Think Out Loud

How an Oregon group is expanding mental health care access for the Latine community

By Rolando Hernandez (OPB)
Oct. 20, 2022 11:37 p.m. Updated: Oct. 28, 2022 10:15 p.m.

Broadcast: Friday, Oct. 21

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House Bill 4074 allocated $6 million to address the mental health of Oregon cannabis farm workers who faced poor working conditions at illegal farms. Racies de Bienestar, an Oregon-based nonprofit that focuses on the Latine community, will be receiving a part of that funding. Starting sometime this fall, the group will launch their program and provide more care to this community. Ruth Zúñiga is the executive director and co-founder of Raices de Bienestar. She joins us to share the barriers and stigmas this community faces when trying to access mental health care, and how she and her group are working to address them.

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Note: This transcript was computer generated and edited by a volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Earlier this spring, House Bill 4074 allocated $6 million to address humanitarian concerns for Oregon farm workers at illegal cannabis operations. The bill had bipartisan support and didn’t receive a single ‘no’ vote in either chamber. Raíces de Bienestar, an Oregon-based nonprofit that focuses on the Latinx community, will be receiving a part of that funding. Ruth Zúñiga is the executive director and co-founder of Raíces de Bienestar. She joins us right now to talk about the group’s work. Welcome to the show.

Ruth Zúñiga: Thank you so much, Dave, for having me. It’s a pleasure to join you this afternoon.

Miller: What are the specific issues that farm workers at these illegal cannabis operations can face?

Zúñiga: Excellent question. One of the things to talk about, what is it that these farm workers are experiencing now, we have to even go back to what they have experienced in general. When it comes to people from the Latinx community – immigrants, people from Latine communities, especially people who are migrant farm workers – they tend to be very underserved. They tend to be excluded from services, from systems, from access of care, from access to resources. There is many challenges already that migrant farm workers and seasonal migrant farm workers experience.

With these issues of people affected by the marijuana, illegal marijuana and hemp industry, the challenges go a little bit more profound and more difficult because there is … When legal involvements [are] happening with these, and illegal industries are happening with migrant farm workers, sometimes they don’t know where to report. They don’t know if things are illegal or not. They may feel a sense of mistrust already with the system. They may not know how to ask for help, and sometimes they may not even recognize what is the help that they need. These create challenges that are not only barriers for them, but also challenges for us to be able to provide the services that they need.

Miller: So where do you even start if there is a healthy, and actually understandable, dose of mistrust for any kind of outsider – including outsiders who speak, say, Spanish or an Indigenous language?

Zúñiga: Where and the question is where to start with creating that trust?

Miller: Yeah.

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Zúñiga: The way to start there is … We can just talk about it at the individual level. But much of this starts – at least the way that we work – is working with the people that already have a trusting relationship with community members. That is community leaders, just members of the community that have supported individuals in different ways, that are visible, that are present in people’s lives every day. Much of this work is what community-based organizations such as the ones that we are partnering [with], like Centro de Servicios para Campesinos, PCUN, UNETE. These are community-based organizations who have people in the field every day, every moment, hearing, experiencing, understanding what these migrant farm workers are experiencing. Because they are visible, they are available, that’s one way to create that trust. For us in the mental health field, that means that if we want to create a trust, we have to also be there. I have many people that have never seen a psychologist or a mental health provider, not [only] in the therapeutic setting, but in their life. They may have seen or they may know a teacher, they may know a nurse, but they may know a mental health provider. There is so much a stigma in regards to mental health and what we do and what we offer and how we can support, that we as providers have to be visible. When I say visible, we have to be there. We have to bring our services to people and don’t expect that people are gonna be able to navigate all the barriers to get to us.

Miller: What are some of the cultural taboos or concerns that you have to overcome when you’re dealing with groups of people who either have no previous experience with mental health professionals or might be mistrustful of the whole endeavor?

Zúñiga: The first thing is understanding that much of that stigma, unfortunately, is created by the system. What people may think and see about mental health is just one idea of mental health. Very few times we talk about mental health as well being. Very few times we talk and understand that mental health is not only about pathology and illness, but it’s about being well, being able to be a productive member in society, being able to feel wholesome and balanced in your life. So if we understand this component, that mental health [is] not only about illness and pathology, it’s one way to deal with that. But [to] your question about what are some of these myths or some of these misconceptions, some of that is the idea of what mental health is, thinking again that it’s about pathology. Also, mental health, the way that usually [inaudible] and the way that people usually are even able to get reimbursement, for example, providers or the way that people are able to access, usually is thinking about only this single, Western oriented, therapy-involved sessions that many of us think that is on a couch, or that we just go and open ourselves to a therapist, and it’s just these kinds of services that many times, again, we see in the movies. And that’s far from reality. That’s one of those things that the community may think that mental health service is about this.

