|Monday, 11 April 2011 18:40|
What are the Mental Health Challenges Youth in Prince George's County Face?
While mental health is critical to all communities within the County, and all Puentes! member agencies provide services to native-born and immigrant communities alike, Puentes! is particularly interested in seeking support for the unmet mental health needs of Spanish-speaking immigrant youth. Generally speaking, youth with good mental health have a positive attitude and can manage life's challenges, feel good about and care for themselves and others, and act responsibly in school, on the job, and in all of their relationships. By contrast, youth with poor mental health are unhappy and indifferent, have low self-esteem, trouble coping with stress, struggle making friends and difficulty dealing with others. While not meant to be technical or exhaustive, the following describes some of the major types of mental health challenges these youth face:
These challenges, if untreated, can lead to many of the social problems that affect and concern us all:
Thankfully, All of These Mental Health Challenges Are Treatable
While each of these mental health challenges are serious, they are treatable. Proven, evidence-based strategies do exist, and are the very strategies Puentes! members, as direct service providers, use every day to great effect. Some examples of successful work with youth in the County include:
From our perspective as on-the-ground service providers, Puentes! sees the unmet needs of immigrant youth as a consequence of at least four interrelated factors: poverty and lack of health insurance, lack of proper mental health coverage for those with insurance, linguistic and cultural challenges, and a lack of a properly-funded system of care.
Poverty & Lack of Insurance. Prince George's is challenged with a large number of relatively impoverished households, where far too many lack health insurance. According to the County's Enquirer-Gazette of October 30, 2008, Prince George's County has more than 150,000 people without insurance, the highest in the state.
Even Those With Insurance Are Not Adequately Covered. Particularly for the type of mental health challenges referred to above, even those with Medicaid are not adequately covered. Medicaid, as is well known, is the largest source of funding for health-insurance for those with limited income, but both the kind and quantity of services needed to best serve youth with the above-presenting challenges are not covered. This forces most mental-health providers in the community to do one of three things: 1) staunchly avoid serving this population, 2) pathologize youth by diagnosing them as having mental illnesses they may not actually have, so they can deliver them the services they need while getting paid for it, or 3) providing them services knowing that they will not be compensated.
Linguistic & Cultural Challenges. Genuine, trustful engagement with the existing community of care is more difficult for immigrants, who are often only beginning the process of linguistic and cultural adaptation. Many Latino families in need of care have mixed language and cultural realities - the parents may be native Spanish speakers and have a Central-American cultural identity, while their native-born youth (or those that came at a very young age) speak English best and have a distinctly North-American, urbanized cultural identity. Particularly when therapeutic strategies involve both youth and their parents, as they often do for best results, the ability of providers to manage multiple linguistic needs and connect with various cultural realities is key.
Elements Towards a Solution
Our position as direct service providers affords us an up-close and critical perspective as to the positives and negatives of the current care structure. It is from that perspective that we believe a genuine solution to meeting the current unmet mental health needs of immigrant youth must include:
Mental Health Services Which Are "Embedded" In A Larger Set Of Services. Because of the stigma still largely associated with mental health, few youth who need services take a direct route to them. The availability of mental health service options along with or within other programs and services really helps to engage hard-to-reach youth. Mixing mental health services with other types of services helps to "normalize" the former and makes mental health practitioners more approachable. Programs that are a "natural fit" with mental health services include after school educational programs such as homework assistance and mentoring, out-of-school programs like GED classes, life skills/leadership programs, job readiness classes, and art programs.
Services Located In Existing Community Centers. Traditional, clinical office settings discourage youth and their families from connecting with the people and services that are available there. Community centers and community based organizations are a natural place where immigrant families feel welcome and are more likely to engage in mental health services. In addition, many immigrant families face transportation challenges with only one or no family vehicles and inconvenient public transportation options. Some Puentes! member agencies successfully service youth because of their proximity to local schools.
Personnel That Have The Multiple Cultural And Linguistic Competencies. As discussed above, multiple language and cultural competencies are necessary to truly connect with immigrant families, particularly when the most effective treatment strategies involve both parents and their youth.
As stake-holders in the future well-being of our County, Puentes! is resolute in our desire to work cooperatively towards a solution to address the unmet needs of young people and their families.