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Mental Health Mind Field
What Hispanics Face and How Communities Can Get Help
By Yolanda Perdomo
The year was 1986 and Henry Acosta was a troubled teen bothered by just about everything. The straw that broke his emotional back was a breakup with his high school girlfriend and he took pills to commit suicide. When Acosta was admitted to the hospital, where he ended up staying under observation for five weeks, there was no one on staff who was bilingual or who spoke Spanish to explain to his parents the situation.
“So who do you think they used as a translator? The 16-year-old kid who was in the hospital, which is absurd and ridiculous,” states Acosta, who is now the executive director of the National Resource Center for Hispanic Mental Health, an organization that focuses on addressing the lack of availability, access to and the provision of quality mental health services for Latinos. “I think for me the reason I got involved [in the mental health field] was because when I was in the hospital, there were no bilingual staff whatsoever. Not one clinician, not one psychiatrist, nothing.”
Acosta’s story of not being able to have someone to assist with a translation in a hospital or community center is all too common in cities with large Hispanic communities where there are few or no trained bilingual or Spanish speaking professionals. When it comes to diagnosing a mental health issue, discussing treatment options and providing support, Acosta says he’s flabbergasted with what he sees today.
 Henry Acosta, executive director of the National Resource Center for Hispanic Mental Health. |
 Dr. Alegria |
Even if Latinos are able to have access, an even bigger hurdle may prevent them from getting the help they need for themselves or a loved one. In the Latino community, overcoming the stigma of mental health may be the biggest barrier. According to Dr. Cora, one of the issues seen in the Latino community has to do with viewing mental health issues as an issue of weakness. And that can be one of the main reasons why people don’t seek help earlier. “There may be more resistance to a diagnosis of depression and they may say ‘I don’t feel really down or depressed,’” states Dr. Cora. “What we would do is show them that their lack of interest in doing the things they usually enjoy doing, their lack of motivation into doing some things are reflective of underlying issue of depression and not necessarily anxiety.”
According to Margarita Alegria, Ph.D., director of the Center for Multicultural Mental Health Research (CMMHR) at the Cambridge Health Alliance, and a professor of psychology at Harvard University’s Department of Psychiatry, when a symptom affects everyday actions and occurrences, bigger problems lie ahead. “One of the most common anxiety disorders we see is called social phobia. This has to do with people having difficulty, like they want to interact, want to talk in public but feel afraid of speaking in front of other people,” says Dr. Alegria. “Where people have excessive worries. The difference is when it causes dysfunction. Not only that you have the feelings, it actually causes dysfunction in your performance, in getting out of bed, in completing your task. It’s not only that you have the feeling, but it affects your routines, the person you are.”
Dr. Cora adds the inability to get the correct information, in English or Spanish, coupled with a person’s acceptance of a stigma, can lead to other issues. “Anxiety and mood disorders are the most prevalent. Another really big issue is addiction,” says Dr. Cora. “One of the things that you see with anxiety is people popping pills. Instead of working through them, it’s easier to take Xanax than to work on the underlying issues surrounding anxiety. So I would say it’s two-fold.”
Despite the problems, improvements are being made in the areas of outreach to undeserved communities. There has been awareness in the importance of recruiting a workforce that speaks the language, who speaks Spanish. “We actually need to train a lot more and I know some people that are doing programs at community colleges and in other centers to see if we could do a better pipeline of Spanish speakers into the workforce,” Dr. Cora states. “I do think that, however, availability of programs and providers in community health centers that have flexible hours that serve the population...we have such big needs and so limited access.”
 Dr. Gabriela Cora. |
 Congresswoman Grace Napolitano, (D-CA). |
While different mental health issues (depression, anxiety, addiction) affect Hispanics, one of the most startling reports focusing on Latina girls is influencing how everyone, from parents to teachers to lawmakers, can be part of a solution to a devastating problem. According to a report in American Psychologist, Latina teens are more likely to contemplate suicide than their other minority counterparts. The report notes that at least 15 percent have attempted suicide while another 25 percent have thought about it.
For Congresswoman Grace Napolitano (D-CA), studies like the one in American Psychologist further underscore the need to help people at an early age. Today she sponsors the “Mental Health in Schools Act” (H.R. 751) where schools would partner with mental health facilities to provide therapists for immediate services to students. This bill, introduced in February, came out of a similar program already in place in the Representative’s district in California where 11 schools have on site behavioral services. Napolitano is confident that the house will pass this bill so young people get the help they may need.
“We are ignoring our children’s emotional needs, their mental needs. The minute you say ‘mental health’ you hear ‘estas loca’ (you’re crazy). Or you need to be institutionalized. We’ve got to erase the stigma and this is part of it,” says Representative Napolitano. “Times have changed, pressures have changed, and the world has changed. They need to change and be accepting of the possibility that they need professional help.”
The bill would provide $200,000,000 in competitive grants of up to $1,000,000 each. Representative Napolitano says helping young people before they become troubled adults should be a priority for everyone.
“[When a tragedy happens], everyone says we got to do something. Well, why are we not beginning to focus on some of the things these youngsters face throughout during their formative years? The signs were there,” says Napolitano, whose colleague Representative Gabrielle Giffords (D-AZ) was allegedly shot by Jared Lee Loughner, a man who reportedly had mental health issues. “Why were we not paying closer attention to the needs of these youngsters? Maybe the parents did not notice or were in denial or couldn’t afford it, I don’t know. But people have to start paying attention.”
“What happened in Arizona is that we know that the shooter had mental health issues that were unaddressed when he was at school and college. They can use that as a leverage to show what can happen at a severe level when mental health issues are not addressed,” says Acosta. “Maybe Representative Napolitano will have an opportunity to get across the message that will get people to listen. Any member of Congress, regardless if they knew the congresswoman or not, on that day, was personally affected. I’m sure many of them thought that could happen to me.”
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