Newsletter-Issue 1, July 2013

Newsletter ISSUE 1, JULY 2013

MEET THE ATTC NETWORK: As a nationwide, multidisciplinary resource for professionals in the addictions treatment and recovery services field, the ATTC Network serves to: Raise awareness of evidence-based and promising treatment and recovery practices, build skills to prepare the workforce to deliver state-of-the-art addictions treatment and recovery services, and change practice by incorporating these new skills into everyday use for the purpose of improving addictions treatment and recovery outcomes.

FROM THE DIRECTOR’S DESK The National Hispanic and Latino ATTC team has the commitment to develop and strengthen the workforce that provides treatment and recovery support services to Hispanic and Latino populations with substance use disorders across the United States. We are focus on raise awareness of behavioral health service providers to reduce the health disparities in the Hispanic and Latino population, build cultural competence skills in order to successfully provide culturally and linguistically substance abuse treatment, and change practice by increasing the number of behavioral health professionals providing up-to-date and effective services for Hispanics and Latinos. This newsletter is part of the suite of services developed to inform about this population’s core topics, and to influence and support system transformation that enhances Hispanic and Latino wellness.

Ibis Carrión, PsyD

MEET THE NATIONAL HISPANIC AND LATINO ATTC: The purpose of the National Hispanic and Latino ATTC is to develop and strengthen the workforce that provides addiction treatment and recovery support services to Hispanic and Latino populations across the United States. This will be accomplished by using diverse technology transfer strategies, services, and practices that have demonstrated effectiveness and are appropriate to Hispanic and Latino populations in need of substance abuse treatment services.

Services for Hispanics and Latinos We asked Mr. Henry Acosta, an Advisory Board member of the NH&L ATTC how to enhance mental health and substance abuse treatment and recovery support services for Hispanics and Latinos. ince 1999, a number of reports

utilization of behavioral health services.

from highly respectable organi-

Immigrants are even less likely to use mental

zations, commissions, and indi-

health services than U.S. born Hispanics.

viduals have highlighted an array of dispari-

Additionally, when Latinos seek help for

ties in the availability of, access to, and the

mental health problems, they are more likely

provision of quality mental health and sub-

to seek help in general medical care settings

stance abuse services, here forth referred to

than in specialty behavioral health care.

S

collectively as behavioral health, for Hispanics and Latinos, the nation’s largest ethnic minority group. Since then, numerous organizations and associations throughout the country have accepted the challenge of better understanding and addressing these disparities, and many have even implemented various intervention strategies aimed at eliminating

identified

barriers.

Although

many are experiencing some

success,

more

and

efforts

services

specifically targeted to Hispanics

are

direly

needed at the local, state, and national level in order to make a significant and meaningful difference in the reduction and/or elimination of existing disparities. Strategic and macro level efforts, such as those planned and currently underway by the National Hispanic and Latino ATTC are truly needed in order to assist providers learn how to best attract, engage, and

Language barriers also figure prominently in writings on Latinos’ use of behavioral health services (Vega & Alegría, 2001; Prieto et al., 2001; US DHHS, 2001, Guarnaccia et al., 2005). A large proportion of the Hispanic population in the U.S. speaks Spanish as their primary language, though this differs among the major Hispanic groups and across studies (in part, depending on how fully they include undocumented

individuals).

While some behavioral health programs, particularly in the Southwest and Northeast, have developed specific Latino-focused programs with large numbers of bilingual/bicultural behavioral health professional staff, the norm is that there are few, if any, bilingual/bicultural staff in behavioral health agencies and fewer masters and doctoral level professionals.

serve Latinos with behavioral health needs in

Strategic and multifaceted efforts to reduce

a culturally and linguistically competent

and/or eliminate barriers are needed in or-

manner.

