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Project Resilience: How Cultural, Language Barriers Can Impact Those Seeking Mental Health Care

For Utah Spanish-speakers, there are many challenges when it comes to accessing mental health services, from language barriers to figuring out what services are affordable. The pandemic has brought the added stress of job and income loss for many. 

But for Isabel Allende, the first and biggest hurdle was acknowledging the need. 


“I am Isabel Allende. I am 40 years old and I live in Magna, Utah.


“I have this condition, which is known as anxiety and it is something that happens in the brain. The amygdala is active and is always saying that you are in danger and it brings me moments of anguish, for no reason. 


“I grew up in Mexico. In Mexico, those of us who are of humble origin do not go to the doctor unless we have something very serious, like a notorious disease. So I never received medical attention. It was many years after I found out I had this condition. It caused me a lot of instability during my childhood and adolescence.” 


While she tried counseling after coming to the United States, the stigma still held her back. She was not very open to it. But later in life, something happened that caused her to seek mental health services with a lot more intensity. 


“The issue was when one of my children began to have physical symptoms,” said Allende. “This was after he fainted at school and this was when his severe anxiety began, but I did not understand at the time. My son said ‘My heart hurts,’ and I said, ‘It is not possible that your heart hurts.’ 


“I tried to explain to him and tell him how it works and he would say, ‘You don't understand me, I'm telling you that my heart hurts. It hurts and you don't believe me.’ I was trying not to pay much attention to him because I thought, ‘He's trying to get attention, but that's not the way.’ 


“Days passed and he continued with the same symptoms, so I took him to the cardiologist. … The cardiologist said the same exact thing, that there was no problem with his heart. He also gave him the same explanation. My son did not believe that they were telling the truth. He said: ‘They are lying. I have something because I feel bad and they don't want to tell me. And because they don't want to tell me, I'm going to die because they aren't treating me.’  


“He had the courage to share what I did not have the courage to share as a child. He had the courage to share it with me and his own mother didn't believe him. I think it was must have been very difficult for him and I have asked his forgiveness many times.  


“When he began to fall into depression, that was what made me take action. Now I had the desire to search and to learn, because I wanted to know what was wrong with my son. So I started looking for more help, I went back to the pediatrician. Now I was the one with the questions. 


“They explained to us that all the physical symptoms he had were real and not a product of his imagination.  


“I started looking for more programs and workshops. I started talking to my friends about what was happening. Many of my friends told me he just wanted attention.  


“Now it is about learning how to handle it, how to help others and that is what has made me not complain about why it happens to me.” 


Isabel found a support group that helped, too. Her group, like many others, was interrupted when the pandemic hit—arguably at a time when they were needed the most. But least one Utah provider has adapted to providing mental health services in the age of COVID. 


Sister Veronica A. Fajardo is a therapist with Holy Cross Ministries and a sister of the Holy Cross. The ministries’ counseling program focuses on underserved populations, and it collaborates with other services in the Salt Lake, Summit and Wasatch counties to provide a number of mental health supports. She collaborates with two of their support groups. When COVID hit, they were interrupted, but they eventually picked up again on Zoom.  


In addition, Holy Cross also added some short-term groups specifically geared toward helping people deal with pandemic stress. 


“Let's do some exercises,” Fajardo said. “Let’s do some anxiety-reducing exercises, things you can do with your kids on mindfulness. So those we did this short term, and then recently, we ran another set of groups. And this time, we collaborated, Holy Cross ministries collaborated with Latino behavioral health. And we took turns once again, when the situation happened at the Capitol. … How do you you know, work with tolerance when you're having issues like what happened in the Capitol on January 6. So just to really provide that for the families, I think that was helpful.” 


So what is different when you’re zooming in on a support group? 


“Obviously, when you're face to face, people actually get to know each other,” Fajardo said. “And it feels more like community building. When you do them via zoom, I've noticed that they vary that, you know, and we don't force people, obviously, if they don't want to have their camera on. But I noticed that when we do it via zoom, a lot of people choose not to have the camera on. … But I think that that the loss is that sense of community of that personal connection, which is a difficult thing.” 


One other change is more participation. The number of clients has increased.  


“I think that we have gotten better and helping our communities,” Fajardo said, “Especially Spanish speakers, to be able to have access either to the internet or you know, sometimes the schools provide free internet and they have to just go to the parking lot. And so sometimes I've had that, the clients go to a parking lot if they don't have access to the internet on their own phones. And so yeah, the numbers have increased. 


“And they vary, I have to say that they vary, some of them want to have now, right now, post-COVID. And once we opened up again, some clients, what I've noticed is they want to do the first session in person, just to kind of for them to get to know who you are and who I am as a    person. But then, later on, they decide that it's okay for them to do it virtually. … When we did the short-term groups, those tended to have a higher attendance, I think because people could commit, you know, for about a month. It was harder, it's harder for them to commit long term.” 


Isabel said face-to-face groups were a great help to her.  


“It always helps a lot to listen to other people's experiences,” she said. “You begin to identify or recognize the symptoms someone is sharing is and you think, ‘Oh, that happens to my son,’ or ‘That happens to me.’ It makes us feel like there is someone who understands us.”