Talking about mental health isn’t easy. Although the societal stigma surrounding mental illness is slowly falling away, it is still an extremely contentious topic to discuss within the Hispanic community. Cultural beliefs and fears about being “loco” or about airing dirty laundry still abound.
When you add other obstacles such as language barriers, insurance issues, religious beliefs and concerns about immigration status, it’s no wonder that only 20% of Latinos with symptoms of a psychological disorder will talk to their doctor about their concerns, and that only 10% will contact a mental health specialist, according to the National Alliance on Mental Illness (NAMI).
However, Latinos are no less likely to face mental illness than people of other ethnicities. Research from NAMI reveals that common mental health disorders among the Hispanic population in the United States include generalized anxiety disorder, major depression, post-traumatic stress disorder (PTSD) and alcoholism. What’s more, studies show that suicide attempts among Latina high school girls occur more often than in the general population.
Moreover, even after recognizing and addressing mental health, “a general resistance to counseling or therapy still exists,” says Erika Bocanegra, MSW, a senior clinical social worker at the Orthopaedic Institute for Children/Orthopaedic Hemophilia Treatment Center in Los Angeles. But treatment can happen in a variety of ways, including cognitive behavioral therapy (talk therapy), medication (such as antidepressants) or a combination of both.
“It Caught Me By Surprise”
Lupe, whose daughter has factor V Leiden and von Willebrand disease, says her family didn’t begin to discuss mental health in a serious manner until her daughter attempted suicide at age 14.
“I knew that she was upset. I knew that she was mad and that she was unhappy seeing so many doctors, but it caught me by surprise,” Lupe says. “She was quiet and used to cry a lot, so my husband and I took her to a counselor. They told me that she had to be admitted to the hospital because she had tried to commit suicide the day before. I didn’t see her wrists (where she had cut herself). I didn’t see anything, because she was very good about hiding those feelings from us.”
Lupe describes the shock and hurt of seeing two nurses taking her daughter to an inpatient behavioral health clinic, where she had to stay for a week, as a turning point fovr her family. Although she initially felt “really depressed” about her daughter’s suicide attempt and subsequent hospitalization, she now realizes that thanks to mental health treatment, her daughter is “doing a lot better now.”
For many Latinos, the stigmatization of mental health comes not just from mainstream culture but also from their own community. Fred Sandoval, executive director of the National Latino Behavioral Health Association, says it’s common for Latinos to label people who may have a mental illness with terms such as “esta loco,” “esta enfermo,” “no se prende el foco,” “esta inchingado,” “brujado,” “no tiene sentido,” “fueron las cabras” and “disgraciado.”
“Let’s say there’s a sister in the family who has schizophrenia, which is an illness that most people don’t understand very well,” Sandoval says. “Family members may make observations about her behavior or how she looks. The end result is that we have a whole set of terms we use to stigmatize and stereotype people with mental illness. We do that to the people in our communities and in our own families, all by ourselves.”
Language and communication barriers can also keep people who want to seek help from being able to find treatment. Sandoval says many Latinos don’t reach out and therefore don’t get the information they need to get help.
“There’s a lack of information and education because there aren’t enough programs that aim to educate Latinos on these resources,” Sandoval says. “Part of it is that there’s a working assumption that everything we need to know comes from the family, but if the family does not have the information, then how can you pass it on?”
Find Specialized Support
When Fel Echandi’s son was diagnosed with severe hemophilia B at 9 months old, he and his wife had to fight to find information and resources to understand the condition. Eventually, as their son got older, they recognized a need for more specialized support in the Hispanic community in Los Angeles. So his wife started meetups, or support groups, where Hispanic families could get together for tea and talk about what their children with bleeding disorders were going through. “It’s normal for parents of newly diagnosed kids to develop depression, but being part of a support group of other parents can be so helpful,” Echandi says.
Bocanegra says Spanish-speaking support groups where patients can meet others dealing with depression and anxiety can be exceptionally helpful. Connecting patients to Spanish-speaking therapists is also key since “language barriers often prevent patients from seeking help and feeling comfortable or understood.”
Religion is important to a person’s well-being, but clergy who are not trained in mental health can lead to barriers to treatment, Sandoval says. “Very few religious leaders have been psychiatrically trained,” he says. This is not the fault of the priests, Sandoval is quick to add. It’s just that these are “limited spheres of training and disciplines.”
“If the person is depressed, it’s not like there’s an absence of the spirit,” Sandoval says. “What it means is that there are things that physiologically are impairing the brain, and this is why this person is having difficulties functioning right now.”
However, religion can also play a positive role when it comes to seeking mental health treatment, Bocanegra says. “Patients often value the guidance they receive from a pastor or priest during times of adversity,” she says.
