Budget cuts and a lack of bilingual therapists, a double disadvantage

Houston – They are a part of our community: children, parents, students, professionals. But in times of economic crisis, their need to access mental health services can make them more vulnerable.

With the proposed budget cuts in the Texas State Legislature to alleviate an estimated $27 billion deficit, mental health services in the Lone Star could have up to $128 million removed from their current services budget.

“It’s scary,” says Sylvia Muzquiz-Drummond, medical director of the mental health division of the Mental Health and Mental Retardation Authority of Harris County (MHMRA).  “With these kinds of budget cuts … waiting lists will get longer, more people will end up in jail, and some people might have to be disengaged out of services…that are stable.  It becomes an issue of public safety.  Harris county is a growing population and what the state has contracted us for has always been the same, with less money.”

The funds provided to MHMRA by the state, she added, have always been to cover the monthly treatment costs of 8,830 adults with serious mental health illnesses and 1,700 children with any mental health illness, not necessarily a severe one.  According to Muzquiz-Drummond, up until three months ago, the agency had managed to serve more than 9,000 adults and 2,500 children per month with these same funds.  Now, she adds, they have no choice but to place those seeking help from her agency on a waiting list, with no definite time as to when they actually will be able to receive treatment.

The 10,000 patients who are currently receiving treatment through MHMRA are considered the most “high risk” of the population.

U.S. Army veteran Felix Martinez (52), a father of four, who suffers from schizophrenia and bipolar disorder, is one of those patients.

At 30, he suffered his first violent episode when all of a sudden he began hearing voices and seeing apparitions in the home he shared with his then girlfriend, Martinez recalls.  By the time police arrived, he was stabbing the kitchen door with a kitchen knife and almost had authorities open fire on him because he refused to drop the knife.

Over the next 22 years, Martinez was in and out of jails and hospitals as he struggled with the increasingly violent episodes of his mental illness.  In fact, the criminal charges he came to accrue during this time included aggravated assault against a law enforcement officer, aggravated assault with a deadly weapon, and attempted murder.  For the latter he was sentenced to seven years in prison, of which he served three between 1990 and 1993.  It was during that final year of his sentence that he first began receiving treatment from an affiliate of MHMRA in the Texas Rio Grande Valley.

“I had the so called blackouts,” says Martinez. “Everything would get all dark, and it was like I had fallen asleep, and every hour or two hours I would wake up again.”  But in reality, he wasn’t asleep, and it was in those times when things would get really dangerous.  After several suicide attempts and even an attempt to kill his own brother, Martinez received the proper treatment.  He is now an employee of MHMRA in its consumer division.

In 2003, he remarried, he now has a seven year old daughter with his new wife, and it has been five years since he’s stepped foot in a hospital because of his illness.  The difference, he says, having finally accepted his illness and taken the proper medications correctly.

Latino problem
For the Hispanic community the situation is even more severe because there are simply not enough bilingual mental health specialists to work with this growing population.

That’s what Ira Colby, Dean of the School of Social Work at the University of Houston, realized five years ago, when both Hispanic parents and mental health agencies, including MHMRA and DePelchin Children’s Center, which specializes in working with children and adolescents, were all urgently asking his institution for more bilingual professionals.

Although most children in Hispanic homes are fully bilingual, says Colby, and can communicate without any issues with an English-speaking mental health specialist, that is not always the case for many of their parents.

The need is obvious: Bianca Walker, director of behavioral health services for DePelchin Children’s Center, points out that her agency’s only six bilingual therapists are responsible for approximately 1,200 individual cases in Harris county.

Over the past five years, the University of Houston has spent much time and effort in providing scholarships to bilingual students interested in obtaining a master’s degree in bilingual social work.  However, they recognize it is still not enough to deal with the growing problem.

“We recognize there are many people who are not fluent in English…” says Colby.  “Being able to have a fully bilingual professional…means you’re able to pick up on the small little pieces that might be significant clues to whatever issue that person or their family might be facing.”

Support for families
For Guatemalan Sergio Aguirre, dealing with his nine year old daughter’s illness has been an exhausting and bitter process.

When she was two years old, her pediatrician recommended he and his then wife take her to a specialist because she was still not speaking.  The diagnosis was autism, and almost immediately her treatment began.  Aguirre placed her in speech therapy and by the time she entered pre-K, Anna-Michelle spoke well enough to participate in special needs classes.  Something her father acknowledges he struggled deeply with to accept.

“A parent never expects to have his or her son or daughter diagnosed with a mental illness,” says Aguirre. “My problem was not understanding her mental illness, my problem was accepting it.”

Anna-Michelle’s constant care needs, in fact, led to her mother making the decision to abandon her two children two years ago.  Aguirre recognizes she was the main caretaker of their daughter during the first five years of her diagnosis.

In the National Alliance on Mental Illness of Houston (NAMI), however, the father found the help he needed to finally accept his daughter’s mental illness.

NAMI is a local non-profit organization run primarily by relatives of people diagnosed with mental illnesses.  Its aim is to provide information on the various forms of mental illnesses and to offer support groups to members of families, especially parents.

“In reality, this is a process whereby all reserves of hope and of the possibility of believing that things will one day get better, are being mined, little by little…into nothingness,” confesses Aguirre.

This story was originally published in Spanish in the Houston Chronicle’s Spanish-language publication, La Voz de Houston.  It was translated to English by the author, Juan Alanis, and may be found in its original form HERE.

When to act if you suspect a mental issue:
Experts say the most important thing for parents to know is that they are not losing anything by seeking a professional opinion if they suspect their child could be presenting symptoms of a possible mental illness.  The following are guidelines for determining whether a child requires a professional evaluation:

-       If a parent suspects their child may be suffering from a mental illness they should seek a professional evaluation.  Experts recommend parents trust their instincts.

-       If a child says he/she wants to die or does not want to live any longer, this should always be taken seriously, and the child should receive immediate attention from a professional.

-       If a child becomes increasingly isolated, their school grades drop suddenly, if they are increasingly irritable, or sleep too much or not enough.

-       If a friend of your child expresses concern about their wellbeing.

-       If a child compulsively bites their nails or washes their hands, or develops any other compulsive behavior.

-       If a child eats too much or not enough.

-       And always, if a child has experienced any form of trauma in their life.

Sources: Sylvia Muzquiz-Drummond, medical director of the mental health division MHMRA, and Bianca Walker, director of behavioral health services DePelchin Children’s Center.

Financial aid for Bilingual Social Workers:
Each semester the School of Social Work at the University of Houston offers five full scholarships, as well as several partial scholarships, for bilingual students seeking a master’s degree in social work. The requirements are:

-       A bachelor’s degree in any discipline.

-       A grade point average of 3.0

-       The student must complete the two-year program.

-       60 credit hours are required.

-       Students must be attending school full time in order to qualify for any kind of financial assistance.

-       920 hours of field work must also be completed as part of the master’s program.

-       After receiving a master’s degree, if the student received one of the five full scholarships, they must work for a local social work agency for a minimum of two years.

-       The current full scholarships cover tuition, fees, and books, approximately $ 12,500.

Source: Ira Colby, Dean of the School of Social Work at the University of Houston.