Latinxs say they could benefit from more Spanish-speaking staff in drug treatment, recovery housing, and mental health facilities in Philadelphia.

Jean-Paul Torres said he knows there are challenges for Spanish-speaking people seeking recovery since they’re not the majority.

“Sometimes we don’t [have] the tools for [getting] in recovery because a lot of doctors speak in English [and] a lot of social workers speak in English,” said Torres, 31, a Puerto Rican native who is in recovery.

There aren’t many Spanish centers in the area, he added.

Despite the City of Philadelphia’s recent expansion of addiction treatment services in response to the overdose crisis, people with substance use disorders and advocates claim that recovery, treatment, and mental health services aren’t equally available for Spanish-speaking people compared to their English-speaking counterparts. Many of them said there is a need for more Spanish-speaking staff in these spaces.

The lack of widespread resources for Latinxs is happening while the number of Hispanics dying from overdoses in Philadelphia rises. In 2017, Hispanics were the demographic with the highest increase of opioid-related overdose deaths at 60 percent, up from 89 to 136 from 2016, according to the Philadelphia Department of Public Health. In 2017, there were 66.6 opioid-related overdose deaths per 100,000 Hispanics or Latinxs in Philadelphia.

For Roz Pichardo, who works at a harm reduction organization in Kensington, having to speak someone’s language fluently isn’t necessary when reversing an overdose. Language isn’t a barrier at that moment. The true difficulty begins when she tries to help Spanish-speaking people with substance use disorders get treatment.

The drug treatment facilities Pichardo contacts in Philadelphia, like the Kirkbride Center and the NorthEast Treatment Centers, need more bilingual staff members, she said.

“You have to wait longer when you’re Latino because they have to wait for somebody who speaks Spanish,” Pichardo said. “Not every facility has a Spanish-speaking person. And if they do, they’re only like in mid-shift or in the morning shift. They’re not 24-hours.”

Regan Kelly, CEO of NorthEast Treatment Centers, said the centers, which has six addiction recovery services locations in Philadelphia, have bilingual staff members. If a staff member isn’t present, they use a phone interpreter service for intakes.

“It certainly makes it a little bit more challenging to always have someone who is bilingual available,” Kelly said. “But that’s why we also use the interpreter services.”

According to Kelly, NET Centers tries to recruit more bilingual staff through culturally-specific resources like newspapers and websites, too.

Kelly said the centers have a good referral relationship with organizations in the city that serve Latinxs like Congreso de Latinos Unidos, Hispanic Community Counseling Services and Asociación Puertorriqueños en Marcha, which provides drug treatment services.

“Quite often, if we feel we can’t serve somebody we’ll make sure they get to the right place,” she added.

Elvis Rosado, the coordinator of community engagement and education at Prevention Point, said the language barrier is one of the biggest issues for Latinxs who seek treatment. Even if a facility gets a translator from the city for an initial intake, there needs to be more “therapeutic” bilingual staff, Rosado said.

Pichardo said the process frustrates Latinxs who seek treatment and then find themselves waiting for someone who can talk to them. If facilities had more Spanish-speaking staff, people would feel more comfortable instead of wanting to walk out, she added.

“They feel like they’re being ignored,” Pichardo said.

"Not every facility has a Spanish-speaking person. And if they do, they’re only like in mid-shift or in the morning shift. They’re not 24-hours."

— Roz Pichardo, harm reduction advocate

‘Why can’t it be in Spanish?’

When Javier Reyes, who is in recovery, first tried to enter a recovery program, not being able to speak Spanish at Narcotics Anonymous meetings was difficult, he said. Reyes, 35, has learned more English since leaving Puerto Rico five years ago.

“I used to get mad I was like, ‘Why can’t it be in Spanish?’ At least now we’re going to groups in Spanish,” he said.

In Philadelphia, Spanish-speaking Narcotics Anonymous meetings are held on Mondays at Visitation B.V.M. Church in Kensington, according to the Greater Philadelphia Region of Narcotics Anonymous. Bilingual meetings are held on Fridays at Girard Medical Center and on Wednesdays and Saturdays at Visitation B.V.M. Church.

