The NAN Project Celebrates Hispanic Heritage Month 2022
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/
Presentations to Medford Senior Class
Each of our partner schools is using a unique blend of in-person and remote learning this year, which means all of our presentations have been adjusted to their scheduless to best accommodate our student audience.
This December, we had the opportunity to completely reorganize our typical presentations while working with the senior class of Medford High School. Our capable team ran three activities for students simultaneously, rotating students each week for a total of nine sessions.
In all, we reached over 250 students!
The Presentations:
Screening of 13 Reasons Why We Need to Talk About Suicide:
Executive Director Jake Cavanaugh and Senior Peer Mentor Andrew Christopher screened vignettes from our 13 Reasons Why We Need to Talk About Suicide series. These videos dramatize some of our core curriculum, and offer some engaging visuals that our remote learners definitely appreciated! The Depression and Anxiety vignettes show a fictional, but honest, portrayal of young people experiencing these mental health challenges, and describe how common symptoms may look or feel for students. These videos are a great jumping off point to discuss some of the signs and symptoms of anxiety and depression, in a slightly different way than our Comeback Stories. Jake and Andrew also lead a discussion around our Coping Strategies video, where some of our own TNP Peer Mentors describe their self-care techniques!
Creating a Self Care Toolbox: Peer Coordinators Elli Peltola and Shilpa Thirukkovalur lead students in an interactive, hands on activity focused on creating a Self Care Toolbox. The activity taught students about different types of self-care, such as physical self care, or spiritual self care that, together, create a well rounded set of skills that can be used across different scenarios – like a toolbox! Shilpa and Elli reported a lot of great interaction in the chat with students, discussing different self-care activities they are doing during the pandemic as well as how their self-care has changed.
Stress relief was a popular topic, and students recommended going on walks and spending quality time with their dogs, cats, and other furry friends. Sounds like a good idea to us!
To check out the activity Elli and Shilpa used, check out Virtual Hangout #10 in our Lesson Plans for educators!
Peer Mentor Presentations:
Clinical Director Donna Kausek and Peer Coordinator Lizzie MacLellan lead our Peer Mentor Presentations to students, using two breakout rooms to create smaller, more personal groups. Peer Mentors shared their updated Covid Comeback Stories, which focus on the strategies and supports they’ve found most helpful in managing their mental health this year. Students were so appreciative of these stories, and asked some thoughtful questions about the challenges our Peer Mentors discussed. Medford was the first student audience for some of our newest training graduates, but you wouldn’t known that from how skillfully they handled the fast-paced Q&A!
That’s four Nan Project presentations running all at once! This strategy was unique, but it allowed us to keep each presentation group small and interactive as our in-person programming. Most students made use of the chat feature to share their reactions and questions, and we were so impressed by their curiosity and insight. Though these students have had a strange senior year, we’re hopeful that this knowledgeable bunch will continue their conversations about mental health through the rest of the school year.
Our Peer Mentors once again rose to the challenge presented by remote learning, as they have all year! We’re excited to return in 2021, and to work with underclassmen in the future!
The NAN Project’s End of Year Recap
End of Year Recap
The NAN Project team has been super busy this school year with our Peer Mentor presentations, professional development trainings, and parent presentations. Since the beginning of this school year, we have presented for 16 schools to over 1,350 students and 770 caregivers, parents, and community stakeholders. That’s a total of 2,120 folks! While most of our presentations were to high school students, we really expanded our audience this year with a successful rollout to middle schoolers and parents. We recently finished up a round of presentations at Beverly Middle School and their students were so excited to talk with us. They asked our Peer Mentors questions about their stories and shared their own experiences and coping strategies. The conversations were enriching for both the students and our team. Check out what Beverly’s teachers had to say about us:
“Speakers were fantastic, love the new addition of the self-care kahoot, great education around strategies to help.”
“I thought it was great. Super well organized. I loved that you had 3 speakers and I think it was 3 others as well [to answer students’ questions]. It felt like you set it up for safe conversation. The speakers chimed in when students were more quiet making it conversational. “
What Does a Typical Middle School Presentation Look Like?
