The future of mental health in America

As you know, multilingual diversity is increasing in the US, with Spanish being the nation’s second most spoken language. The statistics show that from 2014 to 2019, the Hispanic population grew 5%, an increase of 5.2 million. The census projections show that 24% of the population of the US will be Latinx/Hispanic by 2050. There is an average of 30 mental health providers per 100.000 people, without considering if they speak Spanish or not. This data shows the mismatch between the demand for the growth of the Hispanic population and the offer of mental health services in Spanish. The future of mental health in America depends on improving the health of racial and ethnic minorities (Surgeon General Office, 2001).

However, being able to provide services for the Hispanic population is more than a matter of language or translation. To improve mental health outcomes is important to understand the culture and the differences between them. But it is not enough to develop training that incorporates stereotypes and memorization of specific cultural concepts. It is about how to understand the client and the therapy process.

To develop cultural awareness is important to include conversations and experiences about gender, country of origin, socioeconomic status, spiritual beliefs, immigration status, educational attainment, sexuality, and language patterns. But also explore the meaning of rapport and therapeutical alliance, clinical boundaries, and attuned manners. Many therapists have never been trained as a Hispanic therapist until they are already in the field, learning the cultural nuances through trial and error (Trepal, Tello, Haiyasoso, Castellon, Garcia, Martinez-Smith, 2019).

For all these differences is important to create better opportunities for training for culturally sensitive mental health providers: closing the gaps in training and knowledge, creating formal learning opportunities, and promoting access to increase representation. For all this is important to create safe spaces for students to be able to discuss cultural issues, including specific training and supervision strategies for bilingual therapists and develop better methods to help therapists to become more culturally aware.

The world is changing, our clients are not in the same place, they are not thinking in the same way, they are not expecting the same solutions, and people in our profession must take care of these new challenges and move our field forward quickly. The use of technology could help with this endeavor. Being able to access and contact people from diverse cultures and groups from a distance will allow clinicians to learn from others about cultural aspects, understanding universal characteristics and the uniqueness of each individual. It is possible to incorporate and combine programs with universities from other countries, offering social and informal spaces, co-therapy, or reflecting teams, that allow not just to understand the idiosyncrasies but also how to provide services in Spanish, and how to explain concepts and ideas. This exchange online program could allow growing our field in a more global way that is not just in The United States.