The psychiatric hospitalizations of Latino youths in California are dramatically outpacing those of White and Black children and young adults, according to state data. Experts are at odds over what is causing the increase.
Kaiser Health News reports that between 2007 and 2014, Latinos 21 and younger saw an 86 percent spike in mental health hospitalizations, according to information from the Office of Statewide Health Planning and Development. In the same period, White and Black youths saw 21 percent and 35 percent increases, respectively.
Leslie Preston, behavioral health director of La Clinica de La Raza, suggests the shortage of bilingual, bicultural mental health workers limits the access Latino children have to preventative care, which adds to the potential for a later crisis faced by professionals.
“Everybody’s trying to hire the Spanish-speaking clinicians,” Preston told Kaiser Health News. “There are just not enough clinicians to meet that demand.”
Jeff Rackmil, director of the children’s healthcare system in Alameda County, said population growth and the increase of Latino children insured under Medi-Cal could account for the rise.
But California’s Latino population aged 24 and younger increased by less than 8 percent from 2007 to 2014, according to state figures. Furthermore, less than 4 percent of Latino children received specialty mental health services through Medi-Cal between 2010 and 2014, which stands in contrast to 7 percent rates among eligible Black and White children.
“Often, [families] wait until [children] are falling apart,” said Dr. Sergio Aguilar-Gaxiola, a professor at University of California at Davis Medical School.
Other experts contend that cultural resistance and the perceived stigma of mental health counseling exacerbates the lower rates of reporting by Latino families with children facing those issues.
In the experience of Dr. Alok Banga, medical director at Sierra Vista Hospital in Sacramento, some immigrant parents don’t believe in mental illness and fail to grasp the urgency when a child has depression or attempts suicide. Many parents work several jobs, he said, and those without legal status can be afraid of coming to the hospital or crossing paths with Child Protective Services.
But, the lack of child psychiatrists and outpatient services available to Latino communities remains the biggest problem, according to Banga.
“The default course for treatment falls on institutions: hospitals, jails and prisons,” he said.
Juan Garcia, professor emeritus at California State University, Fresno, noted that psychological services in the Central Valley, where many agricultural workers are Latino, are especially sparse. These workers bore and still bear the brunt of the drought and great recession, he argues, which has resulted in anxiety, substance abuse and other psychological issues.
Psychiatric hospitalizations of Fresno County Latino youths more than tripled between 2007 and 2014, according to the data, while rates for their Black and White peers about doubled.
“The services to this population lag decades behind where they should be,” Garcia told Kaiser Heath News.
Some hospitals report children stuck in emergency room hallways for days, waiting for hospital beds amid psychiatric crises. “It makes for a very traumatized experience for both families and children,” said Shannyn McDonald, chief of the Stanislaus County Behavioral Health Department’s children’s system of care.
In recent years the county has expanded its “promotora program,” which enlists members of the Latino community to talk to their peers about mental health.
Rossy Gomar, from the town of Oakdale, is one of those social workers. She spends 60 to 70 hours a week as a liaison between the town government and Latino residents.
“There are many young people who don’t have any hope,” she said.
But thanks to her work, that may be changing. One of Gomar’s clients, a 17-year-old whose name was withheld for her privacy, related how such counseling helped following a break-up with her boyfriend. She had been drinking, abusing drugs, contemplating suicide and was afraid to talk to her parents.
Eventually, she walked into Gomar’s office and began to cry.
“She told me ‘Everything is OK. We want you here,” the girl explained. “When I was talking with her, I felt so much better.”
–Larry Smith
