At a north Charlotte health clinic, staff are training to serve immigrant communities. That can mean speaking a common language or taking a culturally-informed approach.
It also means reaching clients that may struggle to find adequate services elsewhere.
Dr. Carolina Benitez directs the behavioral health programs at the Camino Health Center. Many of her department’s clients are newcomers to the Charlotte area. So, her work often focuses on helping people adjust to the community.
“There’s a lot of challenges that come with relocating. Just even think about moving within the United States. And in this case we're working with a community of migrants coming from all different countries in Latin America, even in parts of Europe sometimes,” she said.
For this demographic, accessing health services can be difficult. Language is one barrier.
As North Carolina’s Latino population has grown, Spanish-language mental health services have dropped.
One study by the University of Arkansas for Medical Sciences found the percentage of North Carolina mental health facilities with services in Spanish decreased between 2014 and 2019.
For every 100,000 Latino residents, North Carolina had 6.4 facilities with Spanish-language services. That compared to a high in Vermont of 47.2 facilities and a low in Texas of 2.1. North Carolina ranked 39th nationally.
“We recognized that there was this need, that there was this void in the spectrum of services that are offered in the state and even just in the city,” Benitez said. “It's not easy to find services where you are working with somebody who is from your same culture. It's not easy to find services with someone who can speak your language.”
In Mecklenburg County, more than 124,000 people speak Spanish at home, according to Census data. More than half of those people, 66,000 of them, say they don’t speak English very well. That’s about 6% of the county’s population, and a demographic that Camino aims to serve through low-cost health care.
“Suddenly you're sitting across from someone who understands a little bit of your story, who understands what are the values that are important to you as an individual and to your family,” Benitez said.
That connection can be powerful, and it can influence whether people come back and seek services.
“You start to see more and more referrals. So, rather than people being referred by a medical provider, being referred by social services, being referred by the school, people are coming in themselves and saying, ‘Hey, I'm struggling with this. Can you help me?’” Benitez said.
Community-oriented support
Camino offers three areas of behavioral health services. There are individual and group therapy services. The clinic held about 1,600 counseling sessions last year.
Then there’s peer support and social navigation services, both of which take a community-oriented approach to health.
David Villanueva is one of Camino’s peer support specialists. His job, in a way, is to be a companion and mentor to people with substance abuse disorder.
“A main portion of my training actually comes from my lived experience. I have my own history of substance and alcohol-use disorder. And today I'm a person in recovery,” Villanueva said. “I use that in combination with my education and other specialized training that I've had.”
His cultural background as a Guatemalan-American has helped Villanueva connect with and understand other peers at Camino. But he’s also taken on the challenge of expanding his cultural competencies.
“Being a Guatemalan person is a little bit in contrast to a Latino from the Caribbean or Latino from South America,” he said. “Part of the training is being exposed to the different type of individuals that work at Camino and the people that we serve. It gives me the opportunity to learn from their experience firsthand and then be able to apply that back into the community.”
Social navigation manager Maria Monachesi, originally from Argentina, says the clinic has observed a difference in the needs of established immigrant residents and the needs of newcomers. For people who have recently arrived, their most urgent need might be housing, for example, and Monachesi can help with that search. But there are also urgent medical needs.
A lot of families come with a high degree of trauma that requires immediate mental health assistance such as counseling or psychiatry, Monachesi said, and many people indicate they’ve never had a health check before.
“We support them through the process. We do not expect individuals who faced some type of trauma to just move on by themselves,” Monachesi said. “We want to be with them during that process to really provide the service that they need. And the ultimate goal is to transform their lives.”
A major goal for Benitez is to train more people like Villanueva and Monachesi to serve the Spanish-speaking community.
“Part of the work that we do is actually training student interns from different schools to provide services in culturally competent ways to the Hispanic community. Some of the students that have come here for training have not been Hispanic, have not been Spanish speakers,” Benitez said. “So, we've trained them to work with interpreters, and we've trained them to consider the family values when working cross-culturally.”
She says she would also like to see more investment in training Latino youth to pursue careers in health.
“Hispanic families value education. They want their children to go to school,” she said. “Que se superen, ¿verdad?”
Latino parents want to see their children overcome barriers and reach higher goals, she said. That’s the reason, after all, that many families immigrate.
