In a North Carolina Clinic, Culture and Language Say it All

Dr. Carolina Benitez directs the behavioral health programs at the Camino Health Center in Charlotte, North Carolina. Many of her department’s clients are newcomers to the Charlotte area. Her work often focuses on helping people adjust to the community, according to WFAE Radio in Charlotte.


“There’s a lot of challenges that come with relocating. Just even think about moving within the United States. And in this case, we’re working with a community of migrants coming from all different countries in Latin America, even in parts of Europe sometimes,” she said.


Dr. Benitez is a native of Honduras who immigrated to the United States in 1995 as a high school student with her parents and siblings. Early personal experiences sparked her interest in the mental health of Hispanic immigrant families living in the United States.

Dr. Benitez directs the behavioral health programs at the Camino Health Center in North Charlotte. Camino is a local nonprofit and ministry that offers services to Hispanic families in Mecklenburg and Cabarrus Counties. She is also an Assistant Professor of Counseling at Gordon-Conwell Theological Seminary.

Many of her clients are newcomers to the Charlotte area. As a result, her work often focuses on helping people adjust to the community. For the past year, in partnership with Camino. Dr. Benitez has been working to bring educational opportunity to Hispanic/Latinos, increase access to seminary education of Hispanic/Latino pastors, and develop cultural competency among counseling and social work students and newly licensed mental health providers.

For the demographic that Camino serves, accessing health services can be difficult and remains an ongoing, daily challenge. Language is one barrier, WFAE reports.

As North Carolina’s Latino population has grown over the past decade, Spanish-language mental health services have dropped.

A University of Arkansas study found the percentage of North Carolina mental health facilities with services in Spanish decreased between 2014 and 2019.  The Arkansas study used data from the National Mental Health Services Survey conducted in 2014 and 2019. The accumulated data were used to measure changes in the proportions of facilities that offered treatment in Spanish overall and by year, state, and proportion of Hispanic residents. Descriptive statistics were used to illustrate state-level changes in services offered in Spanish.

Between 2014 and 2019, the national Hispanic population increased by 4.5%, or 5.2 million people, according to the University of Arkansas. During the same period, the proportion of facilities that offered treatment in Spanish declined by 17.8%, or a loss of 1,163 Spanish-speaking mental health facilities. Overall, 44 states, including North Carolina,  saw a decline in the availability of services in Spanish, despite growth in Hispanic populations across all states. Among states with the fastest Hispanic population growth, several also experienced the greatest reduction in Spanish-language services.

For every 100,000 Latino residents, North Carolina had 6.4 facilities with Spanish-language services. That compared to a high in Vermont of 47.2 facilities and a low in Texas of 2.1. North Carolina ranked 39th nationally.

The study concluded that the availability of Spanish-language mental health services decreased in most U.S. states during 2014–2019. Promoting mental health service delivery in Spanish is critical for reducing barriers to treatment and ensuring health equity across populations.

Dr. Benitez understood that there was an unmet need for linguistically and culturally appropriate care for Spanish speakers in the Greater Charlotte area. For example, in Mecklenburg County where Charlotte is located, more than 124,000 people speak Spanish at home, according to Census data. More than half of those people, 66,000 of them, say they do not speak English very well. That is approximately 6% of the County’s total population, and a demographic that Camino aims to serve through low-cost health care.

According to WFAE:

“We recognized that there was … this void in the spectrum of services that are offered in the state and even just in the city,” Benitez said. “It’s not easy to find services where you are working with somebody who is from your same culture. It’s not easy to find services with someone who can speak your language… Suddenly you’re sitting across from someone who understands a little bit of your story, who understands what are the values that are important to you as an individual and to your family,” Benitez said.”


Camino offers three types of behavioral health services. There are individual and group therapy services. The clinic held about 1,600 counseling sessions last year. There is also peer support and social navigation services, both of which take a community-oriented approach to health.

David Villanueva is one of Camino’s peer support specialists. His job, in a way, is to be a companion and mentor to people with substance abuse disorder. As WFAE recounts:

“A main portion of my training actually comes from my lived experience. I have my own history of substance and alcohol-use disorder. And today I’m a person in recovery,” Villanueva said. “I use that in combination with my education and other specialized training that I’ve had.”

His cultural background as a Guatemalan-American has helped Villanueva connect with and understand other peers at Camino. But he’s also taken on the challenge of expanding his cultural competencies.

Being a Guatemalan person is a little bit in contrast to a Latino from the Caribbean or Latino from South America,” he said. “Part of the training is being exposed to the different type of individuals that work at Camino and the people that we serve. It gives me the opportunity to learn from their experience firsthand and then be able to apply that back into the community.

Social navigation manager Maria Monachesi, originally from Argentina, says the clinic has observed a difference in the needs of established immigrant residents and the needs of newcomers. For people who have recently arrived, their most urgent need might be housing, for example, and Monachesi can help with that search. But there are also urgent medical needs.

A lot of families come with a high degree of trauma that requires immediate mental health assistance such as counseling or psychiatry, Monachesi said, and many people indicate they’ve never had a health check before.

We support them through the process. We do not expect individuals who faced some type of trauma to just move on by themselves,” Monachesi said. “We want to be with them during that process to really provide the service that they need. And the ultimate goal is to transform their lives.”


One of Dr. Benitez’s key goals to train more people like Villanueva and Monachesi to serve the Spanish-speaking community.

“Part of the work that we do is actually training student interns from different schools to provide services in culturally competent ways to the Hispanic community. Some of the students that have come here for training have not been Hispanic, have not been Spanish speakers,” Benitez said. “So, we’ve trained them to work with interpreters, and we’ve trained them to consider the family values when working cross-culturally.

Hispanic families value education. They want their children to go to school,” she said. “Que se superen, ¿verdad?

Latino parents want to see their children overcome barriers and reach higher goals, she said. That is the reason, after all, that many families immigrate, “ WFAE concludes.


© Bruce L. Adelson 2023. All Rights Reserved The material herein is educational and informational only.  No legal advice is intended or conveyed.

Bruce L. Adelson, Esq., is nationally recognized for his compliance expertise.  Mr. Adelson is a former U.S Department of Justice Civil Rights Division Senior Trial Attorney.  Mr. Adelson is a faculty member at the Georgetown University School of Medicine and University of Pittsburgh School of Law where he teaches organizational culture, implicit bias, cultural and civil rights awareness.

Mr. Adelson’s blogs are a Bromberg exclusive.