Therapieces: Let’s Talk About The Lack Of Mental Health Care For Puerto Ricans

Illustration courtesy of Refinery29.

Mental Health — we all have it, and now we should all strive to be more open and vulnerable about it. TheraPieces* is a Slice of Culture monthly column by Mendez, who has a Master of Social Work degree in clinical/medical social work.

May is Mental Health Awareness Month.

In an era where the importance of mental health care is increasingly recognized, the accessibility and efficiency of mental health services for regular citizens in the United States have emerged as crucial topics of concern. However, amongst the Puerto Rican community, there has been challenges in accessing and utilizing these resources.

While strides have been made in recognizing and addressing mental health needs across the nation, disparities persist amongst the Boricua population due to a complex interplay of cultural, linguistic and systemic barriers. 

According to Heathline:

“Puerto Ricans, both in Puerto Rico and the United States, have higher rates of depression than the general U.S. population. Research exploring depression in Puerto Ricans is somewhat limited, especially for people actually living in Puerto Rico. 3,062 Puerto Ricans living on the island — found that people living in Puerto Rico had roughly 27% higher rates of major depressive disorder (MDD) than the U.S. population (9.7% versus 7.6%).” 

Puerto Rican’s mental health challenges and illnesses, specifically depression and anxiety, are influenced by a myriad of factors, including historical and intergenerational trauma and abuse, socio-economic disparities and cultural stigmas. However, many of the barriers to access assistance, stem from sociopolitical, acculturation and economic circumstances of Puerto Rico.

Significant barriers include:

• The island’s ongoing economic crisis, which has strained healthcare resources and led to a shortage of mental health professionals.
• The linguistic barriers, as services may not always be easily accessible and available in Spanish or may be provided by professionals who are not culturally and linguistically competent. 
• The historical and ongoing trauma resulting from natural disasters, such as hurricanes and earthquakes, exacerbates the need for mental health support, yet resources remain limited.
• The stigma surrounding mental illness within the Puerto Rican culture can deter individuals from seeking proper professional help, further complicating access to care. 

These combined factors underscore the urgent need for comprehensive efforts to improve mental health services and support for Puerto Ricans, both on the island and within communities in the United States.

A non-profit organization, known as the Puerto Rican Family Institute (PRFI), is a family-oriented human services agency providing mental health services and various supportive programs such as crisis and residential programs.

PRFI focuses on the person-centered, holistic approach to the direct needs and care of the individuals they serve. They currently operate at three different locations in New York, but they once had offices and locations operating in the Jersey City and North Bergen area.

Besides their work on Catholic charities, PRFI managed a large caseload of individuals, providing services that included free clinical therapy with social workers and psychotherapists, as well as medication management from their psychiatrist. But due to lack of funding, the PRFI closed both of their New Jersey locations, and all of the individuals seeking treatment were transferred to the care of their local hospital, clinic centers, and other catholic charity institutions.

This setback created an even heavier disparity and burden among Puerto Ricans’ access to efficient mental health care services. PRFI accepted all insurance types with also access to a sliding scale for a more accessible way to pay, even providing services for free. They provided a space where all individuals and those of Puerto Rican and other Hispanic backgrounds could gain accessible, affordable and efficient mental health services. 

Many mental health services do not provide government insurances such as Medicaid/Medicare, which limits those of low-income and on disabilities status towards proper access of mental health services. This limitation perpetuates a two-tiered system where those with private insurance receive better access to a wider range of mental health services compared to those reliant on government-funded programs. 

Continuing to identify and address these issues among Puerto Rican’s access to mental health care are crucial.

Mental health providers should continue to advocate for increased funding for mental health services within government insurance programs to expand coverage and reduce waiting for appointments. Incentives for mental health professionals to accept government insurance should also be provided, such as reimbursement rates that reflect the true cost of care.

Integrating mental health services into primary care settings can improve access for individuals with government insurance by reducing the stigma associated with seeking mental health treatment and providing more convenient access points. 

If you want a specific topic related to mental health covered, Daniella Mendez may be reached at dmendez@athenapsych.com.