As a licensed marriage and family therapist, Genesis Espinoza sees the impact of the coronavirus pandemic on Latinos she sees at her practice in San Fernando, California.

Many of Espinoza’s patients are reporting conflicts at home as family members live together for prolonged periods of time. Young adults who can’t go to their college campuses are learning to live with their parents again. Adults are worried about elderly parents.

“A lot of people are worried that they’re going to get COVID-19,” said Espinoza. Some of her clients have tested positive, recovered, and now are “worried they are going to get it again.”

Genesis Espinoza, a licensed marriage and family therapist in San Fernando, California (Courtesy: Genesis Espinoza)

Espinoza is primarily providing services online and scheduling some in-person appointments while following Centers for Disease Control and Prevention guidelines, wearing masks and keeping six feet of distance between her and patients. She sees firsthand how speaking the same language and being familiar with the culture of Latino immigrants who come to her office helps establish a connection.

With Central American patients, Espinoza often tells them that her mother is from El Salvador. “The minute I say that, I see a complete shift. … I sense their body language. They start talking a lot more.”

“It’s super important to have a therapist that you’re able to identify with, that you feel comfortable with, that comes from the same cultural background,” she said, “that speaks the same language as you.”

But for years, Latinos have faced challenges in obtaining culturally competent mental health care. And the need is only growing during the pandemic, as practitioners across the country receive more referrals from patients within the Latinx community.

Only 5.5% of psychologists can provide services in Spanish, according to a 2015 American Psychological Association survey, and U.S. Census data shows only 7% of psychologists identify as Hispanic.

Mónica Villalta, the national director of inclusion and diversity at the National Alliance on Mental Illness, is well aware of this void in mental health services. “When you add the added layer that those services are costly, that the system is complicated, and that many of the individuals in our community do not have insurance to begin with,” she said, “prior to 2020 we were already in a sort of a crisis.”

That crisis, Villalta and other mental health professionals across the country say, is amplified by the COVID-19 pandemic as Latinos are disproportionately impacted by the virus and cope with the trauma, stress and anxiety that comes with family deaths, illness, economic uncertainty, and social isolation. According to CDC data, Latinos comprise nearly 30% of the country’s COVID-19 cases, yet make up 18% of the U.S. population.

“This is something that is going to impact us for the next few years,” said Jennifer Gaviria of the Latino Mental Health Network of Rhode Island. “There’s going to be a greater need to have people in the (mental health) field. There was a need before. I think it’s going to be greater.”

The mental health impact on the Latinx community is already becoming clear. In a CDC survey published in August, researchers found that Latinos “reported higher prevalences” of symptoms associated with anxiety, depression, increased substance abuse, and suicidal ideation. Many Latinos who responded to the survey were also exhibiting symptoms of trauma- and stressor-related disorders related to COVID-19. “Mental health conditions are disproportionately affecting specific populations,” the survey concludes, including young adults, Latinx and Black people, and essential workers.

Among the situations affecting Latinos, practitioners say: essential workers reporting to work in unsafe conditions. Stress on Spanish-speaking parents who now find themselves helping their children with virtual learning. Patients who had COVID-19 and fear contracting the virus again.

Luke Smith is the executive director of El Futuro, a nonprofit that provides mental health services in North Carolina. El Futuro serves Latino families, most of them from Mexico and Central America. Nearly 50 people are on staff, and yet, Smith said, “It’s not met the demand that’s out there.”

The clinic now mostly offers services online. In June, about 70 new patients contacted El Futuro. By July, 200 people had called to inquire for an appointment. COVID-19, Smith said, “turned up the volume on all the stress that’s in the lives of people.”

In Rhode Island, clinical social worker Gaviria is one of the co-founders of the Latino Mental Health Network, which focuses on the professional development of Latinx practitioners. They send out emails on job opportunities and, before the pandemic, organized networking events. The network, Gaviria said, offers an opportunity for community and mentorship.

Before the pandemic, it was already difficult for undocumented immigrants to obtain mental health services since many don’t have insurance. Some clinics do provide free or low-cost services but often have waitlists, Gaviria said.

Even if a mental health provider is bilingual, it’s best that they receive training on providing culturally competent services in Spanish, said Dr. Maria Espinola, an advocate for diversity in the mental health field and an assistant professor of clinical psychiatry at the University of Cincinnati College of Medicine.

“Being able to speak Spanish doesn’t make you capable of providing therapy in Spanish,” Espinola said, adding that it’s necessary for a therapist to be a fully fluent Spanish speaker to get at the intricacies behind the trauma that many Latino immigrants grapple with “before, during and after the immigration process.”

As COVID-19 spread across the United States in the early months of the pandemic, Espinola’s concerns about Latinos without access to proper mental health care grew. So she learned how to film and edit videos, and started posting on her YouTube channel. The videos, available in English and Spanish, provide tips on coping with insomnia, breathing techniques, and how to cope during a crisis. “I just felt like I needed to do something,” she said.

In Pinellas County, Florida, which includes St. Petersburg and Clearwater, the Suncoast Center offers therapy and psychiatric services and has seen an increase in referrals from the Latinx community. Roberto Font, one of the Spanish-speaking therapists on staff, said isolation is among the biggest challenges patients are facing.

Older adults express missing out on visiting their grandchildren, for instance, or people are missing the in-person experience of congregating at their churches. There are also fears about what is happening to families in their home countries. Some clients couldn’t travel home for funerals due to travel restrictions.

Font also points out that every Latino’s lived experience varies widely. Some have suffered significant trauma back home, or left their countries for political reasons. Financial and educational backgrounds also vary. Providing mental health services to this community isn’t a “one size fits all” approach.

“It is about being able to engage, being able to develop trust, being able to validate these individuals’ experiences,” Font said. “Latinos historically have been resilient and have had to deal with different oppressions here in this country.”

Mental health resources

• The NAMI Helpline, open Monday through Friday: 800-950-6264 or email: info@nami.org.
• National Suicide Prevention Lifeline, available 24 hours in English and Spanish: 800-273-8255

This is part of a series funded by a grant from the Rita Allen Foundation to report and present stories about the disproportionate impact of the virus on people of color, Americans living in poverty and other vulnerable groups.