Mental health workers are needed for outreach to Fresno’s low-income residents | Opinion

When community health workers from Fresno travel to the region’s rural communities and disadvantaged urban neighborhoods to provide support, one issue keeps coming up again and again: Growing numbers of San Joaquin Valley residents say they are experiencing acute mental health challenges.

Whether they are worried about where their next meal will come from, the arrival of an unexpectedly high utility bill or the disappearance of the last anti-eviction programs from the COVID era, stress is mounting.

And in this region, it often doesn’t have anywhere to go.

One out of every five Valley residents — including 25% of those with low incomes — say they tried to make an appointment for mental health care in the last year, according to a new regional survey released recently by the California Health Care Foundation.

But more than half of respondents — 54% — said it was difficult to find a provider who takes their insurance. Among those who were able to find a doctor, 62% report waiting longer than they thought was reasonable to get an appointment. Fully half of Valley residents believe the region doesn’t have enough health-care providers, especially for mental health issues.

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They’re certainly not wrong. For years, the Valley has been a federally designated health professional shortage area, meaning Fresno and the surrounding communities have quantifiable shortages of doctors in nearly every medical specialty.

The region has limited access to mental health care services in particular, especially culturally and linguistically competent care from providers who speak the same language as their patients and who have firsthand experience with their lives.

Half of Latino residents says it’s somewhat or very important to find a doctor that shares their ethnic or racial background — but more than a third of Latinos, who make up 57% of the region’s population, say it continues to be difficult to do so.

With these worries piling up, the question is: What can we do about it?

Cultiva La Salud is a community organization that works with partners across the region every day to connect residents to local resources and find mental health supports for those who can’t find it anywhere else. This includes training community health workers in mental health first aid, and working with school districts to connect struggling families with school psychologists or social workers.

But community groups can fill only so many gaps. Local managed-care plans, health-care providers, county government and behavioral health agencies have critical roles to play in increasing access to mental health services. It’s particularly important that they double down on their efforts to train and recruit racially diverse and multilingual mental health practitioners to serve our diverse communities.

Given the enormous health work-force shortages in California right now, the San Joaquin Valley can’t do it alone. There is much the state must do to build the work force needed to ensure more people in the Central Valley can get the care they need.

Five years ago, the blue-ribbon California Future Health Workforce Commission identified 10 priority actions to close workforce gaps — and build a pipeline of health workers who look more like the Central Valley. Expanding the number of community health workers was one of the commission’s top recommendations, since this culturally and linguistically diverse work force is uniquely equipped to provide care in California’s underserved communities.

State leaders have begun to embrace this approach, setting a goal of training 25,000 new CHWs by 2025. Advocates are working to increase Medi-Cal reimbursement rates for community health workers to ensure wages are high enough to attract workers into this important field.

Our elected representatives need to recognize that they also play a decisive part in prevention. Governments contribute to the socio-economic conditions that affect the mental health of their constituents. Reducing stress helps build resilience and keep people healthy; this requires dedicated efforts to promote food security and reduce hunger, income supports to alleviate poverty and real affordable housing options.

It may take time for these changes to be fully implemented and have an impact. But these are the right goals and the right investments. Only if we keep pushing for them can we find a way to assist everyone who may be quietly struggling in our communities.

Genoveva Islas of Fresno is the founder and executive director of Cultiva La Salud. She is also a Fresno Unified School District trustee. Carlina Hansen is senior program officer, Improving Access, the California Health Care Foundation.