Dr. Cynthia Lucero Center 
Latino Mental Health Program (LMHP)

Massachusetts School of Professional Psychology
 
_____________________________________
      Amaro Laria, Ph.D. – Program Director

Presentation: Massachusetts Health Disparities Council Meeting
March 22, 2010

A collaborative effort: faculty, students, consultants, Latino Professional Community

•	20% U.S. general population > 5 y.o. speak “language other than English” at home (21% in MA)

•	…of these => 62% speak Spanish

•	Over 75% U.S. Latinos speak primarily Spanish at home 
    (90% among Dominicans and Central Americans)

•	40% U.S. Latinos report speaking English “less than very well”
    (57% among Dominicans and Central Americans)

•	Working with interpreters proven to be inadequate for effective provision of mental/behavioral health services *

MSPP’s Lucero Latino Mental Health Program 
•	Latinos in the USA:
	
•	In 1990, 9% of Americans identified as Latino or Hispanic: 22 million Latinos
•	In 2002, one in eight (13%) Americans identified as Latino or Hispanic (   from 9% in 1990): 27 million Latinos
•	By the year 2010, one in five (20%) Americans will identify as Latino or Hispanic: 48 million Latinos
•	By the year 2050, one in four (25%) Americans will identify as Latino or Hispanic: 103 million Latinos

Goals of  Lucero Latino Mental Health Program 

I - To increase the number of Latino mental health professionals in the U.S. 

II - To provide psychologists in training (Latinos and non-Latinos) the necessary language skills and culturally-relevant mental health training to deliver quality health care services to the U.S. Latino population
III - Ultimately, to contribute toward reducing the significant disparities in mental health care that disproportionately affect Latinos in the U.S. 

•	Two Major Initiatives:

I – Cultural & Linguistic Competence

•	main program of language & cultural competence studies

II – Latino psychology student recruitment

•	effort in collaboration w/ admissions office to seek increased           recruitment of Spanish-speaking Latino students 

Summer Immersion Program I at “Rancho de Español” in La Guácima, Costa Rica:
Intensive Spanish Classes plus Volunteer Mental Health Services 
[photographs of program participants in Costa Rica]

Summer Immersion Program II at Guayaquil, Ecuador:
 Intensive Spanish Language Training plus Volunteer Social & Mental Health Services
[photographs of program participants in Ecuador]

The Academic Coursework
•	  LMH-I: “The Hispanic World” (introduces diversity of 
       Hispanic/Latino cultures; English/Spanish)
  
•	  LMH-II: “The U.S. Latino Experience” (explores the  
      particular experience of Latinos in the U.S.; taught mostly in    
      Spanish)

•	  LMH-III: “Mental Health Work with U.S. Latinos” (focuses   
     on culturally-relevant interventions with Latinos; all Spanish)

•	  LMH-IV:“Professional Practice in Latino Mental Health”   
     (advanced clinical topics, research studies; all Spanish)
Other Program Requirements
•	Field Placement “internship” working with Latino patients 
 
•	  Research Project (Master’s Thesis; Doctoral Dissertation) 
     on topic with relevance to LMH

•	  Weekly Conversational Spanish language support group 
                (led by native Spanish speaking students)
Other LMHP activities
•	LMHP Welcoming Event (September) – Welcome to new students;    
     presentations by students returning from summer immersion program

•	  LMHP weekly meetings (staff, students)
  
•	  Lucero 5K Run (fundraising event memorializing Cynthia; Sept/Oct)

•	  LMH Conference (every 2 yrs)

•	  Sociocultural Events (e.g., Latino Film Night, Latino Holiday Fiesta)

•	  Latino Mentoring / Networking Event

•	  Involvement in Community Projects (e.g., New Bedford Raid relief work)

Who are our LMHP participants?
2006 – Year 1: 6 participants
2007 – Year 2: 10 participants
2008 – Year 3: 14 participants
2009 – Year 4: 13 partipants.
Most participants are Spanish Language Learners. Others are Native Spanish speakers  (Latinos raised in Latin America) and Advanced Spanish proficient Latinos.

LMHP’s Outcome Measures: as of Spring 2010…
31 LMHP students have participated in Summer Immersion I (Costa Rica) 

14 LMHP students have participated in Summer Immersion I +II (CR, Ecuador)

5 LMHP students participated in optional Summer Immersion III (Guatemala) 

31 LMHP psychology interns currently working w/ Latino patients in   
    various clinical facilities in Massachusetts after having completed 
    specialized linguistic and cultural competence training 

   These interns will have treated more than 500 Latino individuals (children and adults) and families by the end of the training year 2009-2010!

   After our 1st 4 LMHP classes graduate, it is estimated that more than 3,000 Latinos in MA will have received linguistically and culturally competent behavioral health services by LMHP interns

LMHP’s Outcome Measures:  A Case in Point…
Joseph M. Smith Community Health Center (Allston & Waltham, MA)
-  Psych Internship Program in Primary Care Behavioral Health (since 2003)

•	primary care clinic in urban low SES/working class neighborhood with greater than 60% Latino patients (the majority recent Guatemalan immigrants w/ very      limited to no English)
•	medical patients, not seeking mental health services; therefore, strong   
•	resistance to Mental Health Tx and general lack of cultural & linguistic fit
•	every year struggled to recruit Spanish-speaking interns

LMHP’s Outcome Measures:
   Increasing Diversity in the Latino Mental Health Workforce in Massachusetts
After our 1st 4 LMHP classes graduate, we’ll have trained…
  
	- 43 psychologists who can provide linguistically and culturally-competent mental health services to Latinos

	- 14 Latino/Latina psychologists (the majority of them will stay in Mass) 

     …a true workforce pipeline to meet the significant mental health needs of Latinos in the state

LMHP’s Outcome Measures:
…also contributing to our scientific knowledge base of Latino Mental Health
Research Projects    
•	“The Role of Spirituality among Depressed Latinas” 

•	“The Psychological Effects of Child-Mother Separations for Victims of 
           the New Bedford Raid”

•	“The Role of Social Policy Advocacy in Mental Health Work with Socially-Disadvantaged Latinos”

•	“The Role of Acculturation on Views of Severe Mental Illness Among U.S. Latinos

•	“Latino Fathers: The Effects of Migration & Separation from Families 
         on Culturally-based Gender Identity” 

Recommendations for the Committee’s Consideration:
General Considerations:
•	Measures of disparities should be more sensitive to mental/behavioral health.
•	Awareness that interpreter services are generally ineffective and may even be inappropriate for use in behavioral health.  
•	Thus, promote initiatives to increase the development of a linguistically and culturally competent workforce.

Specific Considerations:
•	Upon re-licensure, acquire relevant information about linguistic/cultural competence to accurately assess workforce competence and need.
•	Increase Loan Forgiveness funds at the State level for graduates of language and culturally sensitive behavioral health programs.
•	Encourage replication of this curriculum design for effective provider education and training as a means to address health care disparities among other racial, ethnic and cultural groups.
•	Create public-private partnerships with schools like MSPP to promote training of culturally and linguistically competent behavioral health workforce.