It’s a case of supply and demand.
As more people have access to health insurance, there is need for more health care providers, and the pinch is felt in northern Sonoma County especially when patients need mental health services and speak only Spanish.
In response, the county and The Healthcare Foundation Northern Sonoma County, the only funder exclusively focused on health for northern Sonoma County, is trying to lure local bilingual students into health care careers.
“There is absolutely a shortage,” said Susan Castillo, the county’s community mental health section manager. “In general there’s a huge shortage, and it’s huge in psychiatry.”
In California, nearly one in six adults has mental health needs, and one in 20 suffer from serious mental illness. The rate among children in the state is even higher at one in 13 children, according to the California Healthcare Foundation.
In northern Sonoma County, roughly from northern Santa Rosa to Cloverdale, only one third of parents who rated their children as having definite or severe mental health issues had visited a mental health provider in the past year, and Latino children were considerably less likely to have had a visit than Caucasian children, according to a 2016 St. Joseph Hospital Mental Health Needs Gap Report.
One of the biggest problems is the centralization of services in Santa Rosa, and a lack of reliable and consistent transportation, said Debbie Mason, CEO of The Healthcare Foundation Northern Sonoma County. Families may have one car that they share, or take the bus, which takes all day from Cloverdale to Santa Rosa and back, and that means a missed day of work.
Many people also have reservations about going to see psychologist or psychiatrist for mental health problems.
Miscommunication can occur when both parties speak the same language, let alone when they don’t. Patients also feel more comfortable when they can speak freely with their doctors in their own language.
The problem is exacerbated by some providers who say they are bilingual, when they actually are not, Mason said.
“It’s been a silent and growing epidemic and the fires make it that much worse. People will think they are fine, trying to keep things normal for the family, but there is a lot of post traumatic stress disorder experienced after giant disasters like this. You’re running on adrenaline for three or four months, and all of a sudden it becomes an issue. The question then is, where to go for help?” said Mason.
Alliance Medical Center, with clinics in Healdsburg and Windsor, does have a robust Behavioral Health Department and serves many of the Latino families in the region. It saw about 850 behavioral health visits last year.
The center is fortunate to have five therapists, four of which are bilingual, and each sees 9 - 12 patients per day, and the wait for an appointment is only about a week, said Maria J. Alvarez, Ph.D., bilingual bicultural psychologist, and director of the center.
Alliance only has two psychiatrists on staff, however, and each devotes only eight hours per week to the center. One is bilingual, the other is limited bilingual.
If Alvarez has a new patient who is bipolar, for example, the wait to see the psychiatrist for medication is about five months.