Reyes has been living at Restoration Home Center, a recovery house for Latino men on Kensington Avenue, for a month. While being able to speak English made his experience easier, he said  that isn’t the case for other men in the Spanish-speaking house. For example, he said visiting the welfare office in Philadelphia can be a challenge.

“Not everywhere we go they speak Spanish,” said Reyes, who sometimes translates for others in the house.

Carlos Delfau, 42, is the house manager at Restoration Home Center. Delfau runs the daily operations and helps show the men who stay there that it’s possible to have a “normal life,” he said. Restoration Home Center mostly houses Puerto Ricans, but there are two men from Cuba and the Dominican Republic living in the house right now, Delfau added.

The men attend religious services at Philly Harvest Church in Kensington and receive outpatient treatment at New Journeys In Recovery in Fairhill and mental health services at Citywide Community Counseling Services in Kensington.

The treatment and mental health services at both locations are offered in Spanish, Reyes said.

“At least we have that privilege,” Reyes said. “If it would have been in English, it would have been kind of difficult.”

Torres, who also lives in Restoration Home Center, said there is a need for more clinicians who are Spanish-speaking. For Torres, needing to use a translator makes him uncomfortable.

“You want to express yourself,” Torres said. “And you cannot. You do not feel comfortable telling your things to a [translator] next to you.”

“The language is a limitation of the treatment,” he added.

Casa De Consejeria, which has two locations in Fairhill, is a treatment facility in Philadelphia that offers outpatient and intensive outpatient services for Latinxs in Spanish. The outpatient program requires a minimum of individual counseling twice a week and a one-hour group counseling session each week. The intensive outpatient program requires individual counseling once a week and three group counseling sessions, which last for three hours.

Jennifer Guzman, the administrative assistant at Casa De Consejeria, said about 75 percent of the staff speaks Spanish and there is a translator available for all group and individual therapy sessions.

North Philadelphia Health System’s Torre De La Raza is an in-patient, treatment facility with a 16-bed program for Spanish speaking men in Girard Medical Center. Ana Vazquez, program director and clinical supervisor for Torre De La Raza, said about 60 percent of the staff speaks Spanish, and the facility reviews job boards like Indeed and communicates with human resources to recruit more bilingual applicants.

“You want to express yourself and you cannot. You do not feel comfortable telling your things to a [translator] next to you.”

— Jean-Paul Torres, person in recovery

Culturally specific services in Oregon

While programs in Philadelphia offers some services in Spanish, places outside of Philadelphia, like Multnomah County in Oregon, are providing a variety of government-funded culturally-specific services to better serve Latinxs with substance use disorder.

Multnomah County, which has an estimated population of more than 800,000, has 11.6 percent Hispanics living in the area, according to the U.S. Census Bureau QuickFacts. Nearly 15 percent of Philadelphia’s population of 1.5 million people is Hispanic.

Jessica Jacobsen, the adult care coordination program supervisor for the Multnomah County’s Mental Health and Addiction Services Division, oversees the Addictions Benefit Coordination team, which helps connect residents to resources for substance use disorder and gambling. The team, which started in 2016, is made up of six clinical services specialists.

One coordinator, Jose Luis Garcia, specifically works with Latinx residents and another coordinator works specifically with Black residents. The county wanted to make sure they could serve all the communities within the area, Jacobsen said. There are also two other coordinators who are bilingual and bicultural.

From 2017 to 2018, successful placement of Black and Latinx clients into detox, treatment, or other facilities increased by 43.6 percent from 110 to 158 percent, according to data from the Mental Health and Addiction Services Division.

Multnomah County has fewer Hispanics than Philadelphia but still created the Latinx coordinator position to help its Spanish-speaking residents. The county also funds culturally-specific addiction services for two organizations in Portland: Volunteers of America Oregon and Central City Concern.

Latino Homebase Recovery is a recovery house for Latino men, operated by the Oregon branch of the national faith-based nonprofit organization Volunteers of America. The county gave the program $230,755 for the 2019 fiscal year, wrote Zach Brooks, the county’s contract and budget specialist and Garcia.