Not recognizing that for generations we have been engaged and we have been engaging in different ways of mental health and well being: that communities have a lot of rituals, practices, community events, culture that helps with mental health and well being. Those things are important to celebrate. But there is also a lot of stigma in regards to what others may think. A lot of us, we don’t want to share about our pain or our difficulties, our suffering because we don’t want other people to know. There is a saying in Spanish that says, ‘La ropa sucia se lava en casa.’ Pretty much, it means you don’t air your dirty laundry, with this idea that, let’s keep the family secrets within ourselves. Let’s keep the issues that are affecting bottling up because we have to demonstrate that we are strong, sometimes because we don’t want to affect our family or because we don’t want to worry or preoccupy our family. There is also this idea that mental health is about mental illness and about craziness. Sometimes there is this idea that only these kind of people, and usually the ones that are more severely affected – their mental health severely affected – are the ones that look for mental health services. That is just cultural beliefs. Then there are other barriers that affect our community to access services: from lack of providers that understand the culture, to very few providers that may speak Spanish or Indigenous languages, to how difficult it is to access mental health service, for an individual from the dominant culture, even. It’s hard for an individual from the dominant culture to access mental health services and to navigate the process. It’s even harder when you don’t understand the system.

Miller: What role does religion play in what we’re talking about, in terms of either a reticence to access these services or a cultural framework, a religious framework, for providing people a way to address certain issues they’re dealing with?

Zúñiga: Religion can play different roles. On the positive and strength space, many community members find strength, find support, find healing through congregation, through their religious belief. Even for people in the Latinx community, many of us that may not practice any specific religion, there is so much within our culture that is based on Christianity that sometimes it is difficult to separate religion from our, or at least a spiritual components, with our everyday life. So for some members, it can be a very positive asset in their lives. We actually work with parish leaders with a program that is called Promotores de Salud de la Iglesia. There are community leaders, community helpers, that are in parishes who are able to help community members navigate different systems, including mental health systems, to connect members to those services and connect services to those members. So there is a lot of positive things that happen in congregations and in religious communities.

But also, for other community members, sometimes religion can be a negative influence because there is this idea that, if you pray enough – if you do A, B and C – you’re gonna be able to get the support and the help from God or a supreme being, that maybe it’s that you don’t have enough faith. There is this pressure that your mental health is connected, and has to be connected, with your faith; if your emotional health and well being is not positive or not healthy, then it’s because there is something wrong with you or something wrong with your belief of the way that you are engaging in your faith. We can see this, again religion playing both roles, that can be difficult because in some ways it may play both roles in somebody else life. Like, religion may give an individual a sense of connection but at the same time a sense of disconnection, if they are being cast out or if they are being told to do certain things or not do certain things. Sometimes also unfortunately invalidates people’s experiences: when you have a difficult moment in your life and somebody says, ‘I [inaudible] you should pray more’ instead of saying, ‘I’m sorry for what you’re going through. Can you tell me more?’ and allow that person to share about their experiences. Instead when we go and say you should do this and go immediately into the solution approach that has to be found specifically on this, whatever it is, it’s very invalidating for the individuals.

Miller: Do you have enough Spanish-speaking or Mam-speaking or other Indigenous languages, enough mental health professionals that actually speak languages to help the people you want to reach?

Zúñiga: Unfortunately, not. It’s one of the challenges that we have in this state. There is not enough providers who speak Spanish, and also there is even less providers that speak Mam Indigenous languages. There are several reasons for that. It’s really difficult for many people who are coming from the Latinx culture who are bilingual to become a healthcare provider, to become a mental health provider. The pipeline to get to this kind of profession is challenging, it’s difficult. The other thing is because usually the only people that provide mental health services have to be professionals within these stipulations and these requirements, which is important. But there is a lot of people in the community that are doing amazing work – with validating people, with supporting them, with providing some tools – that sometimes they don’t get the recognition or they don’t get the extra support to support the individuals. So what I’m going to say here is that, because we don’t have enough providers that are able to provide culturally specific, culturally informed… because it’s beyond the language. It’s not only about the language but also about are these people able to understand the culture and to work with different cultural frameworks that are responsive to our community. But because there are not enough providers, we should invest in other people that are already doing a lot of the work, so they can have extra skills to support the community, and also where they can work on prevention of mental illness as well.

Miller: Ruth Zúñiga, thanks very much for joining us.

Zúñiga: Thank you. It was a pleasure, and I really appreciate the invitation.

Miller: Ruth Zúñiga is the executive director and co-founder of Raíces de Bienestar.

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