Three of our Peers present their COVID Comeback stories,which talk about how their mental health has been affected during the Pandemic and what strategies they are using to take care of themselves. Between each Comeback Story, we have a discussion with the students about warning signs they noticed in the story, the importance of reaching out to a trusted adult, and different self-care activities they could try. Every class has a guidance counselor come in to talk about their role and the mental health resources available in the school, so students know they have a trusted adult available if they need to talk. We’ve added a self-care Kahoot, which is a virtual trivia game , to engage students and make presentations more interactive.
Parent Presentations
We’ve also had big turnouts and lots of positive feedback about our parent presentations! Because we are doing everything virtually this year, our trainings have become a lot more accessible for busy parents. Schools have told us that parents they haven’t had any contact with all year have come to our events. One of our popular trainings is called Building Resilient Families, where our knowledgeable trainers go over different strategies to help families adapt to challenging situations and bounce back. We also provide many resources including hotlines and websites with mental health information. Since parents and families are a really important source of support to young adults, we are so happy that we’ve been able to connect with them more in the past few months.
We look forward to continuing our work in the New Year. We hope everyone has a healthy and safe holiday season!
Senior Peer Mentor Training 2019
Written by Sarah Dickie
This Summer, The NAN Project held our second Senior Peer Mentor Training Camp. This six-week, twelve-part training covered a wide range of topics relating to mental health, suicide prevention, and self-care. As summer tends to be a slow time for the work we do, with high school students on break from school, these trainings have three purposes: to provide our Peer Mentors with work; to build on our presentation and suicide prevention skills; and to strengthen the relationships among our team.
Through our participation in this training camp, our Peer Mentors learned a lot about supporting youth struggling with their mental health. Meghan Diamon of Mindwise introduced us to SOS: Signs of Suicide, a series of universal, school-based depression awareness and suicide prevention programs designed for middle school and high school students, as well as their parents and teachers. SOS is similar to the Question, Persuade, Refer or QPR method that we teach: both involve “asking the question” – that is, asking if a youth is thinking about suicide – and encouraging the youth to seek mental health support. We also learned some “postvention” approaches for providing support to loss survivors after a suicide with Debbie Helms of Samaritans of Merrimack Valley. Later, Kelsey Taylor taught us all about Motivational Interviewing, a method of supporting an individual in taking steps toward changing harmful behavior. MI is appropriate for use by clinicians and us average folks, because of its focus on keeping power in the hands of the individual changing their behavior. Though we don’t work one-on-one with adolescents in our line of work, this method is valuable to us in our everyday lives as we help our colleagues and our loved ones in their recovery journeys.
Our team also enjoyed the opportunity through this training to improve our working relationships and practice our self-care. We began the summer with mindful yoga for anxiety relief, led by art therapist Alex Norby. This was a first for most of our Peer Mentors, and many found it so rejuvenating that they sought to add it to their personal routines. Later, Senior Peer Mentor Greta Waag taught us some self-reflection skills through Dialectical Behavioral Therapy, or DBT, a method that has helped her tremendously in her own recovery and one she’s very passionate about. Additionally, our team clinician Donna Kausek led us in a conversation about healthy work relationships, covering topics like effective communication, fostering mutual respect, and making and keeping boundaries – all skills that will prove invaluable to us in our work with The NAN Project and beyond.
To break up the sometimes intense suicide prevention topics, we got to have some fun and flex our creativity with improvisational activities and artistic projects. Friend of The NAN Project and filmmaker Dan Perez de la Garza led us in a film studio workshop. Last year, Dan helped us create the vignettes about mental health that we’ve released on YouTube. He encouraged us to use film as a medium to express ourselves, given that our work in high schools has already made us storytellers. Building on this theme, Agatha from Salem State University lead us in some public speaking and storytelling exercises. We practiced concise phrasing with six-word stories and answering tough questions with no preparation in front of an audience, which pulled many of our Peer Mentors out of their comfort zones. Though it may have been hard to get through, this exercise showed us that we have the skills to power through an uncomfortable situation. Our team did lots of art, too: Alex returned to lead us in a group painting project for which we connected our individual canvases with one continuous line, illustrating how we are connected as The NAN Project team. Finally, art therapist Fernanda Lopez from Lawrence Arts House helped us to create a three-dimensional mural to represent our work. We used daffodils as a symbol of rebirth and new beginnings in recovery, and arranged them around the word hope, which we hope to instill in the students who attend our presentations. We hung this mural in The NAN Project’s Lexington office as a reminder of our incredible journeys and of the great time we had together this summer.
