Hispanic Heritage Month allows us to honor and celebrate Latino and Hispanic histories and cultures. But it should also challenge behavioral health organizations to ask a harder question: Have we evolved beyond merely translating words to truly understanding people? Language access is vital. However, translation alone will not fix mistrust or stigma. Translation won’t ensure equitable access, as many individuals and families face barriers before they even enter our doors, or, once inside, do not see themselves represented in their care experience. Limited English proficiency exists at the intersection of immigration status, acculturation, tradition, discrimination, and socioeconomic inequities (Escobedo et al., 2023). Yes, using a professional interpreter will help us communicate more effectively. But to provide culturally responsive care to every community we serve, it will take organizational transformation.
As a Latina social work leader with 20 years of experience in behavioral health, supportive housing, integrated care, and nonprofit human services, I’ve come to realize how deeply my thinking has been shaped by the people I’ve served and led. During my career, I’ve worked with individuals and families living with serious mental illness and substance use, homelessness and poverty, immigration-related stressors, and fragmented systems of care. I’ve also supervised and mentored social workers and nonprofit professionals. Many are incredible connectors to the communities we serve, but they often carry the weight of translating not just language but also culture and community. And still, they aren’t always empowered, sponsored, or resourced to change the systems they work in day in and day out. These experiences have only solidified my stance on why cultural responsiveness is vital. It’s not only a frontline issue. It’s a leadership issue.
Bilingual, Bicultural, and Culturally Humble Are Not Interchangeable
Being bilingual means a professional can communicate in two languages. That skill can improve clarity, convey deeper emotion, and foster safety and trust, particularly when discussing trauma or symptoms that don’t translate directly. Adding bicultural experience helps a professional understand and navigate multiple cultural frames of reference. This might include an appreciation for how migration, acculturation, racialization, intergenerational family expectations, spirituality, and personal versus collective roles affect how symptoms are expressed and the types of support requested. Recently, researchers explored what matters most to Latino community members when providers try to connect. Spanish-speaking participants in the qualitative study highlighted the importance of language match. English-speaking participants were more likely to emphasize biculturalism and cultural humility (Guzman et al., 2025). The point is this: Just because a person speaks English does not mean they do not feel culturally misunderstood.
Cultural humility is distinct from language proficiency and shared identity. It is a lifelong practice of self-reflection, learning, and restraint in assuming we know how a person from another culture might feel or behave. We cannot all be experts on every Latino culture, and a shared ethnic background does not give us a free pass to assume we understand another person’s thoughts or experiences. Latino and Hispanic communities are diverse. Country of origin, race, Indigenous background, migration story, history, acculturation status, generation, primary language, gender identity and expression, sexuality, income, education, and family structure all shape how people understand emotional distress, mental health, treatment, and healing. At its best, cultural humility means asking questions rather than making assumptions. It means listening without defensiveness and allowing people and communities to define what respectful, person-centered care looks like.
Representation Must Include Decision-Making Power
All too often, employers ask bilingual clinicians, social workers, peers, care managers, and administrative staff to shoulder the responsibility for cultural responsiveness. They translate conversations, repair broken trust, educate colleagues, and uphold communities’ confidence. Yet these same employees often remain unseen within management and executive leadership teams. That is neither fair nor sustainable. Institutions must value bicultural expertise wherever decisions are made, including in budget approvals, program design, partnership development, workforce policy setting, and the review of equality and outcome data.
Leadership diversity matters because leaders decide which problems are defined as problems and which solutions receive funding. Would a bicultural leader recognize that a client who misses an appointment may still be highly motivated to get well? Perhaps they have an inflexible work schedule, caregiving obligations, transportation difficulties, or undocumented immigration status. Maybe they have faced discrimination from providers in the past. I have seen improved outcomes in supportive housing and behavioral health when leaders understand that clinical care is intertwined with housing stability, economic security, family dynamics, and community involvement. Of course, this isn’t to say that one bicultural leader can speak for every Latino client. Instead, leadership diversity helps organizations understand what they are seeing, ask the right questions, and be accountable to those they serve.
