Addressing the field's cultural drought | Behavioral Healthcare Executive Skip to content Skip to navigation

Addressing the field's cultural drought

March 1, 2009
by David Stadler, LPC, LCPC, NCC, Luis Cordova, MS, CSAC II, and Marcella McMurray, BA
| Reprints
Suggestions for attracting and retaining bilingual and bicultural staff

“I am sorry, but our current wait for services is approximately four weeks. We will have someone give you a call when an opening becomes available.”

“I am sorry, but we do not have any providers who speak Spanish. I can refer you to another agency.”

All too often individuals needing mental health services hear such statements when they seek help. Bilingual and bicultural certified professionals are in high demand, but agencies often do not have enough qualified providers to meet growing racial/ethnic populations' needs. Thus, organizations struggle not only to find highly qualified certified staff, but also staff proficient within specific languages and cultures. As agencies identify specific groups' needs and begin the hiring process, they discover the dearth of qualified, culturally competent, bilingual behavioral and mental health providers.

Although professionals of all racial/ethnic backgrounds with proficiencies in all languages are needed, the exponential growth of the United States' Latino population highlights the need for Spanish-speaking and/or Latino providers. According to the Census Bureau's 2007 American Community Survey, Spanish is the primary language spoken at home by more than 34 million people age 5 and older.1 In 2007, the country's Latino population reached 45.5 million-approximately 15.1% of the total population. Nationally, Latinos are the fastest-growing racial/ethnic minority group. The Census Bureau projects that by 2050, Latinos will make up 30% of the population.2

As the national Latino population has grown, the number of behavioral and mental health providers specializing in this group has not kept up, resulting in an “implosion” within the field. In fact, few behavioral and mental health providers are Hispanic or speak Spanish: Only 1% of licensed clinical psychologists identified themselves as Latino in a national survey.3 In addition, the U.S. Department of Health and Human Services reports that for every 100,000 Latinos, there are only 29 Latino mental health providers.4 Consequentially, the need for bilingual and bicultural providers and front-office staff has resulted in competition for the small pool of individuals meeting these qualifications.

Our experience

Mattie Rhodes Center (MRC) has been serving Greater Kansas City youths and adults from diverse populations since 1894. MRC has five locations and offers programming focused on mental health, family education and support, youth development, domestic violence, and substance abuse, as well as Latino cultural arts and arts education. Approximately 94% of MRC's mental health and social service clients identify as Latino, and MRC strives to be a leader on Latino issues and cultural competency.

Hiring competent bilingual and bicultural staff is a consistent challenge for MRC. The pool of bilingual and bicultural service providers in Kansas City is relatively small. Applicants often are acquaintances of current staff, as word of mouth drives most applications. Seventy-five percent of MRC's approximately 40 staff members are Latino, and all are fully bilingual (Spanish and English). Based on our experience, below we identify some challenges to hiring bilingual and bicultural staff, as well as some tips for hiring success.


Agencies often face challenges influenced by geography. For example, organizations in the Midwest face different challenges than those in coastal regions such as California and Florida, which have larger concentrations of racial/ethnic minorities. However, several factors should be considered when attracting and hiring bilingual and bicultural staff-independent of location.

Cultural proficiency. Professionals able to formally speak a language may not be fully aware of the nuances needed to fully understand a client's concerns. The provider might not be able to fully comprehend a particular region's cultural norms. For example, people from Latin America have varying values and cultural attributes. Providers must understand different areas' customs and traditions, as the customs of someone from Mexico City can be very different from those of someone from Bogotá, Colombia.

Gender. Social service providers are predominantly female: According to a September 2007 U.S. Bureau of Labor Statistics report, approximately 62% of individuals within the social service field are women.5 The same can be said for bilingual and bicultural individuals entering the social service field. Unfortunately, this creates difficulties for clients who maintain traditional values and beliefs that place women in a subservient role.

Compensation. The nonprofit sector faces additional challenges when recruiting providers, as salary is a strong factor for mental and behavioral health professionals to consider when seeking employment. The nonprofit sector typically has been a place for providers to begin their careers to achieve appropriate licensure or educational attainment. Then the private sector lures many providers away with the attraction of achieving a greater income or self-sustainability.