Ga. ranks low in mental health care access and language barriers are growing
In “A Mind That Found Itself” (1908), mental-health reformer and founder of Mental Health America Clifford W. Beers chronicled the death of an 80-year-old French-Canadian asylum patient.
Confused by English-only orders and disoriented by psychosis, the man was beaten so violently that his ribs snapped and he died. Beers called him “doubly helpless,” first from illness, then from language.
Over a century later, that indictment still resonates, especially in Georgia, where language and cultural gaps continue to separate people in crisis from the care they urgently need.
According to Mental Health America’s 2024 The State of Mental Health in America, Georgia ranks 47th in the nation for access to mental health care.
Each July, we mark Bebe Moore Campbell National Minority Mental Health Awareness Month — named after the author, advocate and changemaker in serving underrepresented communities — a time to reflect on the reality that mental health is not only about illness, it is about access.
Language barriers can adversely affect health care
According to the U.S. Census Bureau, more than 500,000 Georgians, about 5% of the state, have limited English proficiency (LEP), which means they speak English “less than very well.”
Credit: contributed
Gwinnett County has the state’s highest share of public school English learners at 17.6%, according the Migration Policy Institute. DeKalb County — home to Clarkston, often called “the most diverse square mile in America” — comes in second with 16.7%. Meanwhile, Georgia’s foreign-born population has grown by 123% from 2000 to 2023.
Limited English proficiency means someone may speak enough English to work or manage daily life, but not enough to discuss complex issues like depression, trauma or addiction. Because language fluency can take three to seven years to fully develop, we simply cannot wait that long to support someone experiencing suicidal thoughts, a mental health crisis, or substance use disorder.
National studies show that without interpretation or care in a patient’s primary language, emergency room visits, medication errors, involuntary commitments, and readmissions all rise. In Georgia, the lack of statewide data makes it hard to measure the scope or direct resources where they’re needed most.
At the same time, Georgia, like the rest of the country, faces a workforce shortage. A 2024 report from the Health Resources and Services Administration (HRSA) projects severe shortages of psychiatrists, psychologists, and counselors through 2036. Bilingual or signing clinicians are even harder to find.
To its credit, Georgia has begun laying important groundwork. Several community coalitions, professional associations, and academic centers have developed online bilingual-clinician directories, one focused on Spanish-English providers statewide, and another on clinicians fluent in Asian languages.
These directories are valuable tools for families seeking care, but they also highlight a persistent challenge: even when families know where to look, there simply aren’t enough bilingual mental health professionals to meet the need. Too many Georgians are still suffering in silence.
Georgia can build upon some of its successful models
The good news is that solutions exist, and other states are showing what’s possible. Many have expanded their multilingual mental health workforces through scholarships, loan forgiveness, and streamlined licensing pathways for internationally trained professionals.
Several have adopted the federal National CLAS (Culturally and Linguistically Appropriate Services) Standards to guide clinics in providing equitable care. Others require Medicaid and private insurers to reimburse interpreter services and publish transparent dashboards to help clients know where they can receive care in their own language.
Georgia has local successes it can build upon. The state’s Office of Deaf Services, housed within the Department of Behavioral Health and Developmental Disabilities (DBHDD), offers a proven model for ensuring culturally and linguistically appropriate care, complete with data tracking, provider training and annual performance benchmarks. With the right investment and leadership, Georgia can replicate and expand these efforts to better serve its broader LEP population.
None of these steps are radical. They are the behavioral-health equivalent of fire exits and sterile needles, basic protections to ensure that no Georgian is left “doubly helpless.”
When a hospital would never deny oxygen, it should never deny comprehension. Yet every day in our state, parents of teenagers battling depression, others with autistic children, and immigrants navigating trauma face the same bleak calculus as Beers’s patient in 1908: they cannot communicate, so they cannot be protected or treated.
Bebe Moore Campbell often reminded us that “words have power.” And she was right. Words shape diagnoses, build trust, and save lives, but only when they are understood.
We owe it to Campbell, to Beers, and to all Georgians navigating language and hearing barriers to ensure that every cry for help is heard and answered, in the language of the cry.
The question is not whether we can afford language access in Georgia, but how many more people we can help achieve good mental health, and how much stronger our state will be because of it.
Pierluigi Mancini, Ph.D., is the president and CEO of the Multicultural Development Institute. He is also the current national chairman of the board for Mental Health America, a national and international leader in mental health, addiction, and health equity. A sought-after speaker and consultant, he specializes in cultural and linguistic responsiveness, immigrant behavioral health, and eliminating health disparities. pierluigi@eldoctormancini.com
