As the tragedy of the Key Bridge collapse unfolded, and more details emerged about the identities of its victims, it began to highlight the need for Spanish-speaking therapists, grief counselors and other services.
In the days and weeks after the collapse, therapists, and grief workers that service Baltimore’s Spanish-speaking immigrant community say they are experiencing a significant uptick in referrals and clients — many of whom were already dealing with previous trauma.
Even before the collapse, the Spanish-speaking immigrant community in Baltimore had been hit particularly hard by a series of tragic events.
A February house fire on Lombard Street left two children and an adult dead, and a crash last year on an Interstate 695 construction site killed six construction workers — several of whom were immigrants.
“Everything adds up,” said Catalina Rodriguez-Lima, founding director of the Baltimore City Mayor’s Office of Immigrant Affairs. “That does take away from someone’s mental health.”
Hispanics are at risk for mental health problems because of factors including language barriers, trauma history, cultural stigma against seeking mental health care, and lack of health insurance, according to the American Psychiatric Association.
The immigrant community is particularly vulnerable for a myriad of reasons, according to Rodriguez-Lima.
Some in that community are fleeing violence and intimidation in their native countries, which causes trauma that results in them coming to the United States, she said. That journey to the U.S. can be lengthy and treacherous. Those who make it to North America have to deal with a language barrier and navigating the process of work visas and citizenship, which can result in crossing paths with people without “scruples,” she said.
“If you are undocumented, there is fear that you will be arrested or deported. There is pressure to produce, there is a family at home, or you have to take care of yourself,” she said, adding that some families are separated during migration, which can also take its toll. “The immigrant story can be very lonely. It may be very challenging.”
Donna Batkis, a licensed clinical social worker and member of the Latino Racial Justice Circle, said anecdotally she has seen a 150% increase in Spanish-speaking immigrants seeking assistance for mental health providers since the Key Bridge collapse.
The enormity of that community’s loss cannot be underplayed, she said.
“Putting their lives on the lines makes grief even more complicated. It has all these confounding factors on top of it, and makes it even harder to work through,” she added.
Spanish-speaking immigrants have found resources via WhatsApp, group forums and neighborhood websites. In addition, schools are doing a lot of work and social workers are providing needed services for children, Batkis said.
Amy Greensfelder, executive director of Pro Bono Counseling, a nonprofit that provides mental health services to those who cannot afford it, predicts that the increased needs in the Spanish-speaking immigrant community will come in the coming weeks and months as people move from shock to grief.
“There is an arc,” she said, adding that 30% of her company’s clients are Spanish-speaking. “People tend to their basic physical needs first and then they seek counseling. As the economic impact is felt, they will start seeking help.”
Latinos, who currently account for 62.1 million people in the U.S., are expected to reach 119 million by 2060 — or 28% of the population, according to Census projections.
The Baltimore area also has experienced a noticeable increase. From 2010 to 2020, the Hispanic/Latino population increased by 77%, from 4.2% to 7.8% of the City’s population. Historically, Baltimore’s Hispanic/Latino population has been clustered in Southeast Baltimore. While Hispanic/Latino population continues to grow and expand in Southeast Baltimore, there are also large and growing Hispanic and Latino populations in South Baltimore, particularly in Brooklyn (129% increase); in Lakeland (up 132%); and Northwest Baltimore, particularly in Fallstaff (74% increase).
Nationally, the numbers of Hispanic psychologists do not reflect the population growth. In 2011, 5.50% of active psychologists were Hispanic. Despite that number increasing to 7.9% in 2021, they are still a rare commodity, according to the American Psychological Association.
Baltimore is no exception, according to local experts.
Having Spanish-speaking therapists and culturally competent therapists for the Spanish-speaking immigrant community is paramount, said Jada McCray, chief operating officer at BTST Services, a Baltimore-based mental health agency with four locations throughout Maryland.
“Clients want to have a native Spanish speaker. They understand the nuance,” she said.
And while it is not necessary to be a Spanish speaker to provide care, McCray believes it makes the job of a clinician easier and more effective, adding that her Spanish-speaking clinicians have had the added toll of coping with their own grief as a result of the recent tragedies.
“There’s a nuance that comes from being fully immersed in the culture that can’t quite be replicated. When you’re a member of a culture, some things just don’t require explanation,” she said.
Ana Carrera, therapy manager at Pro Bono Counseling, said the company is unique because it provides unlimited therapy sessions to clients and works various ways to provide access.
In addition to offering transportation to take clients to in-person counseling, the company also provides tablets for virtual sessions, and there is a hotline for clients to receive services via phone. The company offers educational workshops that teach the community about mental illness so that the stigma of it is erased.
“We want people to really know that there are services if they need it,” Carrera said.
About 10% of the company is bilingual. For the last decade, they have offered the Terapias Initiative, which is aimed at the Spanish-speaking community.
“When people started to know that people spoke Spanish, then the community started to trust us,” Carrera said.
Rodriguez-Lima wants the public and politicians to continue to strengthen the institutions that serve the immigrant community — both public and private.
“Support the institutions. Recognize their role in this puzzle,” she said.