Following this extensive training, the wonderful group of young people who participated have all graduated to Senior Peer Mentor status. Thank you to our guest instructors for taking time to come work with us; thank you to the Young Adult Vocational Program in Arlington for lending us a beautiful training space; and thank you to Eliot and the Cummings Foundation for the support to make these trainings happen. Our team is more prepared than ever to return to high schools this upcoming fall!
QPR in North Hampton
By Sarah Dickie
Earlier in June, the NAN Project sent a few members of our team to Western Massachusetts for certification in leading QPR training for suicide prevention. Peer Coordinator Elli Peltola and Senior Peer Mentors Sarah Dickie and Onix Jimenez trekked up to Northampton the night before to enjoy a stay in the beautiful hotel Ellery. Elli and Sarah, arriving early in the afternoon, passed the time with a scenic walk down Main Street in the shopping district. We explored local shops and had delicious hibachi for dinner, giving us a chance to spend quality time together and build our working relationship.
Training proceeded on Thursday, June 6th at Hotel Northampton from 8am to 4pm. An impressive spread of pastries, fruits, and coffee greeted us as we entered the sunny conference room. Floor-to-ceiling windows draped in luxurious, intricate curtains surrounded tables topped with white satin-esque tablecloths. The elegance of it all was daunting. Our team was feeling a bit nervous, a little out of our league, maybe (as this was the first time any of us had taken a trip like this for work), but we were overwhelmingly excited to learn and flex our mental health muscles.
Before training began, we had the chance to enjoy the provided breakfast and socialize with the other trainees: some social workers, some teachers, some nurses, some police officers. We got to share our mission with them and make some new connections with school staff before the upcoming academic year of classroom presentations. Despite our different careers, we had all gathered there with the goal of better equipping ourselves to prevent suicide, lending us a powerful feeling of unification.
QPR – standing for Question, Persuade, Refer – is a strategy for suicide prevention which offers increased possibility of early intervention, stressing action and active follow-up with the struggling individual. Using this strategy does not require the at-risk person to ask for help, but instead encourages friends of the individual to ask about suicidal intent and offer support through the help-seeking process. Peer Mentors at the NAN Project learn this strategy as part of their onboarding, and many of our senior staff become certified to teach this material.
Our trainer for the day was Sarah Gaer of the Riverside Trauma Center, a Master Trainer of the QPR Institute. She shared that she had lost her best friend to suicide as a young adult and had dedicated herself to the cause in her memory. Our team could tell that Gaer was incredibly passionate about the work, which impassioned us, too. While remaining sensitive to the heavy material, she also had a great sense of humor, and thought we ought to have some fun together — this put us more at ease.
In the morning we covered suicide statistics, risk factors, and various warning signs that a suicidal person might show; and in the afternoon, we dove into model delivery of the QPR curriculum, how to properly use official QPR Institute materials, and a QPR “boot camp,” which had us practice answering potential tough questions from an audience of trainees.
We each went home with a bag of goodies lovingly packed: a binder of training guides, a starter pack of QPR information pamphlets, and some reading on providing support to individuals struggling with suicidal thoughts. Additionally, these members of our team are officially certified to teach QPR. According to the QPR Gatekeeper requirements, this means we are able to recognize a suicidal person at risk, demonstrate increased knowledge of suicide intervention skills, and demonstrate the ability to persuade the at-risk person to seek help and stay alive.
Following this certification, our team is better prepared to provide sensitive and well-informed suicide prevention training to new and seasoned Peer Mentors alike; and, to provide guidance to high school students who want to help their friends who might be struggling. Many thanks to all of our supporters: you help us to take advantage of opportunities like this and keep our Peer Mentors trained.