How to Recognize the Signs of Mental Illness in Kids
Young children who are depressed may show signs of sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or even being underweight.
For teens, depression symptoms can include sadness, irritability, feeling negative or worthless, anger, poor performance or attendance in school, feeling misunderstood or extremely sensitive, eating or sleeping too much, using recreational drugs or alcohol, loss of interest in normal activities, avoidance of social situations, or self-harm.
How should parents talk to their kids about mental health concerns? Fred Sandoval, executive director of the National Latino Behavioral Health Association, suggests that parents need to be role models for their kids in showing them how to express themselves. So if you’ve ever dealt with anxiety or depression, it may be a good idea to tell your kids about it.
“Another is the notion of bonding and attachment,” Sandoval says. “When we experience increased problems and challenges, what helps children is for you to validate them by being able to express your emotions, particularly your love, your support and your nurture for them.”
Sandoval recommends establishing a physical bond such as a quick hug or just holding hands as you have a frank conversation with them.
The World We’re Living in Now
There is no denying that current political and cultural attitudes toward immigration and immigrants are affecting the Hispanic community in a negative way, says Fred Sandoval. He calls it a “national traumatic environment” where public policy-making is increasing “trauma on vulnerable immigrant populations.” As Hispanics or Latinos face threats of exclusion, deportation and family separation, more people are going to need mental health services, Sandoval warns.
“It’s having a devastating impact on people’s emotional well-being, to such an extent that we believe that we have to start to plan and prepare for how we address the negative impacts that children and immigrants have experienced,” Sandoval says.
If you're suffering because of immigration troubles or experiencing trauma from negative attitudes toward Latinos, you can find a psychologist through the American Psychological Association.
Common Myths and Facts About Mental Illness
In the Hispanic community, deeply held cultural beliefs about mental illness can keep people from seeking and getting help. Here are some common misconceptions, countered with the truth.
I don’t want to be considered “loco.” It means I am weak.
This is the most common stigma associated with mental health in Hispanic communities, and it often goes back generations. However, 1 in 5 people are affected by mental illness—which means the odds are that you or somebody in your family has a condition. Don’t let fear or shame keep you from getting the help you need.
Nobody can know because “la ropa sucia se lava en casa.”
Hispanic families are often taught not to air their dirty laundry in public. But social workers and other mental health workers are sworn to confidentiality—which means that if you do seek help, your provider will not reveal your mental illness status because of a strong code of ethics and the Health Insurance Portability and Accountability Act (HIPAA).
Only white people have time to talk about their mental health.
Media representations of those seeking therapy rarely showcase people of color—which can be problematic for Latinos who are considering going to a mental health professional. However, mental health affects us all, including more than 15% of Hispanics or Latinos. Make time for your mental health just as you make time for your physical health.
I can’t afford to get help anyway.
The Affordable Care Act has made it much easier to get health insurance. Many plans cover at least a minimum number of mental health visits, and there are also mental health treatment centers across the country that provide services to patients on a sliding scale, which means that you pay only what you can afford.
Getting help can threaten my legal status.
Millions of children of undocumented immigrants are eligible for health insurance under the Affordable Care Act. Furthermore, Latino-based organizations often provide mental health services regardless of legal status. The National Latino Behavioral Health Association is one place to start.
The Signs to Watch for Depression
A mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. Symptoms occur nearly every day and for most of the day. They include:
• Feelings of sadness or hopelessness
• Angry outbursts or irritability
• Loss of interest or pleasure in normal activities
• Insomnia or sleeping too much
• Tiredness and lack of energy
• Reduced appetite or increased food cravings
• Feelings of worthlessness or guilt
• Trouble concentrating or making decisions
• Physical problems such as back pain or headaches
• Suicidal thoughts or recurrent thoughts of death
Anxiety can present itself in different forms, most commonly as generalized anxiety disorder (GAD) or panic disorder. Symptoms of
• Feeling restless or on edge
• Having difficulty concentrating
• Being irritable or easily fatigued
• Muscle tension
• Having difficulty controlling feelings of worry
• Sleep problems
Panic disorder is a type of anxiety disorder. It causes panic attacks, which are sudden feelings of terror when there is no real danger. You may feel as if you are losing control. You may also have physical symptoms, such as:
• Pounding heartbeat
• Trembling or shaking
• Shortness of breath
• Feeling out of control
To learn more about Nami: Visit the National Alliance on Mental Illness (NAMI) at nami.org, or call the helpline at 1-800-950-NAMI. In a crisis, you can text NAMI to 741741. » TO Learn more about NLBHA: Contact the National Latino Behavioral Health Association at nlbha.org or 505-980-5156.