Written by Karla Flores and Mia Celeste Sheets
Cesar Chavez, the Mexican American labor leader and civil rights activist, said, “preservation of one’s own culture does not require contempt or disrespect for other cultures.” As we celebrate Hispanic/Latinx Heritage month in 2022, we not only uplift unique cultures, but we also want to take the time to recognize these cultural differences and what that may mean for the mental health of those in the Hispanic and Latinx communities. Hispanic Heritage Month takes place from September 15 to October 15 honoring the histories, cultures, and accomplishments of American citizens with ancestors who came from Central and South America, the Caribbean, and Spain. The observance was born in 1968, under President Lyndon Johnson and was expanded by President Ronald Reagan in 1988. It was enacted into law on August 17, 1988, with the approval of Public Law 100-402.
September 15 is significant as it is the anniversary of the five Latin American countries Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua. Both Mexico and Chile celebrate their independence on September 16 and September 18. It’s important to understand there is great diversity within this community, where people are connected by shared cultural values regardless of race, ancestry, or national origin. The identities and diverse cultures within the Hispanic and Latinx communities are as rich and complex as their history. Typically, those who identify as Latino, Latina, Latine, or Latinx may consider themselves of Latin American descent (Central America, South America, or the Caribbean), and those who identify as Hispanic may be referring to ancestry from Spain or other Spanish-speaking countries. While the two terms may share overlap, not everyone believes these terms can be used interchangeably to mean the same thing and will instead refer to their country of origin instead of as “Hispanic” or “Latinx”, however, members of the population may use different terms interchangeably.
Through Mental Health America research, over 18.3% of the U.S. population is estimated to be Latinx or Hispanic, which is about 62.1 million people in the United States. Of those, over 16% reported having a mental illness in the past year. That is over 10 million people, more than the number of people who live in New York City! Hispanic Heritage Month also overlaps with September’s Suicide Prevention Awareness Month and October’s Depression Awareness Month, so here at The NAN Project, we wanted to take this opportunity to extend the dialogue surrounding mental health within the Hispanic and Latinx communities. Similar to the way Hispanic culture creates a unique environment for members of the population to show strength and resilience, there are also specific barriers to gaining access to mental health support like financial and language barriers, access to insurance, legal status, lack of cultural competency, stigma, and machismo. These aspects are particular to Hispanic and Latinx culture, which we’d like to recognize, discuss, and provide resources that are working to overcome these barriers.
Financial barriers can affect anyone’s ability to access mental health treatment. According to a research article concerning residents of Washington Heights, New York City, where the population is 67.9% is Hispanic or Latino, “those who experienced financial barriers to mental health care had significantly higher depressive symptoms in comparison to those who could afford mental health care” (Pabayo R et al Financial Barriers to Mental Healthcare Services and Depressive Symptoms among Residents of Washington Heights, New York City. Hispanic Health Care International). We know that one factor that impacts financial access is access to health insurance. One in four Latinos do not have health insurance, and while the Affordable Care Act has narrowed racial gaps in access to healthcare, Latinos are still nearly 3 times more likely to be uninsured than non-Hispanic whites. Many are not aware of the Affordable Care Act eligible for children of undocumented immigrants they can access, and individuals without legal status may not seek or register for mental health services due to fear of separation or deportation, an adding a barrier to access to care.
For those who do have financial capabilities to seek professional mental health care, there may be difficulty in finding a provider who understands them either linguistically, culturally, or both. According to Census data, there are only about 5,000 psychologists in the United States who are Hispanic, representing less than 6 percent of all psychologists. In a nationwide APA survey, only 5.5 percent of psychologists, who may be Hispanic or of another race or ethnicity, said they can provide services in Spanish, making them a rare commodity. In addition, only 6.4% of therapists in the United States are Hispanic or Latinx. Symptoms, as they are described in the Hispanic and Latinx communities, can often be misunderstood by mental health providers or lead to a misdiagnosis of individuals as they have their language as well as differences in beliefs, lifestyles, and customs. A common example is how the word “nervios” in Spanish can be used to describe physical illness and can be symptoms of depression but a mental health professional can still misdiagnose them by misunderstanding this word to describe symptoms of anxiety (NAMI website).
Seeking mental health treatment requires acknowledging that there is a need to do so, which can present its own challenge to members of the Hispanic or Latinx community, due to added stigma surrounding mental health challenges within the community. When it comes to discussing symptoms and recognizing mental health challenges, these can be hard to identify, because Latinx/Hispanic people will often focus on physical symptoms and not psychiatric symptoms during doctor visits. This can also be because there is a common perception in Latinx/Hispanic communities, especially among older people, that discussing problems with mental health can create embarrassment and shame for the family, resulting in fewer people seeking treatment. It can be hard to shift an entire community’s temperament and would require these beliefs to be challenged over time. This is most prevalent amongst older generations due to a lack of acculturation. The level of a person’s acculturation is how thoroughly they have embraced or adopted the predominant culture of the place they live, which can play a role in mental health and access to care. Acculturation has been found to predict an increased willingness to use mental health care services between first and second-generation immigrants from various cultural backgrounds.
