Mental illness and stigma in the Latino community

This article was produced as the first in a three-part series on “Reporting on Stigma and Mental Health Needs in California’s Latino communities” for the Center for Health Journalism’s 2016 California Fellowship. 
 
Other stories in the series include:
 
​Do Latinos have the necessary resources to treat their mental illnesses?

CLICK HERE for SPANISH version. 
 
At first, it was scary, admits Joe Muñoz, 19, referring to his experience being admitted into the psychiatric hospital’s emergency room. “It was overcrowded. You feel you do not belong there. You see others who are much worse off than you, like drug addicts and crazy people.”

Having been born with a partial facial paralysis and an outer ear deformity, called microtia, Joe was bullied by his classmates in high school for being different. They would steal his hearing aids, call him names and make prank calls. The bullying continued on social media, too. The psychological effects reached the point where he contemplated suicide. Once he put a knife to his throat right in front of his mother, threatening to kill himself.

This decision led to a call to the police. A police officer arrived on scene and escorted Joe to the Riverside County psychiatric department’s emergency room.

Researchers have found that Latino youth, like Joe, face an array of factors that may increase their risk for mental illnesses. Stress can manifest itself through depression and anxiety which, in turn, can lead to substance abuse or even suicide.

Many do not look for treatment due to stigma or fear of being labeled as crazy, as not being well informed about the importance of quality behavioral health care. Others do not have the means to access to appropriate services to adequately manage their mental health needs.
 
Image
Coretta Daniel, center, delivered her second baby, Zaria, with the help of BBC doula and founder, Christin Farmer. She says the group's services are "so needed" in her community, and can't wait to see them expand. (Thomas Ondrey, The Plain Dealer)

Coretta Daniel, center, delivered her second baby, Zaria, with the help of BBC doula and founder, Christin Farmer. She says the group's services are "so needed" in her community, and can't wait to see them expand. (Thomas Ondrey, The Plain Dealer)

“Among the many obstacles that the Latino community faces, stigma is first, followed by distrust of government and religion,” said Alfredo Huerta, a Mexican immigrant with 18 years experience as a clinical therapist for the Riverside University Health System’s Department of Behavioral Health.

While Huerta believes that there is an initial resistance to ask for help, once the family comes in and starts treatment,stigma is reduced.

The clinical therapist is not the only one who feels that way. Joe’s mother, Sara Muñoz, commented that in the Latino community, the tendency is to keep one’s personal problems inside. “In our culture, acceptance is the hardest part. I saw it when I would take my son to the clinic and would talk to other parents who did not accept the fact that their son or daughter had a mental health issue even though they were cutting themselves, for example. We all knew we were there for the same reason. That is why I ask, what do we gain for staying silent?”

The problem is widespread

The statistics speak for themselves: Approximately three out of four Mexican-origin adults (73%) with a mental health disorder, needing treatment, will not get it. The problem of under utilization is even higher among Mexican immigrants. According to a recent report called “Community-Defined Solutions for Latino Mental Health Care Disparities” published by the UC Davis Center for Reducing Health Disparities, 85% of Mexican immigrants who needed services, remained untreated.

Veronica Kelley, assistant director of the San Bernardino County Department of Behavioral Health, feels that few ask for help they need due to stigma and fear of government. She also feels that adolescents are especially vulnerable to the effects of acculturation and assimilation on their families.

“Adolescents are seeing that the social norms they are being taught at home are not the same among their peers, such as respect for authority.This can cause them a lot of stress and anxiety,” she said.

Another barrier was that there were a shortage in bicultural and bilingual therapists, she added.

The immigrant paradox

In the case of immigrants like himself, Huerta does not find it strange that they suffer from trauma simply because leaving one’s country of origin and coming to a new one is difficult. Ironically, the UC Davis report indicates that newly arrived immigrants tend to have better mental health than those same age peers that were born in the U.S. This has been coined the “immigrant paradox.” However, the longer the immigrant stays in the country, the more possibilities that he or she will develop mental health problems. For Mexican immigrants, individuals living in the U.S. longer than 13 years have higher prevalence rates than those with fewer years residing in the country. This decline is said to be attributed to changes in lifestyle, cultural practices, increased stress and new social norms.

The report also found that Latinos will almost always face generalized treatments that will not accommodate for their linguistic or cultural needs. Furthermore, if left untreated, mental illness symptoms will tend to get worse with time, which eventually impacts relationships, work and daily life.

Although it has been said there are no cures for these illnesses, there are effective treatments, says Huerta, who personally recommends psychotherapy, medication and support groups.

When to see a professional

Huerta suggests that it might be time to see a mental health professional when someone has a conflict or a recurring problem with no apparent solution. Other symptoms could include: difficulty in sleeping, appetite changes, mood swings, negative thoughts and lack of concern for one’s own personal appearance.  

“Talking to someone is an important first step,” he said. “If the person is a believer and goes to church, they could talk to their pastor or priest. If they have access to a primary care physician, they could make an appointment to see if the problem is physical.”

If the doctor does not find anything wrong, then the patient may be referred to a mental health professional, Huerta added.

In Joe’s case, a Latino counselor from  the Victor Wraparound Program, who came to see him at his home and at school was one of the keys to his recovery.  “The counselor helped me find the resources I needed, and he also talked to me and my family which helped improve our communication.”

About a year ago, Joe co-founded an organization called Youth Advocated United to Succeed, known as Y.A.U.T.S., to help youth like himself who are facing hardships in their lives that are affecting their mental health. “Sometimes life throws us into the ocean and the waves seem to be pushing us further and further away from shore. Our goal is to save lives, like a lifeguard. We are reaching out and bringing back those people who feel alone.”

Given his own struggles, Joe is surprised that he was able to graduate from La Sierra High School, in Riverside, last June. Recently he started his classes at the Riverside Community College where he plans to study psychology, American Sign Language and improve his Spanish, which is his immigrant parents' native language. He loves public speaking and, one day, would like to meet the president to tell his story.
 
“I gave myself a chance”, Joe said. “I took a negative and made it into a positive.”
 
[This story was originally published by LA PRENSA.]
 
[Photos by Yunuen Bonaparte/Freelance Photographer.]