(CNN) -- Thanks to Obamacare, nearly 6 million currently uninsured Latinos
in the United States will have access to affordable health care come
January 1, 2014, including mental health and substance-abuse services.
But some experts say that won't be enough to encourage mentally ill in the Hispanic community to seek help.
In 2011, 15.9% of Hispanic adults reported suffering from a mental illness the previous year, according to the National Survey on Drug Use and Health. But thousands in this population often go without professional mental health treatment.
Perhaps the most
problematic issue for the Latino community is their fear of being highly
stigmatized for accessing mental health services, experts say. Among
Hispanics with a mental disorder, fewer than 1 in 11 contact a mental
health specialist, while fewer than 1 in 5 contact a general health care
provider, according to the American Psychiatric Association's Office of
Minority and National Affairs. Even fewer Hispanic immigrants seek out
these services.
If a mental health issue
is even acknowledged, Latinos tend to rely on their extended, family,
community, traditional healers and/or churches for help during a health
crisis, according to the APA. As a result, Hispanics often mistake
depression for nervousness, tiredness or a physical ailment, and see the
issue as temporary.
There are also a lack of culturally relevant services that cater to this population.
"What makes it worse is
having very few Latino leaders in the mental health workforce," said
Henry Acosta, former executive director of the National Resource Center
for Hispanic Mental Health. Less than 25% of mental health professionals
are minorities, according to the American Psychological Association.
"Most aren't bilingual and management hasn't enforced culturally
relevant strategies."
Acosta knows from
personal experience how trying the mental health care system can be for
Latinos. After witnessing a friend being fatally shot following an
altercation with a police officer in his New Jersey hometown, Acosta
said he knew he would never be the same. But what he didn't expect was
the severe depression that followed and -- what seemed worse -- being
called "crazy" by his high school peers.
"When I was 16 years
old, I tried to commit suicide," said Acosta, now 44. "Latinos always
hear how they have to be self-reliant when they have problems or even
turn to prayer. But if you have a chemical imbalance, prayer won't help
you."
Even though the teasing
in high school was bad, one of his worst memories is translating for his
parents at the psychiatric ward because they only knew Spanish. "I wish
the hospital had translators or even someone who understood us
culturally," Acosta said.
Eventually, Acosta
overcame his mental illness, got into college, majored in psychology and
became a social worker. He's since made it his mission to change
Latinos' apprehensive perspective on mental health issues and better the
health care system in hopes others won't have to go through what he
did.
"The situation for Hispanics in this country will only get worse unless the system changes," Acosta said.
According to the
National Resource Center for Hispanic Mental Health, Hispanics are a
high-risk group for depression, substance abuse and anxiety. About 1 in
every 7 Latinos has attempted suicide. Hispanic
adults and youth are also dealing with unique stressors like
immigration and acculturation, according to the AMA -- which the
organization said is even more of a reason to provide services that
cater to this population.
"Latinos are
overrepresented in service industry and those took a big hit with the
recession," Acosta said. " 'Hard to make ends meet' is definitely a
different kind of stressor."
Many older Latinos find
the strain of acculturation overwhelming. Their traditional values and
beliefs are often at odds with the new culture, or they may lack family
support and face language barriers. Hispanic youth have also been found
to be at risk for higher levels of emotional distress because of the
pressures to rapidly adopt the values of their new culture while they
suffer from inequality, poverty and discrimination.
According to the AMA,
Hispanic youth suffer from many of the same emotional problems created
by marginalization and discrimination, but without the secure identity
and traditional values held by their parents.
"While working at a
clinic in New York, I was seeing a Puerto Rican family who became
increasingly concerned (about their) 21-year-old son," said Luis H.
Zayas, dean of the school of social work at the University of Texas.
"They said he was having trouble with nervios (nerves)."
The young man was eventually diagnosed with schizophrenia.
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"We were able to explain
to the family the severity of the situation. It was a matter of helping
them understand that their son's schizophrenia was a mental illness of
the brain -- not be critical, avoid pejorative judgment and assure them
that they didn't fail as parents."
After several months, Zayas said, the family refrained from using labels and changed their perspective on mental illness.
He said part of the
problem is how the mental health and primary care systems are separated,
and how they are presented to Latinos.
"I worked with
undocumented immigrants who would ask for 'consejo' (advice) knowing
they were asking for mental health services," Zayas said. "We could
reduce the stigma significantly. ... It's how we present it to them. It
helps to have integrated mental health services into the primary care
setting. We should (be) bringing the services to them rather than
bringing the people to the services."
In the last decade, the Latino population -- now at 53 million
-- has grown by nearly 40%, and is expected to make up close to
one-third of the nation's inhabitants by the year 2050. Tackling the
mental health disparity now could prevent serious future health issues,
experts say.
Obamacare will help fund
new clinics and community centers in highly Hispanic-populated cities
around the country, which would allow them to seek mental health care at
little or no cost.
"Change won't happen
overnight, but I think the key is educating the current population and,
even more, motivating the Latino youth interested in the health sector,"
Acosta said.
"After having gone
through my own mental health issues, I can tell you that just knowing
you aren't alone is so important," Acosta said. "Most times we have our
own answers, but if I had someone who understood where I came from it
would have made an even bigger difference."
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