der to make a significant and meaningful

Hispanics, particularly Mexican Americans, have very low rates of behavioral health service utilization, (Vega et al., 1999; Peifer et al., 2000; Vega & Alegría, 2001; Vega et al., 2001 ; US DHHS, 2001, Guarnaccia et al., 2005, Acosta & Chapa, 2010). Lack of health insurance and language barriers are the most commonly cited problems in Latino’s

There are a wide range of barriers to seeking behavioral health care that have been identified in the Hispanic behavioral health literature (Pescosolido et al., 1998; Vega et al., 1999; Vega & Alegría, 2001; Vega et al., 2001; US DHHS, 2001). These barriers can be organized into several dimensions: provider barriers, barriers in the service system, community-level barriers, barriers in the social networks of people in the community, and person-centered barriers. The most important system level barriers include lack of health insurance, language barriers, discrimination from the system and lack of information about services (especially in Spanish). Community centered barriers include the stigma of mental illness and the density of family and other support networks.

Person-centered barriers include lack of recognition of behavioral problems, stigma, and a self-reliant attitude.

difference for improving behavioral health and recovery support services for Hispanics in the US. It will require an array of stakeholders from varied disciplines, and wellcoordinated efforts to enhance the behavioral health and recovery support systems for Hispanics. Efforts are needed that identify and promote the delivery of culturally and linguistically competent services.

The major barriers to behavioral health service use among Hispanics are lack of health insurance and citizenship and immigration status (Vega & Alegría, 2001). Over 30% of Latinos in the US are uninsured; this is more than double the rate among European-Americans [30.1% versus 11.1%], (US Census Bureau, 2011). A significant part of the reason for these high rates of lack of insurance is the low rates of provision of insurance by employers of Hispanics.

Some studies have found that 43% of working received health insurance from their employers compared to 73% of European Americans (Guarnaccia, et al., 2005).

Eyes on stigma

Addressing Stigma in order to Achieve Recovery

R

ecovery from behavioral health conditions is possible and real. Unfortunately, in addition to a lack of available, bilingual, bicultural behavioral health treatment providers and services, there is also a lack of support and understanding for Hispanics currently in treatment and/or living with a behavioral health condition.

This lack of support and understanding may be a factor in why many Latinos do not follow-up with community services upon discharge from a hospital, or dropout of services after only one visit to a behavioral health provider. The notion that people may be “crazy” when they face behavioral health problems and illness is a belief often echoed throughout the Hispanic community. Perceptions such as these, and an array of negative stereotypes and beliefs about people with a mental illness within the Hispanic community, play a major role in Latinos underutilizing behavioral health services and may hinder progress among those already in treatment. The stigma that results from inaccurate myths and beliefs among Hispanics about individuals with a behavioral difficulties is alarming and must be addressed.

Unfortunately, lack of information and education about behavioral health disorders among the Latino community, and the negative images/stories often portrayed in English and Spanish media of individuals with these disorders greatly contribute to stigma. In fact, these factors may also contribute to the underutilization of behavioral health services repeatedly seen among the Hispanic community. Efforts such as collaborative partnerships with media outlets must be established in order to address this critical issue. These partnerships could focus on: 1) highlighting the many contributions of individuals with a behavioral health disorders; 2) on heightening awareness, understanding, and acceptance of these disorders among the Latino population; 3) on highlighting the effectiveness of available mental health services treatments; 4) on increasing knowledge of how to access professional, quality behavioral health services; and 5) on eliminating the negative views often portrayed of individuals with a mental and substance use disorders.

“Individual service providers, behavioral health agencies, Hispanic community community--based social and civic organizations, public and private institutions such as schools, libraries, and hospitals, and the religious community must also be engaged in order to effectively educate the Latino community about behavioral health problems and to eliminate stigma of individuals with a mental illness or in need of behavioral health services”.

“Hispanics/Latinos often have different attitudes about accessing mental health services, and may feel highly stigmatized for doing so”.

- American Psychiatric Association

¿Why is it important to provide culturally and linguistically competent service?

