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Health Care Justice

Report finds mental health services in Md. lacking for immigrant children and non-English speakers

Mental Health
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Even though they have the financial resources from the federal government to help non-fluent English speakers receive interpretation services, many Maryland mental health providers choose not to, a study released last week found.

The study, published by Centro SOL, an agency affiliated with Johns Hopkins University that focuses on health equity for Latinos, and the Public Justice Center, a civil rights legal aid organization in the city, cites three specific real-life examples of young adults and children not being able to receive mental health services because of their preferred languages.

“Children and adolescents in immigrant families are experiencing a mental health crisis, reflected in high rates of depression, anxiety, and self-harm,” the report, titled “The Right to Interpretation and Translation Services for Children and Adolescents with Mental Health Needs in Maryland,” says. “Solving this crisis depends on greater access to quality mental health care.

“Mental health care access depends on clinicians, patients, and family members speaking the same language. Without the capacity to communicate effectively — with clinicians or staff who are either bilingual or through an interpreter — children and adolescents suffering from mental illness are at risk.”

The first case example in the study is of a behavioral therapist who denied care for a 16-year-old struggling with anorexia nervosa because her main language is Spanish.

In the second case, a 15-year-old who was not eating or sleeping well was depressed and was recommended for therapy. The person working on the 15-year-old’s case was told that the agency could not help the child because her mom is a Spanish speaker.

In the third case, a bilingual school-based social worker met with different agencies assisting with mental health care for Montgomery County public school students. However, the social worker found out that the agencies needed to be working with translators to help non-fluent English students before she arrived. Instead, those students were “placed on unattended waitlists because of their language,” the report said.

According to the report, mental health professionals claim they do not have enough funds to provide widespread services to the growing population of non-fluent English speakers who need mental health care.

Ashley Black, lead attorney for the Health and Benefits Equity Project at the Public Justice Center, said that the state must hold mental health care professionals responsible for doing their jobs.

“Maryland is failing children with limited English proficiency by not holding our mental health providers accountable for meeting their obligations under applicable law,” Black said. “Without consistent and timely access to language assistance services in mental health settings, patients with limited English proficiency are unjustly blocked from experiencing long-term mental health recovery.”

The COVID-19 pandemic added stress to children and adults. It was difficult for children and adults alike to receive appointments for mental health care.

Access to mental health care is vital for children and adults, including those from immigrant backgrounds, the report said.

The study also explained that the legal requirement for mental health professionals to provide interpretation and translation services stems from the Civil Rights Act of 1964, which forbids discrimination against people from different nations of origin.

Similarly, the Affordable Care Act of 2010 bars “health programs or activities including mental health professionals from discriminating based on race, color, sex, age, disability, or national origin,” the report said.

The study concluded by laying out five recommendations for improving mental health services to immigrant and non-English speaking children and families:

  • The Maryland Department of Health should provide a guide to interpretation and translation services for mental health providers serving immigrant families in Maryland.
  • Mental health providers should have a language access plan and policy.
  • The Maryland Department of Health should provide financial support for interpretation and translation services.
  • The should adopt a monitoring and enforcement policy for interpretation and translation.
  • The state should provide public education on the right to interpretation and translation services.

The Maryland Department of Health did not respond to a request for comment.