Hispanics are a high-risk group for mental health issues according to the National Alliance on Mental Illness (NAMI), and not do Hispanics suffer higher rates of depression and suicidal thoughts, they suffer many disparities when it comes to getting psychological and psychiatric treatment.
As few as 1 in 20 Hispanics with mental health issues seek professional mental health care, indicates NAMI, and those who do seek care often look to alternative sources–like the clergy– for advice.
But when it comes to addressing the issues seen at the core of the Hispanic mental health disparities, some experts believe more attention should be paid to socioeconomic factors rather than the issue of race and ethnicity. This means putting the focus on reaching single-parents, improving outreach programs through schools and findings ways to reach all individuals who are low-income, not just Hispanics.
“This is a serious public-health issue that is not thought of as a serious public-health issue, said Margaret Alegria, Ph.D, at an American Psychiatric Association forum. “Existing policies are just not sufficient. The onset of mental illness may be lower among minorities, but persistence is greater, she added. Minorities receive only half the services compared with non-Hispanic white people, and they receive less care even within the same [health care] systems.
Better access to care and culturally-sensitive providers are still important, Alegria indicates, but in her opinion the issue is much more complicated.
“There is no single solution, she acknowledged. I think we need to focus less on race and ethnicity to address mental health disparities and more on the socioecology of neighborhoods and on the intersection of socioeconomic status, child and adult adversity, and disadvantaged role constellation. Supply of providersespecially ones who can speak the language of their patientsis a very important driver of access, she emphasized. But supply is not the only thing; its more complicated than that.
So what is the answer?
Alegria indicates that in order to overcome the stigma that Hispanics face and the preconceived notions regarding psychological treatment, the first step is to ensure that care in the public sector is as of high quality as care in the private sector. This is important for all individuals considered low-income, but especially for Hispanics who are treated more often in out-patient settings and are less likely to be insured.
“We must also go to community agencies or schools, where the people are, rather than wait for them to come to us, she added.
For example, Telephone psychotherapy can help overcome stigma and reach patients who cannot or will not go to a clinic. We have to change their negative view of mental health. We also have to change the role of the patient and increase shared decision making so that their agenda is as important as that of the provider, she said. One-to-one mental health care is an unrealistic solution. We need a public-health approach that focuses on social dynamics, on communities rather than individuals.
By reaching communities who are underserved rather than focusing certain races/ethnicities, the medical community would ultimately be able to encompass Hispanics and other minorities with their efforts. Then, once the issue of reaching people is addressed, more targeted outreach programs could be instated to address the specific cultural needs of certain groups.