Is Competency Training Enough?: Mental Health Organizations and Their Approaches to Latinx Culture

Background and Purpose: While many mental health providers and organizations undergo cultural competency training, disparities in mental health outcomes in the Latinx population remain. Multiple factors contribute to this inefficacy (e.g., clients being under-insured, language barriers, service access that is not culturally relevant, etc.). This paper focuses on the underutilization of mental health services within the Latinx community via an examination of culturally relevant access and treatment efforts. Current research indicates that Latinx persons prefer peer referral or a family-like environment in organizations, but few have the bandwidth to change their service models. Research and practice still lag behind the evolving needs of this historically oppressed community. Using a qualitative lens, the objectives of this literature review are as follows: 1) to analyze how social work practice and research can target areas for closing the gaps we currently see in mental health service and access for the Latinx population; and 2) to examine the current literature across social services to explore program adaptations and options toward improving the ways we work with this population. Methods: Five databases (Medline, Social Work Abstracts, PsycInfo, Academic Search Complete, and Social Service Abstracts; N=81) were used to gather literature in order to capture approaches from various disciplines. Keywords included Latinx or Hispanic, mental health organizations, mental health treatment, mental health service access, and cultural competence, to name a few. Criteria for inclusion required that an article be focused on Latinx persons residing in the United States, written in the last 10 years, focusing on cultural relevance of service or culturally focused access in mental health, and that all articles had undergone peer review. After duplicates were removed and after initial review by date of publication, location, and inclusion criteria, a total of 12 articles were examined. All articles that were reviewed for this study were selected based on how well they met the inclusion criteria before analysis on the entire piece was conducted. Results: Greater decrease in symptoms have been seen when services and access are culturally relevant and developed from an ecological perspective. This decrease also depends on previous help-seeking experiences of the client, on-site wraparound care, and adopting of interpersonal and family norms. Although there has been a renewed focus on cultural competence with this population, there are still issues that go unaddressed, such as a lack of cultural congruence in organizations, clinician prejudice, and minority distrust. Conclusions: Stronger emphasis in organizations on provider bias and the benefits of adopting an ecological perspective may see an improvement in mental health disparity for the Latinx population. Further, offering on-site wraparound services may create the family-like and peer supportive environment that has been observed as effective can lead to improvements in service access. Recommendations for improvement are provided across micro, mezzo, and macro levels of mental health care treatment and access with this population.