“[Garcia] has done just an amazing job of creating a network within the larger community,” Jacobsen said. “He knows so much about both the providers that are running, like Latino Homebase Recovery, but also providers that are perhaps like embedded in a program that’s not culturally specific, but who are bilingual or bicultural.”

While Garcia builds relationships with providers in the area, Multnomah County continues to invest in culturally-specific programs for treatment, too.

The county funds Central City Concern, a nonprofit, which oversees Puentes, a culturally-specific drug and alcohol treatment, mental health, and support program for Latinxs, and Esperanza Juvenil, which offers Latinxs ages 14-21 treatment, counseling, and support, according to its website. The county gave Puentes $523,507 and Esperanza Juvenil $148,900 for fiscal year 2019, wrote Brooks and Garcia.

In Philadelphia, Fresh Start’s La Casa Latina program was the only bilingual recovery housing program funded by the Office of Addiction Services, said Dennis Massott, director of nonprofit provider Merakey’s Fresh Start program. La Casa Latina is a 17-bed residential program for Spanish-speaking men. Fresh Start opened a program with 12 beds for Spanish-speaking women on April 15, which is now also funded by the Office of Addiction Services, Massott added.

Edwin Hernandez, 55, has been in and out of recovery since he was 19 years old. The Puerto Rican and Philadelphia native lived at La Casa Latina until April 26 after he started using drugs again last year.

Hernandez said he’s gotten “serious success” from the program by listening to others in recovery, getting a sponsor, and finding a Narcotics Anonymous home group meeting, which he attends regularly.

While in recovery, Hernandez has been building up his resume to become a certified peer recovery specialist for the city. He teaches classes at PRO-ACT’s Philadelphia Recovery Community Center, an advocacy and recovery support initiative at 17th Street and Lehigh Avenue, and enrolled in Project TEACH, a health education program that trains people living with HIV/AIDS to be peer educators, offered by Philadelphia FIGHT, a health services organization on Locust Street near 13th Street.

“My motivation comes from God,” he said. “What I’ve been through, like I’ve taken so much from the community that I want to give back some and prove that I can do good.”

Although the city needs more Spanish-speaking recovery specialists, Hernandez added, he wants to help all kinds of people and set an example for his family members with substance use disorders.

“If I’m needed there, I like to represent my culture, my people, but it’s not absolutely what I’m looking for,” Hernandez said.

“You feel more liberated. People of your race, people of your blood who understand you, who know what you are going through and can say a word that will help you.”

— Jean-Paul Torres, Person in recovery

Meeting the community’s needs

Pierluigi Mancini, president of the Multicultural Development Institute, said Pennsylvania can address linguistic access to behavioral health services by mandating that providers in areas with higher Hispanic populations offer services in Spanish.

“Especially if they receive state funding and federal funding, then that should be a requirement for them to be able to access those funds [and] be able to serve every single individual in their catchment area,” said Mancini, who is also project director for Substance Abuse and Mental Health Services Administration’s National Hispanic and Latino Addiction Technology Transfer Center.

Multnomah County’s Jacobsen said it’s critical to find stakeholders within the Latinx community to help design a program or position, like the Latinx coordinator, that meets the community’s needs.

And advocates along with Latinxs who have substance use disorders see a need for more recovery housing in Philadelphia.

Delfau, who came from Puerto Rico to Philadelphia in 2013, said there were about 12 to 15 Latino recovery houses in North Philadelphia when he got here, and now there are only a few left over.

“Back in the day, it was easier for the people to get help,” Delfau said. “I know some of those recovery houses were doing stuff that they weren’t supposed to, but instead of guiding them, all [the city] did was shut them down.”

Torres said the city should pay closer attention to what Latinxs need. He thinks the city should open more programs, like Restoration Home Center, with Spanish-speaking staff and residents.

“You feel more liberated,” he said. “…People of your race, people of your blood who understand you, who know what you are going through and can say a word that will help you.”