Diversity and culture can greatly influence the landscape of mental health. Communities may develop different approaches and norms for how to engage in various societal structures, such as in our educational and medical systems. For instance, it is common for Latino communities to show a hesitation to accessing mental health services. And unfortunately, these communities also often experience disparities in access to and the quality of treatment they receive.
Sara Vargas is a marriage and family therapist of Mexican heritage who was born and raised in northern suburbs of Chicago. She graduated from Adler University’s Master of Arts in Couple and Family Therapy program in 2017. Currently, she is working at a nonprofit and conducting therapy sessions with a diverse Latino population. She spoke to us about her experiences and shared insight about the mental health stigma within Latino communities.
We often hear about an overarching reluctance to accessing mental health among Latino communities. Do you observe this hesitation in your therapy sessions?
Yes. I observe the reluctance and hesitation when working with Latino populations almost all the time. There is a huge stigma and discrimination against mental health illness. This is caused by a number of factors, including societal pressure, fear of community perception, and fear of isolation. The Latino community has a collectivist cultural background and in collectivist cultures “asking for help” is a taboo subject. It is somewhat connected to being a burden on others or losing your pride. It is not very easy to change that mindset because in collectivistic cultures, individuals tend to think of themselves as interdependent with their groups such as families, neighbors, and others. They benefit from their group memberships, and in turn, they have a desire to make sure that they benefit their group members.
Do you think language can be a barrier to seeking mental health services within the Latino population?
Absolutely. Language is a very impactful factor. It is hard for some clients to name their feelings or discuss emotional problems with others. In fact, translating certain emotions from Spanish to English can be a very conflicting process. Words can have different meanings in different languages. This is especially difficult when forming therapeutic language.
For example, the word “confienza” is translated as “confidence.” In English, the word “confidence” entails a sense of security you develop towards someone to disclose private information. However, in Spanish “confienza” means having trust in someone. It represents familiarity and intimacy.
I think, particularly in case of language issues, the therapist should take responsibility and check his or her own awareness of linguistic barriers.
What else can be a linguistic barrier aside from bilingualism?
Colloquialism (phrases that are characteristic of informal spoken or written communication). The Latino population is a very diverse community and depending on the region and socioeconomic status, clients may talk differently. It is important to be familiar with the sense of humor in their culture to understand the person’s emotional state. Use of sense of humor is really helpful in therapy. In Latino culture, expressing feelings in a direct manner is not the norm, so humor becomes a great tool for expressing emotions.
How do you think laws on immigration impact access to mental health within Latino communities?
That is another big reason why the community members hesitate to seek help. There is a general distrust in the healthcare system. Sometimes, they do not know if seeking mental help will interfere with their legal status in the United States. There is also distrust in government immigration strategies. Individuals tend to seek out mental health professionals only in their most vulnerable state. The fear of deportation can prevent them from seeking therapy sooner.
According to “Critical Disparities in Latino Mental Health: Transforming Research and into Action” (2005), Latinos tend to experience mental health issues in the form of bodily aches and pains. What has been your experience with this and how do you think it is perceived by mental health and medical treatment professionals?
I saw my clients experience depression in the form of headaches, stomachaches, and backaches all the time. The pain persists despite medical treatment. Also, medical treatment systems are shaped by the dominant culture and can be critical or uninformed on minorities’ health habits. This can be particularly challenging because clients may be at risk of getting misdiagnosed. I had a client who was diagnosed with fibromyalgia. She was told that the cause of her condition had emotional roots which invalidated her story and caused her to distrust all medical professionals. It is important for therapists to be aware of how they word medical conditions of the client to avoid discrediting their experiences.
How do you think mental health professionals can better serve Latino communities?
Members of Latino communities will continue to stay reluctant towards seeking mental health professionals until we change up our cultural competencies and incorporate more culturally sensitive treatment models. Increasing the number of therapists who speak other languages and understand different cultures in depth is essential to provide quality care to underprivileged communities. Also revisiting the therapeutic theories in a more culturally sensitive manner could be helpful. This way the therapist can better understand the internal family dynamics of the community members.