http://www.boston.com/yourlife/health/o ... mmigrants/

Mental-health care limited for immigrants
By Daniel Connolly, Associated Press Writer
February 6, 2006

DE QUEEN, Ark. --If Eleazar Paula Mendez suffered from depression, her adopted hometown in southwest Arkansas was not the place to find help: The small community where she is charged with killing her three children has no mental-health professionals who speak Spanish.

Mendez, who told police she was distraught because her husband wanted a divorce, sought spiritual counseling from her priest, but he also did not know where she could get psychological help.

"Her English is very limited," the Rev. Salvador Marquez-Munoz said. "And who am I going to refer her to around here?"

Arkansas had the second-fastest growing Hispanic population in the 1990s, according to Census figures, but many communities have limited social services catering to them.

In De Queen -- which is 50 percent Hispanic -- the largest mental-health clinic relies on an interpreter.

"I think it would be helpful to be able to communicate a little bit better," said Michael J. Cluts, director of the Southwest Arkansas Counseling and Mental Health Center.

The town's only private counselor, social worker Daryl Mitchell, has occasionally helped Spanish-speakers who brought a trusted adult to translate.

Depression can affect many Hispanics because of separation from loved ones back home, financial problems and cultural barriers, said Cesar Compadre, who heads La Casa Health Network, a Little Rock-based organization that connects Hispanics with health care resources.

"The way I see it, talking to people, there is an epidemic of depression among the Latino community," he said. "You almost feel it."

The situation is compounded by the lack of Spanish-speaking mental-health workers in Arkansas, he said.

"We have had people come into La Casa and say 'You know, I need help, I feel that I want to hurt my kids,'" he said.

Some immigrants may be nervous about talking about their problems to an outsider if they entered the country illegally, said the priest, Marquez-Munoz. And emotions and nuances are lost in translation.

"It's like trying to watch a movie that has been dubbed," Marquez-Munoz said.

John Shuler, a social worker with Ozark Guidance mental-health group in northwestern Arkansas, said his program has seen improvement after hiring Spanish-speaking counselors last year to work with school children and their parents.

"Whenever you have an interpreter, because you're not speaking directly with the individual, with the client, it can impact the relationship, the therapeutic relationship in a negative way," Shuler said.

In De Queen, a judge has ordered a mental evaluation for Mendez, who is charged with capital murder in the deaths of Elvis, 7, and twins Samantha and Samuel, 5.

The Mexican-born Mendez had lived in the United States about 11 years and last year moved from New York City to Arkansas to raise her children in a safer environment, neighbors said. She was reserved and had few friends, said an acquaintance, M. Rocio Maya.

Police say Mendez, 43, became distraught when her husband, who was working in New York, asked for a divorce. Maya also said he had begun sending her less money.

But her husband, Arturo Morales, said his marriage was good.

"She was probably suffering loneliness due to the physical separation in the last months," Morales said.

Marquez-Munoz, a priest at St. Barbara Catholic Church, said Mendez met with him to speak about her problems in November or December and again about a week before the children were killed.

"Regarding spiritual counseling, I can help with that, but psychological counseling to a profound level, I cannot," the priest said.

Marquez-Munoz said he'd be interested in working more closely with mental-health professionals and doctors -- people "who can help heal the many wounds people are carrying, their crosses."

The priest, who is also from Mexico, said he could not discuss what Mendez had told him.

"She did not share with me everything she was dealing with, you know," he said. "It takes time.

How did she get away with staying here illegally in the first place? Oh yea, she was "living in the shadows" and "good folks dont just stop at the Rio Grande". This woman could of gotten mental health help almost anywhere that will accept our tax dollars. And she didnt need a translator to convey the fact that she was wanted to kill her kids, so her husband would come home. Evil biotch.