Psychologists recommends one psychologist per every 500 students, but the reality is that many are without that resource.
"I service three schools during the week, and then the other two days I provide district-wide support to other schools," says Cepeda.
Winston-Salem/Forsyth County Schools does have multiple language team support and they use interpreters to help with assessments when necessary. The most recent data from the state shows that suicide rates among youth in 2020 were the highest they've been in a decade, and according to the U.S. Centers for Disease Control and Prevention, Latinos have shown high rates of anxiety and depression symptoms.
"We don't only have a shortage of bilingual psychologists, we have a shortage of psychologists in general," says Cepeda. "So bilingual psychology is even more rare in this particular field. And there's a difference between someone who is certified as a bilingual psychologist and just someone who is a psychologist that happens to speak Spanish."
In North Carolina, without insurance, a private practice therapy session can cost usually between $150 to $250. There's also the option of doing a sliding scale, which can lower the cost for patients in need to around $50-$75.
El Futuro, a non-profit organization that provides support for the Latino community in Durham, is an example of one group that does provide low-cost therapy for, primarily, the Spanish-speaking population in the state.
El Futuro's Communications Manager Mary Hondermann says the organization pays for the patient's therapy thanks to monetary help from counties.
"We don't ask about immigration status to provide services," Hondermann says. "Depending on that person's county, we go there, check the funds, and we cover the cost of that person's treatment."
El Futuro might be able to provide lower-cost mental health treatments, yet as Camila Pulgar Guzmán — our question-asker explains — not every provider is able to lower their costs.
"So that is, you know, a tricky balance because all of our bilingual providers are very passionate about mental health and about talking about these issues," says Pulgar Guzmán. "But we also have to pay our bills and we have to eat."
But there are various organizations that are working to provide even more resources. Winston-Salem/Forsyth County Schools has partnered with a firm to recruit school psychologists, El Futuro is now providing group therapy, which helped decrease the number of people on their waitlist. The new suicide lifeline, 988, also has Spanish-speaking operators and resources available on its website.
This story was produced by a partnership between WFDD and La Noticia. You can read this story in Spanish at La Noticia.
Eileen Rodriguez is a reporter for both WFDD and La Noticia through Report for America, where she covers COVID-19's impact in the Latino Communities.
Periodista de La Noticia y 88.5 WFDD, Eileen Rodríguez reporta el impacto de COVID-19 en la comunidad Latina en Carolina del Norte. Rodríguez es miembro del cuerpo de periodistas de Report for America 2021-2022
Editor's note: This story has been updated to include Camila Pulgar Guzmán's full name.