Baltimore-area children face barriers to accessing mental health care due to language: report

Baltimore-area children face barriers to accessing mental health care due to language: report

A report released Wednesday by two Baltimore-based social justice groups says language barriers prevent children from immigrant families in Maryland from having equitable access to mental health services.

Under Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act, patients are guaranteed free access to translation and interpretation services if their preferred health care language is other than English.

But the report found that young people from immigrant families, which include both immigrant children and those with immigrant parents, are often denied care when referred to mental health providers.

Dr. Sarah Polk is co-director of Centro SOL, which stands for Center for Salud/Health and Opportunity for Latinos, and is a pediatrician at Johns Hopkins University. She helped write the report and said this discrimination based on language is a “chronic frustration”. The report was published jointly by Centro SOL and the Public Justice Center.

“Language is not meant to be the basis of eligibility for health care services,” Polk said.

The report describes patients who are denied care while covered by Medicaid. In one example, a 16-year-old with anorexia was referred by her pediatrician to a therapist for behavioral therapy, but the specialist refused to provide care because the girl’s primary language is Spanish. Another child who suffered from depression was denied care because his mother’s main language is Spanish. The Sun was unable to independently verify the patient’s claims.

Polk noted that while the child in question can receive services in English, he is sometimes barred from making an appointment due to a lack of interpreter services for his parents who are caring for him. health.

Polk and three other authors were unable to quantify the number of children and adolescents affected by the lack of access.

In her practice, Polk has seen patients being denied care by other providers, either because of their lack of English proficiency or because of their parents. Ashley Black, senior counsel for the Public Justice Center’s Health and Benefits Equity Project and another author of the report, said her organization had received at least a dozen direct complaints in addition to hearing from providers, social workers and organizations “who regularly see language access denials”. .”

Black said most of the concerns come from the Baltimore area, but that doesn’t mean the problem is geographically limited. She added that the majority of complaints came from Spanish speakers.

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“We are really going through a pediatric mental health crisis since the pandemic which seems to have been sort of a side effect of the pandemic and also perhaps in a more helpful way the result of somewhat reduced stigma around the mental health so people feel more comfortable talking about these things,” Polk said.

Additionally, children of immigrants may face more risk factors than their peers, such as higher poverty rates or being discriminated against, either at first hand or by observing their parents’ treatment.

Polk said the most common issues, such as anxiety and depression, can be treated. But she added that “by the time you have identified a mental health issue and brought a family to seek specialist care, it is usually because there is a fairly significant level of concern”.

Unaddressed language barriers can lead to harm, Polk said. Patients may take their medications incorrectly or not follow proper care protocol if instructions are given in English.

Among the report’s recommendations, the Maryland Department of Health should provide a guide to interpretation and translation services for mental health providers serving immigrant families and provide financial support for these services, which are not not reimbursed by Medicaid.

The Maryland Department of Health declined to comment on the recommendations, instead referring to the state’s limited English proficiency policy. Spokesman Chase Cook said he has yet to see the report.

“We very much hope that this report will raise these issues, especially for the new administration, and serve both as a reminder to suppliers of their obligations to meet these demands, but also as a resource on the importance of these issues and how to address them. answer. requirements,” Black said.

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