By Christina Cabading (She/Her)
Growing up in a small farm town, Delano, I personally dealt with the stigma of mental health. It is taboo to talk about, especially in a community composed mainly of Latinx and Filipinx residents. Cultural barriers that contribute to the stigmatization of mental health are prevalent in rural areas like the Central Valley. It was only in college that I experienced a positive environment surrounding mental health and wellbeing. Throughout this research, I find that I am not alone in struggling to access mental health services in the Central Valley.
From existing literature analyzed, significant studies exhibited that, “...individuals in rural areas are more likely to live in poverty, lack health insurance, report poor health, have a chronic health condition, and become unemployed.” (Blank & Jameson, 2007) These issues make acquiring mental health services more difficult for those in rural areas than their urban counterparts. In areas with more diverse populations, cultural barriers to mental health services are prevalent. Hispanic and African American populations believe that “a mental illness can be treated or overcome through willpower [...] rather than by seeking external, professional psychological help.” (Kalibatseva & Leong, 2011) In Asian American culture, reputation is a key barrier to any type of professional mental health treatment. Studies suggest that these populations are more prone to seek out nonprofessional sources of support -- clergy, friends, and family.
Immigrants were yet another subpopulation explored. They experience a unique set of extenuating circumstances that impact their mental health negatively. A special limitation to access was actually systemic within the mental health profession itself. One study demonstrated that “clinical psychologists are not well prepared to handle the [variety] of problems that are encountered in rural areas” due to lack of specialized training. (Blank & Jameson 2007)
From my findings, I hypothesized that those who want to seek mental health services in the Central Valley face rigid social and cultural barriers. Those restraints hinder individuals from believing that they are in need of these services. As a result, they are incapable of accessing the services all together.
Data was collected through surveys followed by interviews with respondents and mental health professionals in my area. The survey consisted of questions about their experience with mental health services. Surveys were distributed through my personal Instagram, Snapchat, and Twitter from July 26th to July 31st. I targeted the teenage and young adult population of the Central Valley, focusing on Kern County. In total, there were 133 survey respondents. The main demographics of the survey were 66.9% Latinx/Hispanic, 77.4% female, and 43.6% working class. In total, 30 cities were reached, with 34.6% of respondents being from Delano. Survey respondents ranged in age from 18-31 years.
The survey showcased some staggering results that certainly supported my research hypothesis. For one, 60.9% of respondents have not sought out mental health services in the Central Valley. One respondent elaborated, stating, “I don’t want to be told that something is wrong with me.” It is clear that mental health is not a normalized topic of discussion in this community. 72% of respondents have felt uncomfortable discussing mental health-related issues with their community; in a follow-up question, many stated that stigma was a reason. In a Check All That Apply box that includes several restrictions to mental health services (financial, linguistic, cultural, etc), 75.9% of respondents checked “financial” issues as a primary restriction. In regards to discussing mental health services within the educational environment, 56.4% of respondents felt that their school system in the Central Valley was not open to discussing mental health. Interestingly, 76.4% of respondents felt that the college and university level of education possesses the most positive environment to discuss mental health.
After the survey was distributed, I conducted a total of 14 interviews with survey respondents to answer more personal questions about their experience accessing mental health services. In a majority of respondents, the perception of mental health changed over time. They specified that it became more important to them as they grew older, especially during college.
Several respondents had negative experiences with high school counselors; conversely, others had positive experiences accessing services in college. A common pattern from both the survey and the interviews was the overall lack of knowledge about resources available. One interviewee responded, “It seems as if there isn’t any place to start.” Interviewees acknowledged ways to combat this particular barrier. Within their community, they want to see more school initiatives surrounding mental health, more specialized outreach projects, normalized discussion, or some sort of community forum to discuss these topics.
I connected with a total of seven mental health professionals -- from private practices and university staff to different facilities in Kern County. A common pattern from interviews was the practice of cultural competency training within their workplaces. These trainings better equip staff to treat communities of diverse ethnicities. Additionally, some facilities are actively hiring more therapists from different cultural backgrounds. In regards to integrating mental health services into the school system, responses varied. One clinical social worker, Octavio Magaña, noted that schools were hiring more social workers to help with behavioral issues that arose on campus. Two program specialists from Kern Behavioral Health and Recovery Services, Christina Rajlal and Noe Escobar, also made significant strides in launching educational workshops surrounding mental health to schools in the Central Valley. However, one therapist from Henrietta Weill Memorial Child Guidance Clinic, Kanule Martin, noted that it is difficult to implement services within a high school setting. Although, Martin mentioned that mental health workshops have been given to teachers to better recognize behavioral issues.
Kern Behavioral Health also works to combat linguistic barriers: translating documents to Spanish, Punjabi, and Hindi. They have also implemented public board meetings for locals to give feedback College Community Services mentioned that in response to economic obstacles, their facilities offer a service called Short Doyles in which the county provides financial aid for services and medication to lower class families.
It is clear that the vast majority of survey respondents were unaware of the resources available to them. They want discussion surrounding mental health normalized. This is why I propose launching an Instagram account about mental health in the Central Valley, targeting teenagers and young adults. This project can include webinars with mental health professionals and infographics listing mental health resources available in the Central Valley. This would be a great chance to get a conversation surrounding mental health stirring in our communities. It would be a positive reminder to check up on your wellbeing while doing your daily scrolling through social media. With support from the community and local professionals, this project can benefit many in the Central Valley.
Before this project began, I have always known that the stigma against mental health in my community exists. Now, I am more aware of how detrimental that stigma can be to someone’s well being. I truly believed I was alone in my struggles accessing mental healthcare, but I was not. I am only one of many. And it has become abundantly clear to me that my community wants to access these mental health services. However, we are taught in our schools, households, and communities to not talk about it. In these unprecedented times, our mental wellbeing is especially at stake. In doing this research, I discovered newfound respect and adoration for Community Based Participatory Research. Connecting with my community on such an important matter was certainly special, and there are countless stories that I will carry with me as I continue to spread awareness for mental health. With this research, I hope to further educate myself and my community on the importance of mental health. Work like this facilitates conversation and ultimately destigmatizes mental health in the Central Valley.
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References
Jameson, J., & Blank, M. (2007, July 23). The Role of Clinical Psychology in Rural Mental
Health Services: Defining Problems and Developing Solutions. Retrieved July 14, 2020,
from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-2850.2007.00089.x
Leong, F., & Kalibatseva, Z. (2011, March). Cross-cultural barriers to mental health services in
the United States. Retrieved July 14, 2020, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574791/