Left Out and At Risk: Post-Pandemic Continuation of Organizational Service Reduction in Metropolitan New York City Coincides with Rise in Opiate Use and Mental Health Problems for Latinos.

Increasing opiate use and mental health problems among younger and older Latinos in urban US contexts prompted this investigation into the organizational resources that facilitate help-seeking efforts of Latinos in New York State (NYS). Guided by a Vulnerability Model and a framework of organizational enabling resources, this study used complementary longitudinal and cross-sectional designs. The longitudinal component examined changes in levels of organizational facilitators for Latino substance use disorder (SUD) help-seeking in Downstate NYS across three time periods, while the cross-sectional component compared post-pandemic facilitator levels across service types and regions. A convenience sample of 241 SUD clinicians participated in the longitudinal analysis. A sample of 150 clinicians whose practice information varied by location and service type participated in the post-pandemic cross-sectional comparisons. The findings revealed that the proportion of clinicians reporting organizational facilitation of Latino SUD help-seeking in Downstate NYS has diminished significantly from pre-pandemic levels, with little recovery. Cross-sectional analyses revealed no significant differences in clinician estimation of post-pandemic organizational resources by region or service type. The findings suggest that the organizational bulwarks against SUD and mental health problems are not sufficient to mitigate public health risk for NYS Latinos in the post-pandemic period. Recommendations informed by provider perspectives are discussed.