Kaiser Permanente therapists say mental health care shortages worse for non-English speakers • Sacramento News & Review

A quarter of 1,500 Kaiser clinicians surveyed in California said they had patients who could not access care in their primary language

By Gabriel Thompson, Capital & Main

This story is produced by the award-winning journalism association Capital and principal and co-published here with permission.

Jessica Dominguez started working at Kaiser Permanente Hospital in Richmond, California in 2014, excited to work with Spanish-speaking patients. A licensed marriage and family therapist and the daughter of Mexican immigrants, she had spent several years working with Latin American communities in East Bay. Richmond, she thought, would keep her busy: Overall, the city is 44 percent Latino, and in some neighborhoods surrounding the hospital, the number is up by 80 percent.

She found, however, that Kaiser offered very little to Spanish speakers. There was a sparsely attended meditation class and another support group that served about half a dozen people. “There were no other services in this large Latinx community, when it had robust English services,” Dominguez said. She asked about iniquity. “The management literally told me: Spanish speakers don’t come,” recalls Dominguez. “I was like, well, that’s bullshit, because I’ve been working in the field for a long time with the Spanish-speaking community.”

In 2015, she convinced Kaiser to start a pilot program to bolster her Spanish language services, which became a permanent program in Richmond called La Clínica, where she is the lead clinician. In a short time, attendance rates for Spanish speakers exceeded those of English speakers. The team of clinicians grew from six to 20. When they interviewed patients, they learned that a third had heard of La Clínica through word of mouth. It was a success story, and one that Kaiser trumpeted.

But La Clínica’s ability to bridge the gap between Kaiser and Richmond’s Spanish-speaking community created a new problem: The therapists were burnt out and couldn’t keep up. “How can we help people when we don’t even have time to go to the bathroom?” Dominguez asked. She said she had raised the issue of the need for more resources and staff to address the mental health needs of the Latino community in half a dozen meetings with Kaiser executives, but that she was nowhere. “My team is running out – we’re dropping like flies.”

At the end of the month, La Clínica will lose another clinician: Dominguez herself. “I couldn’t go on and be part of a system that hurts people,” she said, referring to both the pressure on therapists as well as patients, many of whom have to wait six weeks. between follow-up appointments.

Dominguez is one of more than 2,000 Kaiser mental health workers who have been on strike since August 15 as members of the National Union of Health Care Workers. (Disclosure: NUHW is a financial backer of Capital & Main.) His criticism of Kaiser echoes those of other clinicians, who cite an inability to provide quality care due to high workload. But Dominguez and other clinicians also cite the particular challenges faced by immigrants trying to access mental health services in languages ​​other than English, and who have suffered a disproportionate amount of trauma caused by COVID- 19.

“There’s a lot of stigma in the Latino-Latinx community around therapy and mental health,” said Jesus Solorio, a bilingual Kaiser therapist in Oakland. “It takes a lot of courage to reach out and seek out these services. The patients are really disillusioned – it took them so much energy to ask for services, and now I tell them they can’t see me for six weeks. Before moving to Kaiser, Solorio worked at a small community mental health agency in Hayward, which he said had more Spanish-speaking therapists than the entire adult psychiatry department in Oakland. “The resources are not there for us.”

After nationwide protests sparked by the killing of George Floyd, Dominguez helped lead a survey of racial justice issues with more than 1,500 mental health clinicians at Kaiser facilities across California, which included the challenges faced by their non-English speaking patients. More than a quarter of respondents said they had patients unable to access treatment in their primary language, and 36% said their patients had difficulty because documents were not available in their primary language . Among the key recommendations was the hiring of more bilingual and culturally diverse staff.

In an emailed statement, a representative for Kaiser said more than 18% of its therapists identify as Hispanic or Latino and more than 7% as black or African American, and that it invests $30 million. dollars to recruit and train new and diverse mental health. professional workforce. “At Kaiser Permanente, we are building a highly inclusive, engaged, and psychologically safe workplace where everyone has an equal chance to reach their full potential and use their diverse perspectives and strengths to support our mission.”

Last December, Dominguez learned from colleagues in San Francisco that Kaiser planned to cancel its only Spanish- and Chinese-language therapy groups in the city, citing low attendance. “It’s a pervasive theme with Kaiser,” she says. “When people from other cultures or languages ​​don’t show up, the first thing to do is cancel it and allocate resources elsewhere.” There are 90,000 Chinese-speaking people in San Francisco with limited English proficiency and another 32,000 Spanish speakers. Despite protests from Dominguez and others, classes were canceled.

For Dominguez, it was another painful example of why, after spending eight years with Kaiser, it was time to move on. “When I see a Kaiser billboard in Spanish, I feel like screaming,” she said, holding back tears. “Because you don’t provide what you say on that billboard in Spanish. I don’t care if you show brown people. That’s not true.”

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