Today, only 40% of Hispanic adults with mental health conditions receive treatment, compared to 56% of their white counterparts, a disparity that persists despite similar needs. This gap is especially urgent for the estimated 2.3 million individuals with limited English proficiency who require Spanish-language mental health and substance use services.

For Dr. Pierluigi Mancini, addressing this language barrier became his life’s mission. A psychologist and international leader in immigrant and refugee mental health and substance use disorders, Dr. Mancini has dedicated 25 years to expanding linguistic access to care. Meaning, helping people get the care that they need – no matter what language they speak – through increasing access to interpreters, translated documents, bilingual health care staff, and more. In recovery from substance use for 40 years, his personal journey has fueled his drive to ensure communities of Latine and Hispanic descent receive support in their own language and from professionals who understand their culture.

Building what didn’t exist

Just two years into his recovery, Dr. Mancini entered the mental health field. His career shifted dramatically in 1999, when colleagues came to him with a dire gap: there was nothing in Georgia for people with substance use or mental health issues who also had limited English proficiency.

Seeing the need, he launched an agency – without funding or backing. The first lesson was harsh: the very people he aimed to serve often worked in jobs without health insurance and couldn’t pay for care.

Dr. Mancini began knocking on doors to secure support. Many applauded the idea but refused to fund it, stating no outcome studies existed for a clinic treating people in a language other than English. Working 18-hour days, he reached the point of questioning whether he should continue – until an unexpected moment of clarity arrived.

One morning, he walked into his office to find three nuns from the Sisters of Mercy, five patients, and a $2,500 check. “Since that day, I have never doubted that this is my mission: to build an infrastructure where people with linguistic barriers can access services for mental health and substance use disorders,” said Dr. Mancini.

Turning awareness into action

Dr. Mancini transformed that mission into tangible programs: clinics, clubhouses, and school prevention efforts – all centered on improving linguistic access for people with mental health conditions. By the time he stepped down from his clinic in 2016, it had become one of the nation’s leading Latine-focused behavioral health organizations. It served more than 150 people daily in clinical care, reached 10,000 youth across five cities in Georgia, secured nearly $5 million in grants and revenue, and grew to 72 staff members representing 20 Latin American countries, Spain, and Brazil. Dr. Mancini also mentored 42 bilingual clinicians to full licensure, including two psychologists and one psychiatrist.

“Right now, my mission continues to be linguistic access, especially as we navigate current discourse about diversity and equity and ‘English only,’” he said. “We still have millions of people who lack services because of language barriers. That can’t deter me – it just means I must be more creative.”

He encourages others in the Latine community who want to create change to keep moving forward, even when faced with obstacles: “Be persistent. Something will open up. Keep knocking on doors. One of those doors is going to open.”

Mental health in communities of Latine and Hispanic descent

Dr. Mancini describes strong family bonds as both a strength and a challenge in communities of Latine and Hispanic descent. Families provide comfort and connection, but their love can also lead to minimizing or justifying warning signs of distress. “If someone is behaving in a way where they may hurt themselves, and you minimize or ignore it, you’re not listening to what they’re trying to tell you: that they are hurting somehow.”

Other barriers persist: lack of insurance, difficulty assimilating to U.S. culture, and too few bilingual clinicians. At the same time, cultural traditions – religious services, holidays, and community gatherings – are vital sources of resilience. These practices remind people they are not alone and strengthen recovery.

A message of hope

Access to mental health care should never depend on the language you speak. Dr. Mancini’s work shows what is possible when systems are culturally and linguistically responsive: lives change, families strengthen, and communities thrive.

Now it’s up to all of us. Policymakers, providers, and community leaders must ensure equity, culture, and language remain central to mental health services. And for those in communities of Latine and Hispanic descent who may be struggling, know that help is available in both English and Spanish. Reaching out is a sign of strength, and you are not alone.

If you or someone you care about needs support, call or text 988 anytime to connect with someone who cares. The 988 Lifeline offers English and Spanish call, text, and chat services, and voice calling is available in many other languages. Together, we can ensure every voice is heard, every culture respected, and every community supported.

Visit MHA’s online Spanish Resource Center and MHAScreening.org for information and tools in Spanish.