Can mobile units fill the mental health care void for Tulare County’s farmworkers?

Employees of the Tulare County Health and Human Services Agency (HHSA) mental health branch have said one in eight, or even as few as one in 10, Hispanic farm workers are being treated for some sort of mental illness. That’s unfortunate, since experts within the agency say the number of laborers in need of mental health services is 25 percent. Without transportation, a supportive work environment or an adequately funded public mobile unit program, a significant portion of Hispanic farm laborers is left without a chance to get the services they need.

As one source inside the mental health branch of HHSA said, it is not as if these types of workers have the ability to request time off or have paid sick days. Instead, they are not paid for whatever days they do not work. And even if they could take advantage of time off, they are still at a loss for transportation because many farm laborers lack personal transportation. And to take public transportation is not only inconvenient but also very time-consuming in a rural spread out county. But one service that holds considerable promise for these workers is the mobile unit program.

The county’s mental health branch mobile units have been effective, especially considering that the majority of farmworkers don’t seek out mental health services or cannot gain access to them. For instance, between 2008 and 2011, 16,670 residents received mental health services from the county, and 1,697 of those received services from mobile units. In the 2015-2016 fiscal year, mobile units made contact with 1,711 residents and treated 362.

However, one drawback to the program is that it does not operate on weekends or after-hours when farm workers are available for treatment, and the units do not visit unincorporated communities where impoverished farm workers often live. Instead, the units mostly visit five labor camps, between the hours of 8 a.m. and 5 p.m. Mobile units also have to compete with other county mental health programs for funding.

The best way to give readers a sense of the challenges local farmworkers face when it comes to mental health is to illustrate their struggles. By sharing first-person perspectives, readers will have a better chance of understanding the difficulties of being a poor farm laborer wrestling with mental health. I’ll also ride along in a mobile unit, where I can report on the kinds of services farm workers are receiving.

From my initial research and reporting on the mobile program, a funding shortfall is the chief barrier to expanding services. The Tulare County Board of Supervisors recently approved a draft budget of $1.8 million in fiscal year 2018-2019. The funds will change the way services are provided, allowing the county to move from larger RV-like units to smaller vans. Smaller vehicles are better able to maneuver unpaved roads where services are typically provided. And while that might seem like a promising change, it does not further solutions such as weekend staffing or transportation dedicated to taxiing farm workers from their community to care centers or counseling meetings.

[Photo by metrocreativecollection.com via The Foothills Sun-Gazette]