Lily recently moved from Central America to the United States to escape her country’s dangers and to find new opportunities abroad. Six months have passed, and while Lily has adjusted to her new job and has a comfortable place to live, she has been feeling sad, alone, and anxious. She has noticed that adjusting to the new American culture has not been easy. Questions like “How American am I? How Latina am I? Should I speak more English than Spanish or vice versa?” often course through her mind.
As we can see with Lily, mental health issues do not overlook Latinos. Concerns can range from depression, anxiety, and post-traumatic stress disorder to alcohol and substance misuse. One of the most prominent challenges that Latinos face surrounds identity issues, especially concerning their level of acculturation. US-born Latinos, in particular, struggle with the upkeep of their family culture and American culture simultaneously. For example, they are often concerned with which language to prioritize and which customs to follow.
Another issue among Latinos occurs around the focus on the family versus the individual. The Latino culture is known to be a collectivist one, while the United States is individualistic. This cultural difference can present specific challenges to bicultural Latinos. Do they honor their family’s needs above their own, in line with their upbringing? Or do they, like many living in the States, prioritize their own needs? For many, it’s a difficult dilemma. Choosing themselves might lead to their family feeling betrayed and/or an internal experience of anxiety or guilt. Choosing their family might lead to feelings of sadness or frustration as their own needs go unmet. It’s not surprising that during the process of acculturation, Latinos often evidence symptoms of anxiety and depression.
Latino mental health issues are complicated by certain factors. In the Latino culture, the perception (and expression) of mental health issues is largely influenced by what is seen as acceptable versus unacceptable. Showing signs of anxiety and depression is often considered a sign of weakness and can be a source of shame. The Latino culture emphasizes the need to restrain emotions, leading to the masking of symptoms, though it does not mean that depression and anxiety are not present. These disorders might present in Latinos as frequent sadness; a loss of interest in activities; difficulty concentrating; thoughts of suicide; and as physical symptoms such as difficulty breathing, body tremors, and heart palpitations.
Research shows that US-born Latinos evidence more mental health symptoms than their immigrant counterparts. Factors such as not having extended family support in the US, experiencing feelings of not belonging in the community, living in areas of mixed populations, and feeling the pressure to help other family members due to their status have been linked to higher levels of depression and anxiety among US-born Latinos. Research shows that immigrant Latinos tend to be more resilient, associated with lower levels of depression and anxiety. As immigrant Latinos are born outside the US, they generally do not deal with discrimination in their countries; thus, they experience a sense of belonging and have the support of family, friends, and their community growing up. Additionally, immigrant Latinos commonly have the mentality that no matter what they face in the US, their life is improved compared to the less stable circumstances they experienced back home. This mindset can serve as a protective factor.
Despite research showing that mental health issues occur more frequently in US-born Latinos, immigrant Latinos might struggle with post-traumatic stress disorder (PTSD), in addition to depression and anxiety. Trauma can occur prior to immigration as a result of various country conditions. As part of their immigration to the US, Latinos can experience trauma around leaving loved ones behind and around the dangers associated with crossing the border, such as possibly being detained or otherwise harmed in the process. Anxiety can also develop as immigrant Latinos worry about being discovered and deported back to their home countries and about not being able to work due to a lack of legal documents.
In order to cope with the distress that they experience, some Latinos turn to alcohol or substances to get by. Use can turn into misuse and dependence over time. According to a 2018 national survey, 7.1% of Hispanic Americans have a substance use disorder. 3% have an illicit drug use disorder, 24.6% engage in binge drinking, and 5.3% are alcohol dependent. Latino mental health concerns might be further complicated by alcohol and substance misuse.
Research shows that most Latinos do not speak about their symptoms, do not seek help, and do not take any psychiatric medications; Latino mental health issues largely go untreated. Some barriers to receiving mental healthcare include a lack of health insurance, insufficient resources to pay for therapy, worries about deportation, and the language barrier. Latinos must also contend with stigma around mental health. Some Latinos believe that seeking help for mental health issues might signify that the person is “crazy.” They might also find it difficult to talk about private matters with a stranger and might doubt that someone they don’t know will be able to help them. Another factor that can interfere with Latinos seeking psychotherapy is the concern that the therapist might not understand Latino mental health concerns if they are from a different cultural background.
At Gatewell Therapy Center, located in Miami, we are deeply committed to improving the mental health of the Latino population. We are pleased to offer counseling and psychological services in Spanish and English. We aim to provide culturally competent care to help Latinos feel comfortable around seeking help, and our team is skilled in working with anxiety, depression, trauma, and other concerns common in the Latino population. If you are a Latino struggling with mental health symptoms, please know that our goal is to create a safe and supportive space for you to address these symptoms and to improve your well-being and overall quality of life.
Written by Jennifer Tejada, Gatewell Graduate Practicum Student