Across the U.S., there is a mental health crisis—according to the National Alliance on Mental Illness (NAMI) one in five Americans have a mental health condition. While issues such as depression and anxiety affect all populations, Latinos’ mental health issues are often related to certain lived experiences, including discrimination, cultural identity, immigration, and unique family and community stressors.
While mental illness vulnerability rates among Hispanics are similar to those of the U.S. population as a whole, Latinos and other minorities have higher rates of untreated mental health concerns. Only 34% of Hispanic adults with mental illnesses receive treatment annually according to NAMI. There are a host of reasons for this, including barriers to care such as cultural stigma and distrust in the healthcare system.
Why are Latinos suffering in silence and what can we do to ensure the health and wellbeing of our Latino community members?
Barriers to Care
According to the National Institute on Minority Health and Health Disparities (NIMHD), “among U.S. adults with mental health disorders, racial/ethnic minorities are only half as likely as Whites to get treatment; they are also more likely to drop out before completing their treatment.”
Often, this can be attributed to some Latinos claiming that they don’t want treatment. But it’s not that they don’t want to feel better—let’s explore the underlying causes of this desire to avoid mental health treatment.
While there is certainly a stigma attached to mental health treatment throughout the general population in the U.S. (although this has begun to ease in recent years), the stigmatization of seeking mental health services is exacerbated in Hispanic communities, partially due to a culture of privacy and secrecy. Among Latinos, it is a common belief that these types of challenges are shameful and should be dealt with within the home to avoid unwanted attention on their family that may result from accessing therapy or other services. In some cases when Latino families do recognize that a loved one needs help, they may encourage the struggling individual to find solace within religion. While this may be helpful for some, religious leaders are not always properly trained or equipped to address serious mental health issues.
Access to Care
Even when Latinos have acknowledged the need for care despite the stigma, many face barriers in access to mental health treatment. Because the topic is culturally taboo, many Latinos may have limited awareness about what kind of help is available for the challenges they are facing. Additionally, these services, like most healthcare in the U.S., tend to be quite expensive. While costs for mental health services vary depending on the provider and level of care required in accordance with the severity of one’s diagnosis, the nationwide average for a single therapy session is $182. A patient with major depression, for example, can spend an average of $10,836 a year on health costs, according to CNBC—that’s nearly 20% of the median household income for Hispanics.
While some insurance policies include mental health services, coverage is often limited, and nearly half of psychiatrists don’t even accept commercial insurance. What’s more, access to insurance is also a barrier to care for Hispanics, as they are three times as likely as whites to be uninsured—in fact, they have the highest uninsured rates of any racial or ethnic group within the United States, according to the U.S. Department of Health and Human Services Office of Minority Health.
Immigration status is another major factor preventing Latinos from seeking and accessing mental health services. Undocumented immigrants are not eligible for Medicare and their access to Medicaid is usually restricted to emergency provisions. While some undocumented immigrants are able to obtain private insurance, most are uninsured—undocumented Latinos have lower percentages of insurance coverage than any other group according to the National Library of Medicine. Beyond being uninsured, they often lack job security due to their migratory status, and thus are frequently unable to have the flexibility to leave work due to health issues.
Additionally, research by the Kaiser Family Foundation suggests that immigration policy changes enacted during the Trump administration resulted in increased fears among immigrant families about seeking health care services. While some of these policies have thankfully been reversed during the Biden administration, it will require ongoing efforts and improved policies to rebuild immigrants’ trust in programs available to them.
Language Barriers and Cultural Competency
Latinos’ concerns and distrust of the health care system are valid—for many who seek care, the next question becomes: is it effective? For many, the answer is unfortunately no. Oftentimes, the quality of care is inadequate due to language barriers and lack of cultural competency among mental healthcare providers. According to the American Psychological Association, only about 5% of psychologists in the U.S. are Latino.
Trying to work through the deeply personal issues that come up in therapy is challenging enough as it is—now imagine having to do so in your second (or third) language. The lack of diversity among mental health professionals may lead not only to an inability to understand certain issues unique to the Latino community, but could also lead to implicit bias, presenting further obstacles to receiving adequate care.
Improving Mental Health for Latinos
We are slowly starting to observe increasing numbers of Latinos seeking mental health services, such as a rise in millennial women and second-generation immigrants going to therapy, as reported by Salud America. However, the COVID-19 pandemic has presented new challenges to mental health. Among Latinos, 20% reported suffering from increased anxiety due to the pandemic.
Poor mental health and a lack of access to services not only impacts individuals and their communities—according to NAMI, depression and anxiety disorders cost the global economy $1 trillion in lost productivity each year. So, what can you do to help ease the burden on your Latino employees and ultimately your business? You can start by cultivating a safe, healthy, and accepting company culture. Pay attention to any workplace discrimination or harassment issues that may arise and address them swiftly. Provide adequate health insurance coverage to your employees and ensure that these plans include mental health services. Consider offering “mental health days” to your employees without repercussion so that they feel empowered to take preventative measures to ensure their mental wellbeing. Additionally, be sure to promote that these benefits exist and are available, as most employees are unaware that they can access these desperately needed resources.
By recognizing that culture has a big impact on personal and communal well-being, we can begin to address the disparities that exist for the Latino community in accessing care for mental health issues.