FEATURE ARTICLESHEALTH

NOT LOCO: UNDERSTANDING AND BREAKING LATINX MENTAL HEALTH BARRIERS

By: Pamela Zuber – Sunshine Behavioral Health – Guest Writer, Adelante Magazine

While COVID-19 has rightfully dominated health news since early 2020, that doesn’t mean other conditions have disappeared. In fact, COVID-19 has created, worsened, or highlighted other issues for Latinx people.

One of these issues is mental health. COVID-19 has hit Latinx communities particularly hard.
Statistics about Latinx people and the COVID-19 pandemic
November 2021 statistics from the Centers for Disease Control and Prevention (CDC) indicate that Latinx people are:

• 1.6 times more likely to have COVID-19 compared to white people.
• 2.5 times more likely to be hospitalized because of the disease.
• 2.1 times more likely to die from COVID-19.

In addition to health concerns, the ongoing public health crisis has created other worries. Because of the pandemic, Latinx respondents in a 2020 survey by The Commonwealth Fund noted that:

• 55% experienced some sort of financial consequence.
• 49% used up most of or all of their financial savings.
• 26% worried that they wouldn’t be able to afford necessities such as food, rent, or heat.
• 21% took out a loan or borrowed money.

Given these concerns, people of color are hurting. The 2020 survey stated that 40% of Latinx people reported feeling “stress, anxiety, or great sadness” because of the pandemic, compared to 39% of Black people and 29% of whites.

Barriers to Latinx mental health treatment
Although some Latinx people have needed mental health treatment, many are not receiving such assistance. Such barriers include:

Language
Since early 2020, many of us have learned scientific information and unfamiliar terms such as viral load and breakthrough infections. We may have had to visit doctors and deal with pharmacists and health insurance providers who used specialized language of their own.

As difficult as it can be to navigate these new terms, it can be even more challenging for those of us who aren’t native English speakers. About 68% of Latinx people reported that they spoke English proficiently, according to the U.S. Census Bureau and the Pew Research Center in 2013.

Compared to previous years, this number was higher, but it still meant that almost one-third of all Latinx survey respondents said that they didn’t speak English well or didn’t speak it at all. Immigrants were less likely to know English than people born in the United States.

Documentation status
Some in our community may be reluctant to seek mental health assistance or sign up for health insurance benefits due to their documentation status. This is because they may be fearful of their status or that of a loved one being reported, so they go without.

Not seeking help for mental and physical health can create additional conditions. A Chicago nurse practitioner and professor who works with immigrants says she knows people sometimes don’t receive the regular health care they need. They fear immigration authorities and find it difficult to find employment for undocumented workers like themselves. Because of their worries, they’ve experienced stress-related issues such as anxiety, insomnia, and reflux problems.

Finances and insurance
An undocumented status can hurt job prospects in significant ways. Employers may pay less if one resides in the country as undocumented, or even hold the threat of reporting that person’s status to the authorities.

Language challenges can make it difficult for people to receive the education and on-the-job training needed for many positions. Even better-paying jobs may lack adequate mental health insurance coverage, especially if someone needs longer-term care to treat complex conditions such as addiction or pay for expensive prescriptions.

Furthermore, if you’re struggling with conditions such as anxiety and depression, you might find it difficult (if not impossible) to work. You might not be able to take enough time from work to attend to your health needs.

Cultural beliefs
Of course, some people or their families might not acknowledge their mental health needs in the first place. For instance, some Latinx men might be more susceptible to stress, depression, and substance abuse because they adhere to an ideological code known as machismo that sometimes contributes to certain views of masculinity.

Other Latinx people might hold persistent stigmas about mental health. They might be reluctant to discuss such conditions because they fear what others might say about them or their loved ones.

According to these stigmas, people with mental health challenges are crazy (loco) and possibly dangerous. In this view, their problems are incurable and could be random acts of fate or punishments for things they did wrong.

Mental illness, in such views, could be a form of spiritual or religious retribution. To address such views, practitioners need to understand their Latinx clients.

