Culture plays role in mental health

Therapist Maria Diaz can see her clients relax as they relate their troubles in their native language to someone who understands their culture.

"They feel right at home and they open up. They trust you and they can talk about things back in Mexico and expect you to understand," said Diaz, a mental health therapist born in Mexico and raised in the United States. "There is an automatic trust between the client and the therapist. That is something that an Anglo therapist would have to work at with a client."

Diaz is one of four bilingual-bicultural therapists at the Multicultural Services Program at North Range Behavioral Health. The therapists speak both English and Spanish and were either born or have lived in a Latin American country.

Since its opening in 2003, the program has treated hundreds of Weld County Latinos who weren't comfortable at other treatment centers, said program director Becky Marrujo.

Marrujo and her crew deliver mental health counseling to children, adolescents, adults, couples and families. They also offer a parenting class. The patients range from new immigrants to Greeley residents and natives.

The clients share a common desire to get treatment from therapists who speak their language and understand their culture. According to the 2000 Census, Weld County has more than 48,000 Latinos, the majority from Mexico.

Providing mental health care in a clients' second language, with an interpreter or without knowledge of the client's culture, can prove unsuccessful, Marrujo said. She has worked in the mental health field for 25 years.

Diaz said the differences in family structure, religion, traditions and holidays between the Mexican and Anglo cultures can sometimes trigger an incorrect diagnosis from a non-bicultural therapist.

Diaz remembers when a religious woman came in to the clinic who believed she had been cursed. Another therapist wanted to diagnosis her as psychotic. Diaz, however, understood that such a belief is a not uncommon among religious women in Mexico.

"You can't label people right away without knowing their culture and beliefs," Diaz said.

Marrujo and staff have reduced the waiting list from 250 to 40 since they opened. However, like many mental health care facilities in Colorado, the demand still outweighs the number of therapists.

The program treat more cases of traumatic stress disorder and depression than any other illness. Marrujo said that some immigrants go through traumatic experiences arriving to the country and others suffer grief issues from having left behind communities full of family and friends. They also see many cases of battered women and cases of child sexual abuse.

"The family tries to help them, and the community tries to help them in ways that they know, but generally you need some skilled intervention and that's us," Marrujo said. "I think the fact that we add that cultural piece makes it a little different than just traditional therapy."

The program avoided the major budget cuts that many North Range Behavioral Health programs suffered two years ago. In addition, the program receives funding from the Colorado Trust, a grant-making foundation focused on advancing the health and well-being of the people of Colorado.

Marrujo said they are lucky to have a full bilingual-bicultural staff, considering the national shortage in the field.

In an effort to address this need, the center plans to implement an internship program for students interested in becoming bilingual-bicultural mental health therapists. The interns will help the multicultural program treat more clients as well as prepare more qualified therapists for the field.

Other mental health care centers offer services in Spanish, but the multicultural center remains the only one that does so at reasonable rates, said Penny Gonzales-Soto, of Catholic Charities Immigration Services. The center offers sliding rates and works with low-income clients on payment plans.

North Colorado Psych Care offers mental health care services to Spanish-speaking clients with two bilingual therapists, one bilingual psychiatrist and four bilingual staff members. They offer a free peer support group called "Links," said spokeswoman Karen Nicholson.

Diaz said the presence of bilingual-bicultural therapists like herself helps wary Latinos overcome the negative stigma that surrounds mental health in the Mexican culture.

"It's hard enough for them to seek the help that they need," Diaz said. "So once they're here and see that we're here, it makes it easier for them and their family."