Training Should Lead to Organizational Accountability
One-time cultural awareness training alone cannot accomplish this work. A systematic review found wide variation in how workplace diversity, equity, inclusion, and antiracism training is designed, delivered, and measured, indicating that no single training strategy is sufficient on its own (Wang et al., 2024). Training can open the door to deeper learning, but employers must link that learning to supervision, policy, data, and leaders’ day-to-day behavior. Organizations should examine whom they recruit and retain, whom they mentor, sponsor, and promote, and whether they fairly compensate employees for bilingual and bicultural expertise. They should also review access and outcomes by language preference and other relevant demographic factors, partner with trusted community organizations, and create feedback systems that give service users and families a meaningful voice in decision-making.
Employers should also stop relying on family members, who may be clients or caregivers, or on untrained staff to serve as interpreters. Working effectively with clients who prefer a language other than English requires professional language services, and bilingual proficiency should be assessed rather than assumed. Even with skilled interpreters, interpretation is most effective when integrated into the care team and supported by culturally responsive practice. A study of Spanish-speaking Latinx people living with HIV found that language barriers often co-occurred with inadequate interpretation, cultural differences, intersectional stigma, and immigration-related fears (Sherbuk et al., 2020). This is why isolated accommodations will never be enough. We need systems that recognize the complexity of people’s lived experiences.
A Leadership Priority Year-Round
Behavioral health leaders can begin by setting one clear, meaningful expectation: No person should ever have to check their language, identity, family structure, or dignity at the door of any care setting. Meeting that expectation requires bilingual access, bicultural understanding, and cultural humility at every level of the organization. That commitment must be visible at every point of contact, from the front desk and direct-service teams to supervision, governance, and the C-suite.
Hispanic Heritage Month is a meaningful time to advance this conversation, but commitment to equitable care cannot be seasonal. An organization’s true values are reflected in what it does 365 days a year: whom it listens to, whom it develops and promotes, what it measures, and whether community knowledge meaningfully informs decision-making. Moving beyond translation is not just about language access. It is a leadership strategy essential to building behavioral health systems that earn people’s trust.
Rosita L. Marinez, MS-NPL, LMSW, ADV-CSW, CSWM, is a Latina social work executive, consultant, author, speaker, and advocate. For two decades, Rosita has worked in behavioral health, supportive housing, integrated care, and the nonprofit sector. She is the founder of Housing ER Consulting (HER) – Housing Equity, Resilience, operating under the mission statement “Built on Solutions.” At HER, she helps organizations strengthen housing operations and services, including leadership, workforce development, compliance, and culturally responsive care coordination.
Rosita has developed and managed programs that serve individuals and families affected by serious mental illness, substance use, homelessness, poverty, reentry, and health disparities. She centers her leadership on equity, dignity, and accountability and believes that housing is a human right. She strives to cultivate emerging leaders and expand advancement opportunities for Latino and other historically underrepresented professionals.
Rosita currently serves on the Steering Committee for the Social Work Equity Campaign. She hosts the Fostering Social Impact podcast and frequently engages in dialogue on topics ranging from housing and behavioral health to mentorship and building resilient organizations. Rosita is a Doctor of Business Administration candidate at Capella University, connecting scholarship with practice and community-informed solutions.
For more information, email [email protected] or visit www.housingerconsulting.com.
References
Escobedo, L.E., Cervantes, L., & Havranek, E. (2023). Barriers in healthcare for Latinx patients with limited English proficiency: A narrative review. Journal of General Internal Medicine, 38(5), 1264-1271. https://doi.org/10.1007/s11606-022-07995-3
Guzman, L.E., Fite, K.M., Frank, H.E., Martinez, R.G., & Bridges, A.J. (2025). Understanding treatment barriers for major depressive disorder in the Latino community: A qualitative study stratified by language preference. Transcultural Psychiatry,62(6), 683-699. https://doi.org/10.1177/13634615251359457
Sherbuk, J.E., Petros de Guex, K., Anazco Villarreal, D., Knight, S., McManus, K.A., Flickinger, T., & Dillingham, R. (2020). Beyond interpretation: The unmet need for linguistically and culturally competent care for Latinx people living with HIV in a southern region with a low density of Spanish speakers. AIDS Research and Human Retroviruses, 36(11), 933-941. https://doi.org/10.1089/aid.2020.0088
Wang, M.L., Gomes, A., Rosa, M., Copeland, P., & Santana, V.J. (2024). A systematic review of diversity, equity, and inclusion and antiracism training studies: Findings and future directions. Translational Behavioral Medicine,14(3), 156-171. https://doi.org/10.1093/tbm/ibad061
