It was a busy night at 211 Connecticut, where I worked for nearly three years. 211 does phone intake for a statewide mental health program for youth called Emergency Mobile Psychiatric Services (EMPS). EMPS is designed to help children under the age of 18 who are in an immediate mental health or behavioral crisis. It seemed my coworkers and I were on back-to-back crisis calls.
My phone rang again. When I answered, a clinician from an EMPS provider was on the line. She needed an interpreter. Confused, I clarified what she needed because 211 also does intake for hospitals needing a sign language interpreter. But she was not with a hospital and she did not need a sign language interpreter; she needed a Spanish interpreter for a child.
I informed her I could not make such an arrangement and she would have to follow her agency’s protocol for securing an interpreter. She was upset and stressed she needed to communicate with the child. I apologized and empathized with her urgency, but told her again I could not help. She muttered she wasn’t even sure what the protocol was and she would have to speak to her supervisor. After she disconnected, that call stayed with me. A child was in crisis but was having difficulty getting help because the agency helping him or her did not have a protocol in place. My immediate thought after the call ended was what about Title VI, the civil rights law that says you have to provide an interpreter? Or the CLAS Standards?
What are CLAS Standards, you ask? According to the Department of Health and Human Services website, “The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards) are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the United States.”
But what does that mean, you ask? It means health care providers should have protocols in place to be able provide culturally and linguistically appropriate services to their patients. Providers should be able to speak to patients in the language they speak. This is one of many steps needed to eliminate health disparities. Increasing access to care includes providing care in the patient’s language and understanding the culture in which they live, where they practice health. I do not know the outcome of the call I received that night; legally, I’m not supposed to know what happened. But I often wonder about this child. I put myself in this child’s shoes and it makes me angry. Now, the counter-argument would be this child should already know how to speak English.
This argument would come from my own grandfather, born in Mexico. As a migrant farm worker, he followed the crops up to Duncan, Canada, where he met my grandmother on the Cowichan reservation. When my mother’s family moved to Seattle, Washington when she was a toddler, my grandfather made the decision not to teach his children Spanish. They were in America, he said. They should speak English. This is a choice I, a second-generation American, would regret. There is a connection lost when you can’t speak the same language, a lesson I would learn on a visit to Mexico when I was 12. I felt love and joy on this trip, but also a deep frustration because I could not communicate the way I wanted to with my own family.
I was on a family vacation. This child was in a mental health crisis. Apples and oranges, right?
So what is being done here in Connecticut? The Connecticut Multicultural Health Partnership (CMHP) has a standing Language Services Committee designed to ensure language is not a barrier. At the recent Health Justice CT forum, Brad Plebani spoke about working with Spanish-speaking people in Willimantic and finding out directly from them what is needed. Complaints can be made against providers if a patient feels his language needs were not met.
But it is the dawn of 2014. No child in crisis should have to wait to get services because he cannot speak English. It is time to do more.
Image credit: iStock Photos