Maria Rinosa, a patient at the Kentucky Racing Health Services Center, works as a hotwalker at Churchill Downs.
Maria Rinosa, a patient at the Kentucky Racing Health Services Center, works as a hotwalker at Churchill Downs.

The unseen workers who help ensure thrilling thoroughbred races at Churchill Downs now have better mental health support for the emotional problems their itinerant jobs often compound.

Recently, the Kentucky Racing Health Services Center – an award-winning, nonprofit clinic run by University of Louisville School of Nursing faculty – began offering mental health services to grooms, hotwalkers, exercise riders and other backside racetrack workers.

Catherine Batscha, DNP MSN, UofL School of Nursing assistant professor and psychiatric-mental health nurse practitioner, provides counseling at the clinic to workers with anxiety and depression. A majority of the patients are from Latin America and speak limited English. Most also consistently travel across the United States throughout the year to work at other racetracks.

“It’s a hard life,” Batscha said. “When you look at the track, a lot of the people who work there have families that are far away. They miss their children. Some have been sexually abused, raped or have grown up in families with alcoholism and substance abuse.”

Previously, the clinic had to send patients to other facilities in the community for mental health treatment, which often took months for an appointment.

“If you’re in the middle of a crisis, you don’t want to wait the eight weeks it’s going to take to find a provider,” Batscha said. “If they have someone who needs to be seen today, I can see them today.”

Providing mental health treatment in-house has made it easier to coordinate care with other nurse practitioners at the clinic, which offers comprehensive services including physicals and women’s annual exams, treatment of minor illnesses and maintenance treatment for conditions such as diabetes, asthma and hypertension.

Founded 11 years ago, the clinic is a joint venture between UofL and the Kentucky Racing Health and Welfare Fund to provide free or low-cost health care to backside track workers and their families. Nursing students see patients under the supervision of faculty members. Students from the Latin American and Latino Studies program also gain experience by serving as translators.

Because most of her patients are transient, Batscha gives them ways to manage anxiety on the road.

Batscha created a SoundCloud relaxation audio in Spanish that patients can access through their smart phones. The audio walks users though progressive muscle relaxation techniques, useful for people who need help getting to sleep or calming their bodies and minds.

The clinic has eliminated barriers to care for the backside workers.

Maria Rinosa, a hotwalker at Churchill Downs and a native of Guatemala, sought mental health treatment for depression at the clinic after the death of her 1-year-old son due to a viral infection.

Without the clinic, Rinosa said she would have limited health care options.

“I don’t know where else I would go,” Rinosa said. “Without medical insurance, the cost is really expensive and the little we earn doesn’t stretch that far.”

Despite their hardships, the workers are incredibly dedicated to their jobs and take pride in their work, Batscha said.

“Everyone is up at 3 in the morning with their horses on the track,” Batscha said. “It’s just humbling to work with folks who have been through so much. They’re still on their feet and working to do a good job and make a difference for Kentucky.”

The clinic is located across from Churchill Downs at the Kentucky Racing Health & Welfare Fund office, 422 Heywood Ave. For more information, click here.