Breaking the Stigma
Finding the right therapy for someone involves trial and error, and mental health experts argue that not incorporating a person’s customs and culture into the mix is a disservice. Photo by Alamy
The pandemic exacerbated mental health disorders faced by Latinos and other marginalized groups. Advocates and therapists say cultural understanding is key to turning things around.
Editor’s note: This story was first published by Illinois Latino News.
The impact of the coronavirus pandemic on Latinos, who have been disproportionately affected, has been discerned.
Due to higher rates of death, unemployment, college dropouts, and homelessness, as well as a lack of access to quality health care, this community is also more prone to developing symptoms associated with post-traumatic stress disorder stemming from loss during the pandemic. Systemic barriers to mental health support have worsened for the community — at a moment when getting timely help has been more critical than ever.
In addition to these challenges, the community has been coping with a mental health care system that wasn't built with them in mind. To adequately move forward in meeting the mental health needs of Latinos, beyond conventional structures and practices, thought leaders say it is critical to focus on culture. Although some aspects of culture contribute to stigmatized views of mental health, it might also be the solution.
Pamela Fullerton, a mental health counselor and owner of Advocacy & Education Consulting, a firm that offers mental health and education-based services to minority communities, describes the mentality that is culturally ingrained into many Latinos: no matter what, keep working. As a result, conversations about self-care, work-life balance, and mental health are much less common than in other communities, which comes at a price.
“Only 34% of Latino adults with mental illness receive treatment every year.”
"We were comfortable because we just put our heads down, and we'd keep going, and I think that's what we'd been taught to do. Sigue, sigue, sigue, trabajando, sigue. Go, go, go, go, go and when we look up again, we find ourselves in chaos because we haven't looked up in so long," said Fullerton.
In 2015, a Substance Abuse and Mental Health Services Administration report found that only 34% of Latino adults with mental illness receive treatment every year.
As an essential worker who can work from home, Fullerton's experience differed from those in public-facing industries, as she was less at-risk in terms of physical health. However, adjusting to staying home, running a business, teaching and caring for her two children, and assisting her clients through their new stressors were challenging changes to balance.
"I did work with essential workers who had to go into work, and so dealing with their anxiety of that, their stress about that. I've had clients who lost their jobs during the pandemic, and so a part of them kind of felt relief on the one hand. But then, on the other hand, a loss of income is a big deal, so I was helping many individuals find scholarship monies, grants, anything to kind of help them stay afloat," she said. "I was doing that, which is very stressful knowing that I got a client who needs to get food on their table."
Centers for Disease Control and Prevention surveys conducted in June 2020 show that overall, around 36% of working adults reported symptoms of anxiety and depression during the pandemic. Rates were even higher among essential workers, with 42% saying they experienced these symptoms and 25% reporting they started or increased substance use to cope.
In the February 2022 episode of ILLN Opinion+, Andy Wade, executive director of The National Alliance on Mental Health of Illinois, discussed the organization's efforts to specifically target minority communities, who traditionally have stigmatized mental health views and who make up most of Chicago's essential worker population.
How People Deal With Grief
Two NAMI Illinois initiatives, Sharing Hope for the Black community and Compartiendo Esperanza for the Latino community, each consist of three videos that explore mental health from the lens of their respective community through dialogue and storytelling, followed by a guided discussion.
"This is only for them (the Black and Latino communities) to talk about their community, to talk about their struggles, their challenges, and hopefully, in some cases, their success as well," said Laura Martínez, mental health equity & inclusion director for NAMI Illinois.
“Our indigenous ancestors did ancient healing practices, so mental health has been there; it just looks different than what we see here in the United States.”
She notes that culture influences people's concerns and how they cope with emotions like grief. For example, she recalled a recent event in which her neighbor's husband died, and after praying, the mourning group began recounting old memories and crying.
"I took the opportunity to turn it into a Compartiendo Esperanza (session), and I said, ‘You know, there's this video,’ and I had my phone," she explained. The specific video Martínez shared shows a grieving family, with the father explaining the need for him to be "macho" and not allow his children to see him cry.
It sparked a response from the men in the novena group.
According to Martínez, one man spoke up to say, ‘You know what, I want my children to know it's not okay. We have a lot of mental health issues on my side of the family, and so I want them to know that if they're not feeling okay, I want them to get the help that they need, right when they need it.’ Because (one of them) he had lost someone to suicide. He said, 'I don't want to go through that again.'"
