There was an assumption on the role of limited English proficiency in racial and ethnic mental health inequalities. Surprisingly, there were only a few empirical researches that were done regarding the relationship between language barriers and mental health inquiries. Language barriers pose a problem due to the fact that mental health diagnosis and treatment must be communicated to the patient rather than through objective tests (Sentell, Shumway, and Snowden, 2007). Most of those who suffer from language barriers are the immigrants who have a low-income status.
A study showed that Latinos and Asian-American immigrants do not seek mental health treatment because of their inability to speak English and lack of insurance. In addition, 37% of Latinos do not have health insurance and only one among 20 individuals who have mental health problems seek treatment from mental health specialists. The Office of the Surgeon General also released a report in 2001 which showed that compared to whites, Asian-Pacific Islanders “were less likely to seek mental health treatment or discuss mental health problems with friends or relatives” (Medical News Today, 2006).
Added to the problem of language barriers was the treatment disparities associated with mental health treatment. Minority communities have seemed to bear this problem along with the loss of economic productivity, high disability burden, and unnecessary suffering. Thus, health care providers must necessarily understand the differences in services received by people from different race and ethnicity. This will help them in facilitating the needs of those who are of low income status and do not speak English.
In one study, results showed that mental health patients consider it important that they seek and receive help from physicians regarding their emotional distress. Furthermore, the study found out that those who belong in racial or ethnic groups are likely to find help from primary care providers with regards to mental health problems. However, these concerns of minority groups seem to go unnoticed in primary care. Furthermore, it is worsened by language barriers which hinder primary care providers from providing the patients’ mental health needs (Sentell, Shumway, and Snowden, 2007).
Cultural Divide and Stigma Again, minorities belonging in racial and ethnic groups, especially Asian immigrants, are the most vulnerable when it comes to cultural divide and stigma. Many health professionals are discovering ways on how to work with immigrants who might feel stigmatized. Koreans in particular are less likely to seek help regarding mental health treatment because they think that mental illness is a family curse that they can cure. Furthermore, Koreans are afraid for people to know that they have mental illness because it might affect the prospect of marriage for relatives.
Immigrants are also faced with the lack of “culturally sensitive” health providers (Henry J. Kaiser Family Foundation, 2007). An example where culture served as a hindrance was a case of a Latina, Ana Lazu, who did not believe in depression and was taught that psychiatrists and psychologists only care about the money. Furthermore, Lazu grew up knowing a culture where people fix their problems by helping each other. Lazu had difficulty seeking help because of the cultural divide. As she put off seeking help, she became very depressed to the point of suicide.
Even when she was admitted in the hospital, she was still depressed because she could not understand what the health care providers were telling her. The therapists also did not understand what she was telling them. Moreover, Lazu did not believe in the antidepressants that the doctors prescribed for her because she thought that her illness was caused by ‘brujeria’, which is a spell or curse (Peck, 2005). To address the problems that have stemmed from cultural divide, the health care system is facilitating some changes in the way minority groups are treated.
One way is to increase their knowledge of cultural, religious, social, and psychiatric aspects of the patient and fine tuning and improving treatment to meet the needs of the patient. Another way is to limit the time so that consultants could serve new cases. In addition, a committee was established which aimed to further improve the health care delivery (Lehmann, 2002). Insurance Many of poor people seeking mental health treatment do not have insurance. Most of the studies conducted regarding mental health treatment showed that immigrants are less likely to have insurance (Henry J.
Kaiser Family Foundation, 2007). Other studies found out that limited English proficiency and the individual’s immigration status might hinder people who have or at risk of mental health illness in acquiring a health insurance. In turn, lacking a health insurance prevents them from seeking mental health treatment (Sentell, Shumway, and Snowden, 2007). The lack of insurance is a problem not just for immigrants but also for Native Americans. 16 percent of the adult American population does not have health insurance.
There are some people who have insurance but do not have mental health coverage, while there are also people who have already used up their mental health benefits (Council on Medical Service, 2001). A study showed that 36 percent of the respondents did not seek help for mental health treatment because they did not have insurance. As such, insurance coverage is seen as an important factor with regard to patients seeking help and receiving adequate care (Mechanic, 1990).