THE NEGLECTED HISPANIC HEALTH ISSUE: MENTAL ILLNESS
National health experts have identified a serious need for more cultural competency when dealing with mental health issues related to the Hispanic community.
The subject gained prominence at a conference hosted by the National Alliance for the Mentally Ill in Washington, D.C. June 28-30. Participants cited discrepancies in identifying and treating Hispanics and the need to raise the standards of “quality care,” including better multi-language services and increased transportation assistance.
NAMI executive director Michael Fitzpatrick told Hispanic Link News Service that mental illness is too easily isolated and stigmatized. It needs to be put into a broader range of health care, he said.
According to NAMI’s multicultural action center, Hispanics – particularly females – are subject to disproportionate rates of depression and anxiety. Mental illness is more likely to occur in U.S.-born Latinos than among recent immigrants, NAMI reported. Hispanic teenagers are identified as among those most likely to attempt suicide. The Centers for Disease Control reported that in 2005, 11 percent of Latinos and 15 percent of Latinas in grades 9-12 said they had attempted suicide.
Experts in the field agree that there is a lack of practitioners who can meet the needs of Latinos and that there are cultural practices and immigration factors that lead to depression and other mental illnesses.
More qualified bilingual and bicultural mental health professionals are required to respond to the demands of Latinos, said Henry Acosta, deputy director of New Jersey’s Mental Health Institute. Only three percent of psychologists and seven percent of social workers are Hispanic, he said, adding that there are often linguistic and cultural barriers between the patient and the care-giver.
Latinos tend to underutilize available services, according to Dr. Sergio Aguilar-Gaxiola, chairman of the National Mental Health Association. Too often they aren’t aware that they need treatment, he said. About 54% who met the criteria for major depression did not know they had the disease, he related, and this lack of knowledge adds to the problem: they don’t know where or how to get care.
Even among those Latinos who do receive treatment, there is a 60-75% chance they will not return for the services a second time, he pointed out.
Martha Silva, director of NAMI New Jersey En Español program, pointed out that many outpatient programs are “not geared toward the Latino idiosyncrasies,” but added that Latinos must adjust to the treatment offered despite the difficulty in doing this while mentally ill.
There are other cultural conflicts. Many Latino children want to live the “American life,” Acosta said, but are handicapped by their low socio-economic status and educational attainment.
Unique problems immigrant Latinos face in the United States also play a role. Once a family has moved here, the “whole immigration experience can be tortuous,” Acosta expanded.
Parents may have difficulty helping their second- and third-generation children with tasks such as homework and spending recreational time as a family, remarked Silva. It is these generations that tend to have much higher rates of depression, said Aguilar-Gaxiola. Communication can also deteriorate with a Spanish-speaking parent and English-speaking child.
As a culture, said Acosta, Latinos are inclined to count on family and church for help because they are familiar to them. There are also many stigmas within the community which lead to families being silent about mental illness.
Aguilar-Gaxiola stated that these problems will fester unless there is a “concerted national effort to counter these trends.” Insufficient data are still unavailable about Latinos and mental health, he said, while more accessible, understandable systems of care and services are essential.
© 2006 Hispanic Link