Limited English proficiency (LEP) may contribute to mental health care disparities, yet empirical data are limited.
To quantify the language barriers to mental health care by race/ethnicity using a direct measure of LEP is the objective of the study.
Cross-sectional analysis of the 2001 California Health Interview Survey is the study's design.
Adults aged 18 to 64 who provided language data (n = 41,984) were the participants of the study.
Participants were categorized into three groups by self-reported English proficiency and language spoken at home: (1) English-speaking only, (2) Bilingual, and (3) Non-English speaking. Mental health treatment was measured by self-reported use of mental health services by those reporting a mental health need.
Non-English speaking individuals had lower odds of receiving needed services (OR: 0.28; 95% CI: 0.17-0.48) than those who only spoke English, when other factors were controlled. The relationship was even more dramatic within racial/ethnic groups: non-English speaking Asian/PIs (OR = 0.15; 95% CI: 0.30-0.81) and non-English speaking Latinos (OR: 0.19; 95% CI: 0.09-0.39) had significantly lower odds of receiving services compared to Asian/PIs and Latinos who spoke only English.
LEP is associated with lower use of mental health care. Since LEP is concentrated among Asian/PIs and Latinos, it appears to contribute to racial/ethnic disparities in mental health care. Heightened attention to LEP is warranted in both mental health practice and policy.
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"Under this policy, each county's Medi-Cal agencies in California are required to provide language assistance programming in the threshold language. Based on California's Health Interview Survey of 2001, Sentell, Shumway, and Snowden (2007) found that non-English speaking Asian adults were significantly less likely to receive services than were English-speaking Asians. "
[Show abstract][Hide abstract] ABSTRACT: This paper explores the role of English proficiency, ethnicity, and California's threshold language policy in the rates of discontinuing mental health services among Asian-American children. We used data from the 2001-2006 Client and Services Information (CSI) System, which contains county-level information about service users in public mental health systems. Our data included 59,218 service users under the age of 18. We used logistic regression to determine the likelihood of discontinuing services, while controlling for sociodemographic and clinical characteristics. English-speaking Asians were 11% more likely than English-speaking Whites to discontinue mental health services. Non-English-speaking Asians were 50% significantly more likely to stay in services. The results also revealed some inter-ethnic variations in the discontinuation patterns; however, the patterns of mental health service utilization appear to be driven by the availability of mental health services in Asian-ethnic languages in county of residence. Further research is needed to understand the intake and referral processes that Asian children go through within the mental health service system.
"In order to be prepared to serve these diverse-language communities, counseling, psychology, and social work education programs will need to consider effective ways to train their graduates to provide bilingual services (Ivers, Ivers, & Duffy, 2013). A lack of fluent bilingual counselors, psychologists, or social workers likely contributes to a low service utilization rate among linguistic minorities in the United States (Sentell et al., 2007) or to misdiagnoses and inadequately provided services (Arredondo, Gallardo-Cooper, Delgado- Romero, & Zapata, 2014; Biever et al., 2002). Bilingual supervision is a key element in helping trainees feel competent in providing services (Trepal, Ivers, & Lopez, 2014), yet little has been written in the professional literature specifically regarding effective approaches to bilingual supervision. "
[Show abstract][Hide abstract] ABSTRACT: Due to the increasing presence of clients who speak a language other than English, educators and supervisors will need to address bilingual training issues in mental health service provision. Supervision that utilizes the preferred language of the client is an effective way to support growth in bilingual trainees, but there is little scholarly literature describing best practices or approaches to this complex task. We describe our experiences with bilingual supervision in Spanish (from both trainee and supervisor points of view) and provide resources and suggestions to encourage other supervisory dyads to attempt bilingual service provision.
Full-text · Article · Jul 2015 · The Clinical Supervisor
"As with other populations, one concern is whether they live near local providers—safety net access as a spatial concern (Allard, 2009). For immigrants with low incomes, in particular, the question of access to social services also rests on whether the particular organization delivers services that are culturally relevant and linguistically appropriate (Abe-Kim et al., 2007; Fiscella et al., 2002; Huang, Yu, & Ledsky, 2006; Sentell, Shumway, & Snowden, 2007). Immigrant service organizations are nonprofits that provide one or more programs or services with the objective of helping immigrants better participate in the economy, and deliver these services with linguistic and cultural sensitivity to coethnic clients (Hung 2007). "
[Show abstract][Hide abstract] ABSTRACT: Just as more poor people in America now live in suburbs than in primary cities, immigrants are more likely to live in suburbs than in the urban core. This study examines the nonprofit safety net in select Chicago suburban municipalities to assess the capacity and accessibility of these service providers relative to the location and need of low-income immigrants. We identify differences between immigrant service providers and mainstream organizations, particularly their willingness and ability to outreach to and serve immigrants, and analyze their role as mediating institutions.
Full-text · Article · May 2015 · Human Service Organizations Management