September 15th marked the beginning of Hispanic Heritage Month, which spans until October 15th. This is a month that celebrates the rich and beautiful Hispanic culture, and the enormous influence and contributions that members of the Hispanic community have made to the world. To celebrate Hispanic Heritage Month we sat down with two members of the Latinx community, both of whom are mothers from Pennsylvania. Astrid Arroyo is a stay at home mom who lives in the Pittsburgh area, and Ana Pacheco is a Bilingual Parent Advisor at the Peal Center. Both of these women have experience advocating for their own and other families and know what kind of barriers and needs are unique to members of the Latinx community when seeking mental health services. We know that there are few things more valuable than lived experiences. That is why we wanted to speak to Arroyo and Pacheco about how service providers can best make Latinx families feel comfortable, heard, and understood.
The Language Barrier
This is the most obvious challenge that Latinx families encounter if their native language is Spanish and not English. Both Arroyo and Pacheco were in agreement that this is a huge challenge that stands in the way of many Latinx individuals and families seeking or receiving services. "That is a big thing. Even right now talking to you it is hard for me to fully express myself in a language that is not my native language. If there is a complex issue, especially medically, it is very hard to explain it in a different language. Trying to convey all of your feelings is difficult," said Arroyo.
Pacheco confirmed this sentiment and said it is often even more than the language. "I know it is not always possible but I prefer a service provider to speak Spanish. Not only is it easier for me to communicate with them but also I, and many families, perceive that this person will have a better understanding of the Latinx culture as a whole. They will understand my religious beliefs, what I like for food, my music choices. All of this is a part of me and is the foundation of that essential relationship between you and your service provider," said Pacheco, "When you see a provider you do not want to be judged, you want to be understood." Pacheco went on to say that you want to build a relationship with your, or your child's service provider, and being able to communicate in a way that is comfortable to both parties goes a long way toward accomplishing this.
If it is not possible for your office to have a bilingual, or Spanish-speaking provider Arroyo recommends getting a professional translator, and being patient and professional. "My father speaks perfect English but has a very thick accent. People will say things louder to him as if that would help him understand them, even though he understands everything perfectly. Do not assume just because an accent is present that they're not understanding English. If I am in a service provider's office and already stressed about being there and they continually tell me they don't understand me because of my accent or to repeat myself, it is very annoying," said Arroyo.
Both Pacheco and Arroyo wanted to emphasize how important cultural competency is, for all cultures. They encourage service providers to take the time to learn about the different cultures of the people you serve and figure out how those cultures could potentially impact how you serve them. "You want to provide services that are effective and meaningful. You are providing services because you want them to benefit from them. If I go to the doctor I want them to listen to me and understand what I am saying. If I say something that is not typical I want them to understand what that means. If they prescribe me or my child a medication I want to make sure that we are on the same page about what the issue is," said Pachecho.
For more information on how to be Culturally Competent Specifically for the Latinx community click here to be linked to NAMI's page.
Mental Health in the Latinx Community
Both women agree that there is a stigma surrounding mental health in the Latinx community, however, this stigma is lessening with every generation. Arroyo is from Puerto Rico and explained; "It is a big no-no, at least where I am from. It is looked at as an embarrassment and many people feel ashamed. I didn't seek help and I never thought about it until I came to PA. To this day it is really hard to reach out and say there is anything going on. My husband grew up here and is very open about mental health, he has a history of mental health challenges in his family and he goes to a therapist every week. It is deep-seated in me that you are to be embarrassed about needing help but I have gotten better, it is there to help you why not use it?" said Arroyo. "It is a very delicate topic for many Latinx families. They will feel more open to talking about it when they feel they can trust the service provider," said Pacheco.
How to Make Latinx Families Feel Comfortable in Your Office (Or Over Telehealth)
"Especially right now, if a family is coming to your office make sure that they fully understand your COVID policies so that they can come fully prepared for the visit. Go beyond just scheduling and confirming an appointment, take the time to make sure they understand how to be prepared for the visit," said Pacheco.
In terms of telehealth, Pacheco feels patience, and being adaptable is the best way to ensure that your services are benefiting the Latinx families you are serving. "This means that the family needs to know how to download an app. We are talking about technology and that can be very difficult. I have been in the position of having to teach families how to use email. I ask families; 'What is the best way to communicate with you?' sometimes it is email, sometimes the phone, and sometimes even text messaging. I used to talk to a lot of mothers during the day and now many of them have requested that we talk after 3 PM because they are supporting their children through distance learning. Parents have a lot going on right now and have lost that flexibility they had when their children were at school. Be patient and be collaborative, sometimes just providing instructions is not enough," said Pacheco.
Translating Your Literature and Signs into Spanish
"Even me, I have been here for a long time and I speak fluently in both languages but it is easier for me to see medical terms and grasp complex topics if it is in my native language. Many of the things families are reading are very personal and important. Even if they do have a partner who can translate a document for them it won't have the same impact as it would if they could look at it and read it for themselves. If it is possible, do it," said Arroyo.
"Not only does it help with understanding the material but it also gives you a sense that you are welcome," said Pacheco. "When you walk into an office and you see your language, that gives you a sense that your service provider is really making an effort. You begin to think that you have a really good chance of building that relationship. It doesn't mean it will be 100% effective. You want to welcome people from diverse cultures into your office. Not only translating documents but hiring bilingual staff, displaying information in a number of languages, it is nice to see something in a lobby that is related to your culture," said Pacheco.
Are you looking for resources to provide to your Latinx families? Our tip sheets are available in Spanish! Simply click on the link to open then select the arrow on the right to see the exact same document professionally translated. The topics include:
How to Effectively Meet With Your Legislators
Don't just hear the family voice; Listen to it
"They (the parents/primary caregiver) are the ones that are going to implement the services at home with the child. There needs to be an effort in collaboration and communication. To be an effective provider you need to make sure your recommendations are understandable and the family is able to provide feedback. Any doctor who has prescribed something to my son; I am the one here at the house implementing it and observing if it is working or not. When you have a child with behavioral challenges it impacts the entire family; parents and siblings, not just the child. Latinx families care deeply about our children and we cannot be happy if they are not happy and healthy. When we see that our kids are well and happy that has an immediate impact on the parents. Your child is the most precious thing in the world to you and you are responsible for their wellbeing. It is a lot on a parent's shoulder to make decisions for that child, especially if the child is nonverbal and the parent has to observe and speak for them. Because of this, it is essential that the family trusts their service provider and their recommendations. Listen while the family is talking. They are deeply involved in the wellbeing of their child; listen to them don't just hear them," said Pacheco.
Are you a provider who offers culturally competent services to a Latinx audience? Let everyone know by adding your organization to our "Find a Service Provider" database. Simply fill out this form to be added. If you're a parent looking for a service provider in your area visit our Find a Service Provider page.