Workforce pipeline to help address disparities in mental health services in Massachusetts

Supporting clinical training programs that develop language skills and cultural competence and forgiving educational loans for psychology graduates who have this kind of training can help meet the critical need for mental health providers to care for Latinos and other underserved populations, said leaders of Massachusetts School of Professional Psychology (MSPP), who spoke at the state Health Disparities Council meeting earlier this week.

Dr. Nicholas Covino, MSPP president, and Dr. Amaro Laria, who directs the MSPP Latino Mental Health Program, were asked by the Council to describe their efforts to create a workforce pipeline to help address the disparities in mental health services in Massachusetts and recommend ways the state can help further such efforts.

While depression and other mental disorders have an enormous impact on all elements of society (affecting nearly half the populations at some point), the burden is greater among Latinos and other minorities, said Covino. "This is not because of greater incidence or severity, but because they have less care or poorer care than their Caucasian counterparts," he said, adding that even where mental health services exist, cultural and language differences inhibit the therapeutic relationship.

"And because of the stigma attached to mental illness in many cultures and the sensitive and personal nature of the therapeutic relationship, using interpreter services has not been effective," said Laria, adding that research has shown that patients are more likely to continue and benefit from therapy when the therapist speaks and understands the nuances of their language and displays sensitivity to their culture.

The fastest growing segment in the US, today Latinos make up more than 15 percent of the population (US Census Bureau, 2008). Yet, only two percent of mental health professionals have the linguistic skills to work competently with this population.

The Latino Mental Health Program at MSPP is designed to immerse graduate level psychology students in the Spanish language and cultures of Latinos. The program includes courses aimed at helping students attain a deep understanding of the psychological experiences of Latinos by focusing on the social factors that drive them to migrate into the US, as well as the characteristics of their lives in this country. These courses are taught initially in English and then progressively in Spanish, and students receive constant training and practice to refine their language skills; they also do their internships in community mental health settings with high Latino populations, In addition, they are required to research some aspect of Latino mental health for their doctoral or master's theses.

A major highlight is the summer immersion programs, said Laria. Students are immersed in intensive study of Spanish and provide volunteer mental health services in Latin American countries for at least two summers of their academic programs.

The LMHP not only trains non-Latino psychologists, but also actively recruits Latinos to enter the field.

Juan Rodriquez, an MSPP student, who will receive his doctorate in clinical psychology this Fall spoke eloquently of the experience, especially of the summer programs. "Being able to experience life in their native countries-these are things you don't get from reading a book. Going to Costa Rica, Ecuador and Guatemala allowed me not only to provide services, but also to understand some of the cultural nuances."

According to Laria, by the years 2013, the program will have graduated 43 non-Latino and 14 Latino psychologists prepared to care competently for Latinos in the community.

In addition to expanding Loan Forgiveness and supporting more culturally sensitive training programs, Covino and Laria urged the Council to increase their attention to mental health in their measures of health disparities and to be aware that interpreter services are generally ineffective, if not inappropriate, for mental health treatment situations. They also recommended that the state collect information about the cultural and linguistic competency of psychologists during the licensing process to accurately assess the workforce needs in serving particular groups.