As the pandemic continues to rage within the communities of Everett, Chelsea and Revere, every day it becomes more apparent how much more the virus impacts communities of color than other racial groups.
This is particularly being shown to be true in the Latino community – whether it is documented or undocumented immigrants, and even those that are citizens.
One Mass General researcher told a teleconference sponsored by the Robert Wood Johnson Foundation last week that now is the time for communities and medical providers to prepare for the psychological impacts on Latino families that will begin to show up in the coming months.
“We should be ready for the post-mental health challenges that will come after the virus, particularly in Latino families,” said Dr. Margarita Alegria, one of the country’s preeminent experts on racial and ethnic disparities and chief of the Disparities Research Unit at MGH. “There is such psychological stress from foreclosure, job loss, sickness, and it brings on depression, anxiety and substance abuse. This psychological stress is higher on low-income people and intensifies their risk. We need to be prepared for all this, especially in vulnerable populations where they may have job loss and were already challenged economically…It would be tragedy to have another wave of death due to these disparities and we are not ready.
“There is a real opportunity to be ready and to serve Latino and minority families,” she continued.
While other communities of color, such as Black/African American populations have also suffered from COVID-19 disproportionately, Alegria said it was particularly the Latino community that is most at risk due to the fear and anxiety over losing housing, over immigration status and over the new public charge rules. The public charge rules are a branch of immigration law that began to be enforced again this year, and it prohibits legal immigrants from accessing government benefits for a period of time – with grave consequences for their citizen sponsors if they do.
“What we have seen on the ground for undocumented families is that it’s even harder for them because they aren’t being recognized for receiving benefits from the government,” she said. “Families are very, very afraid to go forward, whether it is for reporting domestic violence or even going to medical facilities for testing because they feel information will be used against them for public charge or to deport them. People don’t want to talk about information or about being sick or giving information.”
She said there are also reports of landlords throwing undocumented families out if they think one or more of them has gotten sick with COVID-19, despite the many protections put in place by the courts and lawmakers.
All of that has primed the Latino community for severe mental health and anxiety challenges in the coming months – challenges that could exacerbate the current situation in large immigrant communities like Everett, Chelsea and Revere.
Alegria said now is the time that the state and federal government should focus on non-profits in the communities – ones that those on the fringes or in Latino communities trust. It is there, in association with local health centers, that Alegria believes early and frequent mental health check-ups can ease the problem.
“Making money from federal stimulus packages to these community-based organizations is important and I would advocate doing that,” she said. “I would advocate training workers at these community-based organizations to offer mental health counseling under the supervision of clinicians and primary care providers. That could be the way to go. We have done this before when we used community-based organizations in other situations. These are the places people trust and will turn to when they won’t go to a medical facility.”
She said the key would be accessing federal monies for such a program and making sure the proper training is put in place.
“These workers and staff members would be supervised and trained by clinicians,” she said. “It’s doable, but we need to make sure resources are going to these community-based organizations and make sure they are received for these services.”
These organizations in local communities could perform in-person visits – perhaps in association with a Food Pantry – or they could be trained to do tele-health appointments and check-ins. Many of these organizations, she said, have already been on the front lines of Latino communities and have been helping residents with food, diapers and living expenses. They have built up tremendous trust, Alegria said, in a way that a health center or hospital has not. To tap into that trust to treat mental health in the coming months could be a tremendous help for adults and children in those communities who are going to suffer from the trauma of the last eight weeks.
If situations and symptoms are too difficult for simple counseling, the association with clinicians at a local health center could be used for support – as a referral where a trusted person relays the patient to a more qualified physician. “We know we need to get them mental health supports early on,” said Alegria. “In past epidemics and recessions the people who do well have emergency mental health supports and ongoing maintenance afterward.”