Ethnic Utahns can face barriers created by language, culture and racism. But nowhere are those barriers more daunting than in the mental health system.
They are so difficult to overcome that about 200 mental health and health and human service officials from across the state gathered at Snowbird Thursday and Friday for a conference titled "Mental Health Care for Ethnic Minorities: Raising the Standard.""The service system is geared for the majority," said Juan Mejia, Utah Ethnic Mental Health Proj-ect and conference organizer. "A lot of times there's not any ethnic staff. . . . It's a very serious need."
While many of the treatments offered for mental illnesses are the same, regardless of race, the road to getting that treatment can be very different, Mejia said.
People from ethnic minorities are still more likely to be counted among the working poor. They have a different interest - and stake - in education, gang activity and other areas. If language and cultural misunderstandings are thrown in, accessing appropriate and effective treatment can be very difficult.
Discrimination compounds the other problems.
Dr. Meredith Alden talked about cultural stereotypes, ranging from acute to innocuous. The new Mental Health director, who is a practicing psychiatrist, cited as examples "Latin lovers" and "Scots frugality."
"The fact is, people are very different" within racial groups, she said. There are also "stolid Italians" and "sober Irishmen," but no one talks about them.
It goes even deeper than that, Mejia said. Ethnics must be treated the same - and differently. A schizophrenic has obvious need for medication that has nothing to do with ethnic background. But if the patient and doctor speak different languages or come from completely different cultures, diagnosis is tricky. For example, "a hallucination may or may not be psychotic (when considered) in cultural context."
Mejia is the only bilingual, bicultural clinical psychologist in the entire state, he said. There are no bilingual and bicultural psychiatrists and not nearly enough social workers with ethnic backgrounds. While some speak other languages, they still run into confusion caused by culture clashes.
The number of ethnics in Utah is growing, but every minority is underrepresented in the field of mental health. Native Americans are probably slightly worse off that way than others, he said.
"We need to work with the universities, the public mental health system, etc., to recruit and hire more minorities. We can train and increase sensitivity and awareness of a nonethnic, but we need ethnic" mental health practioners, too, said Mejia.
Alden warned that "the stigma against mental illness happens throughout cultures and around the world. We have a tremendous task to educate about, treat and advocate" for ethnic minorities in the field of mental health.
"We need to create a plan and confront the stigma and inequities of treatment," she said.