Untreated or poorly treated behavioral health issues may be a major contributor to Hispanic’s over representation in some of the nation’s most high need and vulnerable populations such as the homeless, the uninsured, the poor, the incarcerated, and those involved with the juvenile justice and child welfare systems. Many providers across the nation have yet to realize the importance of providing behavioral health services that are culturally and linguistically competent. Sadly, for one reason or another, some have realized its importance yet fail to implement services that meet the cultural needs and preferences of service recipients. Additionally, some fail to recognize the barriers that Latinos face in accessing services, thus they do not attract the population into treatment. This lack of effort, and the array of barriers facing Hispanics may be major reasons why the population as a group tend to underutilize behavioral health services, or do not seek treatment early and often utilize emergency rooms and crisis centers as their first entry point into the behavioral health system.

Upcoming events Cultural Elements in Treating Hispanic and Latino Populations WHERE: NDRI 71 West 23rd Street 8th Floor.

New York, New York WHEN: July 30-31, 2013.

References Acosta, H. & Chapa, T. (2010). “Movilizándonos por nuestro futuro”: Strategic development of a mental health workforce for Latinos consensus statements and recommendations report. United States Department of Health and Human Services Office of Minority Health. Rockville, MD. Guarnaccia, P. J., Martínez, I. E., & Acosta, H. (2005). Mental health in the Hispanic immigrant community: An overview. Mental Health Care for New Hispanic Immigrants: Innovative Approaches in Contemporary Clinical Practice. The Haworth Press, Inc. Hough, R. L., Landsverk, J. A., Karno, M., Burnam, M. A. Timbers, D. M. Regier, D. (1987).

Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic Whites. Archives of General Psychiatry, 44, 702-709.

Peifer, K., Hu, T., & Vega, W. (2000). Help seeking by persons of Mexican origin with functional impairments. Psychiatric Services, 51, 1293-1298.

Pescosolido, B.A., Wright, E.R., Alegría, M., & Vera, M. (1998). Social networks and patterns of use among the poor with mental health problems in Puerto Rico. Medical Care, 36, 1057-1072.

Prieto, L., McNeill, B.W., Walls, R.G., & Gómez, S.P. (2001). Chicanas/os and mental health services: An overview of utilization, counselor preference, and assessment issues.

Counseling Psychologist, 29, 18-54.

U.S. Census Bureau (2012). Income, poverty, and health insurance coverage in the United States: 2011. Retrieved from: http://www.census.gov/prod/2012pubs/p60-243.pdf

***************************** WHERE: St. Anne’s Conference Center 155 N. Occidental Boulevard.

Los Angeles, California WHEN: August 7-8, 2013. ****************************** Advancing Latino Behavioral Health: From Margin to Mainstream WHERE: Sheraton Los Angeles Downtown Hotel 711 S. Hope Street, Los Angeles, CA 90017 DATE:

September 10-13, 2013

LINK:

http://lbhi.org/lbhi19thannual-%20conference information/

U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity – A supplement to mental health: A report of the surgeon general.

Rockville, MD: U.S. Department of Health and Human Services, Public Health Services, Office of the Surgeon General.

Vega, W. A., Kolody B., Aguilar-Gaxiola, S., & Catalano, R. (1999). Gaps in service utilization

by Mexican Americans with mental health problems. American Journal of Psychiatry, 156, 928-934.

Vega, W.A. & Alegría, M. (2001). Latino mental health and treatment in the United States. In: Aguirre-Molina, M., Molina C. & Zambrana, R., eds. Health Issues in the Latino Community. San Francisco: Jossey-Bass, pp. 179-208.

National Hispanic and Latino ATTC Newsletter

ISSUE 1, JULY 2013

National Hispanic and Latino ATTC Universidad Central del Caribe PO Box 60327 Bayamón , PR 00960-6032 787-785-5220 ph 787-785-4211 fax www.ATTCnetwork.org/hispaniclatino hispanic@attcnetwor.org hispaniclatinoattc@uccaribe.edu