Fullerton adds that the significant disconnect between minorities and mental health practices dates back to the origins of these disciplines, which never considered diverse cultural experiences.
"If you think about psychology which is the root, psychology and psychiatry, they were started by white men. White, European men and white, older American men and they did all their work on white men and white, middle-class wives. What do they know about everybody else?" she said. "And have we seen mental health in other ethnic cultures? Yes! Our indigenous ancestors did ancient healing practices, so mental health has been there; it just looks different than what we see here in the United States."
For some Latinos, seeking mental health support is heavily stigmatized, in part because people who receive these services are often labeled “crazy.” Photo via Alamy
Fullerton says that mental health providers continue to do a disservice to people of color by not implementing their customs into treatment. It may be a process of trial and error to find one's individualized and preferred method, but doing so creates trust and allows people to feel more comfortable opening up.
"That's what I think is the beauty of mental health; it's being in a partnership with the client that you're working with, with the community that you're working with, getting their input so that they're comfortable with what you're doing in the room because if not, they're gonna do what so many Latinos, so many Black Americans have been doing for years, which is coming to counseling for maybe one or two sessions and then leaving because they didn't connect with the human being in front of them," said Fullerton.
The lack of resources and services available for minorities became apparent during the pandemic. However, many local organizations attempted to provide what these groups needed, whether it was food security, protective gear, or a sense of community.
Sin Título is a cultural and social justice-focused online apparel company founded by Iraís Elizarraraz and her sisters, Diana and Itzel, in August 2020. They opened with phrases like "first generation" and "you love the culture, now support the people" printed on their t-shirts, but have since expanded to hosting a mental health initiative, Fruits of My Labor, after Iraís was inspired by a panel she joined, where she answered questions about self-love and her identity.
"All these people of different backgrounds came up to me and said ‘Your story resonates with me so much, and I didn't know; I thought my story was just a singular bubble, but it wasn't,'" she explained.
Sin Título's mission focuses on uplifting Black and Brown people, but their recent Cinco de Mayo event was designed to elevate Mexican culture, voices, and experiences. Elizarraraz says that being teased by her family as a child by chanting "quiere llorar, quiere llorar" has led to her reluctance to publicly show emotion as an adult. But she couldn't hold back at the event and noticed audience members also wiping tears away.
"I'm like, wow, people were crying at the event, and a lot of barriers were taken down after the discussion," she continued. "Those moments I'm like wow, this is working, and it's going in the right direction, but then also not only do we have to talk about it but how do we heal from it… We need to address it and make sure it doesn't happen for generational trauma in the future."
Some advocates believe that community support is the key to normalizing the need for mental health services. Photo via Alamy
Fullerton points out that simple talking about problems isn’t enough for individuals with more severe mental issues or who require medication. Still, narrative therapy, a type of counseling that focuses on a person's story and treats them as the expert of their own lives, has proven effective for Latino communities.
"We're storytellers as Latinos, too, so I think it really speaks to the heart of who we are, using this type of therapy where we use stories to reauthor a new story that really is about who we are," she said.
She says that informal settings such as NAMI's Compartiendo Esperanza and Sin Título's Fruits of My Labor also help ease Latinos with these sometimes intense discussions. She says that rather than calling them therapy groups, she and her patients call them pláticas, where she approaches them as a friend looking to catch up.
"We're just gonna sit here and talk and enjoy each other's company. Let's bring in coffee; let's do a coffee cake. We love to eat, we love to drink, we love to talk, so bringing things in that culturally make us comfortable and that we're familiar with will help to ease some of the anxiety that comes with thinking, 'I'm working on my mental health,' which is stigmatized or tabooed in our culture and other cultures as well," she explained.
These differences in approaching mental health make a difference to groups who've been programmed to believe that only "crazy" people seek therapy. But whether it's addressed or not, mental health, like physical health, needs to be monitored to prevent crises.
"What I'm trying to do is take us to a point where we don't only think about our mental health when we're in chaos. But prior to all of those, when just trying to deal with the daily stressors of life… That's what mental health awareness is really all about. It's preventative," Fullerton said.
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Annabel Rocha is a Multimedia Journalist for Illinois Latino News (ILLN). A native Chicagoan, Annabel graduated with a BA in Journalism & Media Studies from the University of Nevada-Las Vegas in 2018. Her areas of experience include broadcast production, news writing and interviewing. She now resides on the south side of the city, with hopes of amplifying local Hispanic/Latino voices and sharing stories of inclusion and diversity.