Breaking mental health treatment barriers

For practitioners
Understanding, in fact, can help break down treatment barriers. Health care providers can learn about the cultures and beliefs of the people they serve.

If practitioners work with Spanish-speaking populations, they might want to learn the language themselves or at least health-related terms. They might want to visit online sites that offer information about different Latinx cultures and glossaries of medical terms in English and Spanish.

Providers should also remember that while clients might be part of groups, they’re still also individuals. Different countries have different cultures. People within similar cultures might vary because of varying personalities, experiences, or whether they were born in the United States or abroad.

For those interested in MH Services
If you or someone you know is interested in learning about mental health conditions and how to treat them, there are many on-line resources. To learn about mental health issues relating to COVID-19, for example, visit the site How Right Now/Qué Hacer Ahora. This campaign includes English and Spanish materials that can help people determine how they’re feeling and find resources for assistance. (Note: The Adelante Medical Resources Guide lists several organizations which provide medical and mental health services. These organizations provide care regardless of your immigration status and ability to pay.)

Learning about conditions and treatment options might make them less frightening and more accessible. Having access to tools in different languages could reduce the risk of misunderstanding or mistakes.

For everyone
Asking questions can also alleviate confusion or misconceptions. No one knows everything. A large part of mental health assistance is education. You can ask practitioners questions, and practitioners can ask you their own respectful questions. A little – or a lot of – awkwardness in the beginning can prevent considerable problems later.

It’s critical that our Latinx community enter the fields of medicine, mental health and addiction treatment. Studies have shown that when people and their mental health practitioners have similar backgrounds, clients

• Are less likely to leave treatment early.
• Use treatment options more often.
• Experience more positive treatment outcomes.
• Report greater satisfaction with their treatments.

Latinx practitioners can reassure people that they’re not alone, that there are people similar to them who are available to help. They’re reminders that people have ways to understand and treat mental health issues instead of hiding or stigmatizing them and the people who have them.

Since the start of the COVID-19 pandemic, we’ve been hearing that we’re all in everything together. But compared to whites, Latinx U.S. residents have been 50% less likely to have assistance to treat their mental health needs.

There are ways we can help address our shared needs. When mental health assistance benefits different communities, it benefits society as a whole.

Other resources
American Society of Hispanic Psychiatry – Find a Physician

La Familia – Get Help Now

Mental Health America – Latinx/Hispanic Communities and Mental Health

National Alliance on Mental Illness (NAMI) – NAMI Compartiendo Esperanza: Mental Wellness in the Latinx Community

Substance Abuse and Mental Health Services Administration (SAMHSA) – Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S.

Therapy for Latinx – Mental Health Screening

UC Davis Center for Reducing Health Disparities – Community-Defined Solutions for Latino Mental Health Care Disparities

About the author: Pamela Zuber has written and edited pieces on science, mental health, addiction and treatment, human rights, gender issues, and other topics.

Sources
www.sunshinebehavioralhealth.com

cdc.gov – Risk for COVID-19 Infection, Hospitalization, and Death by Race and Identity

commonwealthfund.org – NEW SURVEY: Black and Latino Americans Face Greater Mental Health, Economic Challenges from COVID-19 Than White Americans

vcuhealth.org – Breakthrough Infections, Viral Load: What Does This Mean to You?

pewresearch.org – English Proficiency on the Rise Among Latinos

chicagotribune.com – Fear, Anxiety, Apprehension: Immigrants Fear Doctor Visits Could Leave Them Vulnerable to Deportation

sunshinebehavioralhealth.com – Mental Health Issues Facing the Hispanic & Latino Community

ncbi.nlm.nih.gov – Exploring Structural, Sociocultural, and Individual Barriers to Alcohol Abuse Treatment Among Hispanic Men

journals.sfu.ca – Examining Cultural Mental Health Care Barriers Among Latinos

cdc.gov – How Right Now/Qué Hacer Ahora

washburn.org – Spanish Clinical Language and Resource Guide

ncbi.nlm.nih.gov – The Influence of Race and Ethnicity in Clients’ Experiences of Mental Health Treatment