By Kira Cordova
This story is part three in an ongoing series exploring systemic barriers to mental health care present within Gunnison’s Spanish speaking and Cora community. Part one can be found HERE. Part two can be found HERE.
Reporter’s Note: The word Hispanic refers to ethnicity and is separate from race. The US Census Bureau did not include it on the census until 1976. The term is controversial, with many pointing out that it generalizes many diverse communities and has etymological ties to Spanish colonialism.
While other descriptors can be more accurate, because the data we have utilizes census information, and therefore the word Hispanic, it’s included in this article and the subsequent about Spanish and Cora language behavioral and mental health resources in the valley.
Systemic barriers like linguistic isolation and a lack of multilingual and multicultural mental and behavioral health providers in the Gunnison valley (and in general) exacerbate the mental health crisis for Hispanic community members.
While organizations like Gunnison Health and Human Services and Project Hope and the valley’s major mental and behavioral health providers (the Center for Mental Health and the Behavioral Health subsect of Gunnison Valley Health) have systems in place to help community members access existing resources and provide multilingual support with the help of community interpreters and online interpretation services, a lack of information about these services, especially publicized in languages other than English, makes them difficult to access.
So how can the Gunnison community improve access to multilingual and multicultural mental and behavioral health resources moving forward?
Café con Comunidad, a living document Health and Human Services created to quantify and share the barriers the Spanish-speaking community in Gunnison faces in their own words, lists the following as the mental health resources needs of the community:
- In addition to the Multicultural Office and DHS, we need to have other resources where we can ask for help.
- We need more information about suicide, substance abuse, and domestic/partner abuse (particularly female as a victim).
- We would like to have suicide, substance abuse, and domestic/partner abuse support groups (particularly female).
- We need more information about psychologists that can help us when needed; preferably one who speaks our language.
- We need AA and Alanon groups in Spanish
- We need more information on how to talk to our children about difficult topics: suicide, substance abuse, domestic violence, and sex.
- We need more information about the services provided by the Center for Mental Health to the public.
- Since cost is a barrier to seek services, we would like to get an approximate estimate of cost for each service provided.
- We would like to have physical activity programs in Spanish to increase participation (Programs where we feel safe, welcomed, and actually know what’s going on).
- We would like to be trained on how to help others- including our families, friends, community, and ourselves in mental health crises.
- We think that safe places for meetings could be our parks, the Rec Center, churches, Fairgrounds, Hospital, Library, event rooms.
The One Valley Prosperity Project, brought together representatives from the following entities in 2014 under the Community Builders Task Force to assemble a report on resources and needs in the valley, called the One Valley Prosperity Strategy:
- Gunnison County
- The City of Gunnison
- Western Colorado University
- The Community Foundation of the Gunnison Valley
- Gunnison Valley health
- The Crested Butte South Property Owners Association
- The Town of Crested Butte
- The Town of Mt. Crested Butte
- Crested Butte Mountain Resort
- The Gunnison-Crested Butte Tourism Association
- The RE1-J School District
- The ICELab at Western Colorado University
- The Gunnison Valley Regional Housing Authority
The Community Health Equity Action Plan from this strategy identifies needs in the valley and their priority levels, timeframes, and collaborators, as well as whether or not efforts to meet these needs are nascent, ongoing, or completed. Objective 3.4 is to “improve mental healthcare services.”
In addition to extended and after-hours mental healthcare, suicide prevention meansures, a clinic in Crested Butte, a residential in-patient failicy/program, and adult substance abuse prevention and education, needs include increased numbers of bilingual clinicians. At the time of this document’s publication, none of these projects were listed as started.
On a statewide level, the 2020 Colorado Behavioral Health Needs Assessment identified the following as action points to address the gaps in behavioral health resources for non-White and Hispanic Coloradans:
- Consistently and completely collect demographic data to better understand where and why disparities exist, it is important to improve race/ethnicity demographic data collection through the behavioral health system and other survey protocols. Ensuring that data are consistently and comprehensively collected and maintained across providers is also important. Additionally, data need to be collected on the workforce itself to understand to what extent providers reflect those they serve.
- Work with appropriate stakeholders to develop additional measurement, and ensure that data tracking systems and new data integration efforts include data items to assess contextual factors (e.g., social determinants of behavioral health including socioeconomic factors, unique issues associated with geographic variability that will facilitate understanding of trends and differences.
- Focus efforts to improve the completeness and accuracy of mental health and substance use treatment data; ensure that the new data integration efforts and systems include processes to ensure high data quality and facilitate on-going monitoring of needs and emerging concerns.
- Set up processes (data reports) to continually analyze behavioral health patterns in relation to population shifts, policy changes and other contextual factors to monitor trends and pinpoint contributors to change over time.
- Identify opportunities and strategies to better provide services for non-English speaking populations, particularly refugee populations, to ensure they have access to services in their language as identified via stakeholder engagement. Relatedly, there was mention of ensuring culturally competent and trauma-informed care to be better able to serve all patients.
- Build collaborations for statewide support for behavioral health organizations to improve recruitment and retention of diverse providers. This could include collaboratives between foundation and philanthropic partners with State agencies and behavioral health providers to improve organizational culture, to support careers in behavioral health and to improve cultural competence.
Yazmin Molina, Gunnison Health and Human Services Multicultural Resource Coordinator, also welcomes feedback and suggestions from current students since students have different needs from the rest of the community, which “might align with needs that the community didn’t know [it] needed.”
Information about accessing mental and behavioral health resources needs to be available in Spanish and Cora in accessible places around the community, including online. The only hit for “Español” on GVH’s website is for Financial Assistance in Spanish.
The only hit on the Center for Mental Health’s website is an article about coping with postpartum mood disorder that includes the following text in Spanish about the Center: “A community behavioral health center serving individuals and families in Gunnison, Delta, Montrose, San Miguel, Ouray, and Hinsdale Counties.”
Online resources like the Center for Mental Health’s Suicide Prevention Information Sheet additionally need to be made available in Spanish.
The documents included in this article that evaluate the community and state-wide needs are all pre-pandemic, which means there’s also a need to reevaluate the needs of the community and available resources moving forward.