English Language Abilities and Unmet Needs
in Community Mental Health Services:
a Cross-Sectional Study
Anna Durbin, MPH, PhD
Frank Sirotich, PhD
Janet Durbin, PhD
Language has been described as medicine’s most essential technology and its principle
Even so, persons with limited English proﬁciency (LEP) often do not have access
to providers who speak their language.
In many jurisdictions in North America, many health
services are provided in English without linguistic assistance.
There is evidence that
compared to clients with greater English proﬁciency, persons with LEP have less understanding
of the care they receive,
are less likely to follow recommendations for treatment and follow-
are more likely to have delayed diagnoses,
and are less satisﬁed with care.
employees, or nonﬂuent health care professionals),
which may transform the communication,
leading to omission of questions, failure to mention medication side effects, and ignoring
Given these challenges, it is not surprising that LEP individuals also
have been shown to have more emergency department visits, more hospital admissions, and
longer hospital stays for many medical and surgical conditions.
For clients with mental illness, language barriers can be particularly problematic since mental
health (MH) diagnostic and management processes rely more on communication than on
Similar to patterns of use for general health care, research has indicated that
LEP persons have lower utilization of MH services than English-speaking patients even when
they have greater MH need,
although interventions conducted in clients’ native language
can be much more effective in terms of symptom reduction and client satisfaction.
Address correspondence to Anna Durbin, MPH, PhD, Canadian Mental Health Association–Toronto Branch (CMHA),
Toronto, Ontario, Canada. Phone: (416) 824-1078; Email: Anna.firstname.lastname@example.org.
Frank Sirotich, PhD, Canadian Mental Health Association–Toronto Branch (CMHA), Toronto, Ontario, Canada.
Frank Sirotich, PhD, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
Janet Durbin, PhD, Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, Ontario,
Janet Durbin, PhD, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Journal of Behavioral Health Services & Research, 2016. 483–497. c
2016 National Council for Behavioral Health. DOI
Language and Unmet Needs in Community Mental Health DURBIN ET AL. 483