Stigma and a lack education about mental illness cause great suffering for
Latino families, MaJosé Carrasco, M.P.A., director of the NAMI
Multicultural Action Center, told attendees at the Congressional Hispanic
In the minds of some Hispanics, "mental illness is associated with
danger and violence and is often attributed to a lack of character or to
punishment from God," she said.
Carrasco moderated t he program, which was organized by Rep. Grace
Napolitano (D-Calif.), at the caucus's Public Policy Conference in Washington,
D.C., in October. Napolitano's district around Norwalk, Calif., was the site
of a demonstration project funded by the Substance Abuse and Mental Health
Services Administration (SAMHSA) that sought to prevent suicides among
high-risk Hispanic girls in three middle schools and one high school beginning
Research has found that, compared with non-Latino whites, Latinos in the
United States are more likely to under-utilize mental health services, turn to
primary care clincians when they do use such services, and receive less
guideline-compatible mental health care.
Salud mental—mental health—among Hispanic Americans is
complicated not only by cultural attitudes but also by limitations on the care
many can receive. "Latinos need to be able to recognize the illness they
have and then have access to treatment," Carrasco said.
The problems faced by the Hispanic community in general are especially
acute for young people, said Andres Pumariega, M.D., chair of psychiatry at
Reading Hospital and Medical Center in Reading, Pa., and a professor of
psychiatry at Temple University School of Medicine in Philadelphia. Pumariega,
who represented APA at the conference, is chair of APA's Committee of Hispanic
Psychiatrists and chair of the American Academy of Child and Adolescent
Psychiatry's Committee on Diversity and Culture.
Increasing rates of depression, substance abuse, anxiety disorders, and
behavioral disturbances are being identified in Hispanic youth, said
Pumariega. Data from the Centers for Disease Control and Prevention revealed
that Hispanic youth, especially young women, have higher rates of sadness or
hopelessness and of suicidality than other ethnic or racial groupings in the
United States. For instance, 7.3 percent of white youths and 7.6 percent of
black youths have attempted suicide, compared with 11.3 percent of all Latino
youth and 14.9 percent of young Latino women.
Young people who are immigrants or the children of recent immigrants face
other major stressors beyond minority status, said Pumariega. The migration
process itself, legal or otherwise, is highly stressful. Many also have a hard
time assimilating into U.S. society and face discrimination, even while they
are losing many of the protective cultural values and strengths of family and
community. Some are exposed to community violence.
More funding is needed for all children's mental health services, but
school-based services would have particular value for this population, said
Pumariega. "Access to care is important, and we can improve access by
providing care where the youth are. Collaboration between mental health and
educational professionals enhances services and is less stigmatizing,
The 2007 Mental Health in Schools Act (HR 3430), introduced by Napolitano
and others in August, would provide grants for comprehensive mental health
programs in elementary and secondary schools. A similar bill has been
introduced in the Senate.
If the bills pass, such programs could "open schoolhouse doors for
minorities," whose high dropout rates are not accidental, said
Overall, mental health issues in the Hispanic communities in the United
States could first be addressed by increasing awareness of mental illness
symptoms, said Carrasco. She noted the efforts of Univision, the
Spanish-language television network, which won an award from SAMHSA for its"
Salud es Vida....¡Entérate!" (Health Is Life..
.Inform Yourself!) initiative. However, local radio and television stations
and newspapers must also do more, she said.
A fact sheet from the U.S. surgeon general on Hispanic mental health
is posted at<http://mentalhealth.samhsa.gov/cre/fact3.asp>.
The Congressional Hispanic Caucus Health Task Force's priorities for the 110th
Congress are posted at<www.house.gov/baca/chc/tsk-health.shtml>.▪