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Growing public health threats continue to plague underserved communities and communities of color. Among them is the critical need for increased awareness and use of mental health care services, mental health professionals, and peer specialists. This need has become even more apparent amid an isolating pandemic.

The stay-at-home orders that were necessary to prevent the spread of COVID-19 created a sense of isolation and contributed to an increase in the number of adults who experienced symptoms of depression, anxiety, or other mental health illnesses, according to the Kaiser Family Foundation. With vaccines making their way into our community, there’s renewed hope that life can soon regain a sense of normalcy as we return to a world surrounded by other people. The reality, though, is that the pandemic has only exacerbated pervasive feelings of loneliness and the toll on mental well-being. As we turn the corner on this pandemic, we need to expand community options to support those who are struggling with mental illness.

Mental health in San Antonio and nationwide is the new frontier for wellness, prevention, and public health for Latinos and other people of color. Locally, Latinos and other communities of color are, in some cases, more than twice as likely as white populations to not have health insurance, to delay health care because of the cost, and to suffer from stress, anxiety, and other illnesses such as diabetes and heart disease, which led the City Council to declare racism as a public health crisis in San Antonio.

Entities such as UT Health and the Center for Health Care Services are working diligently to address these disparities, but more could be done to address the growing need. This is critical for communities of color, where counseling and mental health care, in many cases, take a back seat to other socioeconomic challenges. 

Culturally we’re taught to take care of our own, but many times don’t recognize mental illness and, thus, can’t provide the support or seek the care and treatment needed.  A peer-to-peer model is needed to enhance mental health services for underserved and uninsured communities and communities of color. Similar models based on peer-to-peer care, such as Promotoras (lay health workers), have been used by public health professionals to address health disparities such as those in immunizations, women’s health, and wellness. Utilizing a peer-to-peer model to train adults who have experienced mental health issues to work as Mental Health Peer Specialists (MHPS) in the community can help build trust. People connect with and listen to peers who can guide them and facilitate appropriate services. 

The model of peer support using trained, licensed personnel by the State of Texas makes a difference by reducing health care costs in the emergency setting and by relieving the use of first responders and other emergency health care providers. In addition to the San Antonio Clubhouse, which takes a peer-led approach to wellness, a number of other local organizations provide similar support.

The San Antonio chapter of the National Alliance on Mental Illness facilitates community events as well as peer-led mental health support groups and education classes for people and their families living with mental health conditions. Younger individuals experiencing mental illness can turn to the Alamo Area Teen Suicide Prevention Coalition to find resources or connect with a peer on the advisory board for support.

These programs and others exist locally, but San Antonio is only beginning to scratch the surface of what is needed to address mental health and mental illness in our community. By increasing the training and utilization of peer specialists, we can expand community options that will be available to support the thousands of individuals – our family members, friends, and neighbors – who are struggling with mental illness and require support services. 

Our city can also increase the utilization of trained peer specialists when responding to mental health crisis calls. Several local and national programs and initiatives are using this strategy, such as the Bexar County Specialized Multidisciplinary Alternate Response Team (SMART) and the Crisis Assistance Helping Out on the Streets (CAHOOTS) program in Eugene, Oregon.

For over 30 years, the CAHOOTS program has proven to save lives and money. Of the 24,000 calls CAHOOTS responded to in Eugene in 2019, police backup was requested just 150 times. In the same year, it saved the city about $14 million in ambulance and emergency room treatment costs, as well as $8.5 million in public safety costs. Versions of the CAHOOTS model are being considered and replicated throughout the country, including in Denver, San Francisco, and New York City.

Through my work at the San Antonio Clubhouse, I’ve found that there’s healing in connecting with and being understood by a community of peers. The pandemic brought this issue to the forefront like never before, which is why we’ve been offering free daily, virtual opportunities to connect with peer specialists on a group and one-on-one basis for anyone who’s interested. These meetings, which include wellness check-ins, activities, and open discussion, have been in high demand, further demonstrating the need for human connection and to eliminate the social and economic isolation of adults experiencing mental illness. 

As we turn the corner on this pandemic, now is the time to recognize the significant impact that social isolation has had on the physical, emotional, and psychological well-being of so many of us, and expand the community that will be there to support those who are struggling. San Antonio has incredible resources and Mental Health Peer Specialists who are trained and ready to help. During this critical time, we will continue to offer the authentic connection that our community needs, after all, we’ve been there, too. 

Eric Estrada

Eric Estrada

Eric Estrada is the executive director of the San Antonio Clubhouse. He is a former Air Force officer, civil servant, and management consultant.