Despite this, according to SAMHSA’s National Survey on Drug Use and Health, overall mental health issues are on the rise for Latinx/Hispanic people between the ages of 12-49. Major depressive episodes increased from 12.6 percent to 15.1 percent in Latinx/Hispanic youth ages 12-17, from 8 percent to 12 percent in young adults 18-25 age range between 2015 and 2018. This reinforces the importance of increasing access and creating more dialogue around mental health that does not create further stigma but instead normalizes the discussion and encourages seeking treatment for mental health challenges.
Mental health stigma has many layers in the Hispanic community, one of which is known as machismo. The term “machismo” has been described as the belief that you must be able to provide for your family despite any pain or hardship the man endures. Latino men even go to the extremes of avoiding going to the doctor because it is seen as a sign of weakness. In a study, one Latino man said, “[In] machismo we are taught that the men always had to be strong. . . The man doesn’t cry, the man is the provider of the family, the man shouldn’t complain, and the man doesn’t go to the doctor.” Similarly across many minority and immigrant communities, there is a phenomenon known as the “Eldest Daughter Syndrome” that is extremely prevalent amongst the first-born daughters of immigrants. The high pressure to succeed in an environment different from their parents and set a good example for their younger siblings, can lead to anxiety, depression, and other mental health challenges. Some feel burdened with the responsibility of taking care of their younger siblings and at a very young age they adopt more of a maternal role in their family system, adding stress to their critical developmental stages of life.
Despite these obstacles and challenges, the Hispanic/Latinx community continues to show strength and resilience. This year’s theme in celebrating Hispanic Heritage is Unidos: Inclusivity for a Stronger Nation. Here at The NAN Project, we also recognize these barriers and are actively trying to provide support to overcome them. We work with schools, organizations, and people in the community to educate and bring awareness surrounding mental health. We recognize that inclusivity doesn’t just look like bringing equal access to resources to various communities, but also identifying what one specific community’s needs are and understanding what we can offer to fill those needs. By bringing our work, support, expertise, and resources to schools and community centers that are predominantly Hispanic, the goal is to bridge the gap between mental health and what it means to be part of the Latinx community. Understanding how they correlate to each other is the first step in improving on the lack of access and stigma that prevents people from seeking the treatment they need.
Please visit The NAN Project website for a Resource Guide regarding Mental Health Resources hotlines with trained operators who are available 24/7 to help you find support.
Also, check out local organizations here in Massachusetts working closely with our Hispanic/Latinx communities!
- La Colaborativa is a human services organization in Chelsea that provides social services and programming to Latinx immigrants like language courses, career training, citizenship support, and distributes food to families in the communities. https://la-colaborativa.org/
- Eliot Family Resource Center (FRC) in Everett supports families with youth who are at-risk of needing court involvement because of their behaviors. FRC helps families find resources regarding housing support, education, utility assistance, legal help, summer camps, sports leagues,and more. https://www.eliotchs.org/family-resource-center/
- UTEC in Lowell helps young adults through street outreach, violence intervention, programming at correctional facilities, social reintegration, transitional coaching, workforce development, mental health services, and more. https://utecinc.org/
- CTI YouthBuild of Greater Lowell helps young adults between the ages of 16 and 24 who have dropped out of high school and provides opportunities like G.E.D. preparation, vocational training, one on one case management, leadership development, life skills training, and career and academic coaching.
- Roxbury YouthWorks INC helping youth struggling with victimization, poverty and violence transition successfully into adulthood. Services provided are bringing to commercial sexual exploitation of children, work with law enforcement, child-serving public agencies, and other non-profits to help reintagrate youth from court-ordered detention and treatment facilities back into society. http://www.roxburyyouthworks.org/
- The Boston Alliance of LGBTQ Youth (BAGLY) is a youth-led, adult-supported social support organization, committed to social justice and creating, sustaining, and advocating for programs, policies, and services for the LGBTQ+ youth community. https://www.bagly.org/
- YouForward in Lawrence and Everett supports young adults ages 16 to 25 who are experiencing mental health challenges through mentoring, achieving goals, and helping discover talents and use it to inspire others. http://youforward.org/
- The Center for Hope is a Rape Crisis Center in Lowell with a goal to deliver multicultural and inclusive approaches to reach those who have historically have not been adequately served (i.e. limited English speakers, LGBQ/T folks, refugees and immigrants, children, youth, people with disabilities, etc) and also provide different programs for survivors as well as youth prevention groups. https://chhinc.org/