Mental Health in the Latinx Community

Hi Friends!
Welcome to Issue 20 of this newsletter. This is our final consecutive week talking about Mental Health. Today we turn our attention to the Latinx communities of the United States. As a Puerto Rican and Dominican person, I grew up with Latinx food, music, traditions and culture. While some Latinx people are light-skin, even white passing, I am not, I am an Afro-Latina, descended from slaves, Tainos and Spaniards. For me, the fact that some of my cousins were two shades lighter and some were two shades darker, some had straight brown hair, and others had coiled dark hair, some spoke Spanish and some spoke English, just seemed fun, until I got older, and felt confused. Even within the microcosm that is my life, it’s clear to see that the Latinx experience is so varied. “The Hispanic/Latinx community in the U.S. is very diverse, including people from many different nations and regions of the world. Individuals of Mexican, Puerto Rican, Cuban, Central American and South American descent have been part of the American cultural tapestry for centuries.” (NAMI) It was very clear during the election that a lot of folks in America thing of Latinidad as a monolith, when that simply isn’t the case. While some areas in my research on mental health overlap, there are so many nuances within specific ethnic groups and regions, just like all people. With that being said, let’s get into it!

Key Words

Hispanic: This English word evolved from the Latin word Hispanicus, which is reported to have been used to refer to people living in Hispania — the Iberian Peninsula in today’s Spain — during the Roman Empire. It came into use by the United States government during Richard Nixon’s presidency, which spanned 1968‒1974. It first appeared on the U.S. Census in 1980, as a question prompting the Census taker to determine whether or not the person was of Spanish/Hispanic origin. It specifically refers to people who speak Spanish and/or are descended from Spanish-speaking populations.

Latino/Latina/Latinx/Latine: In an effort to be more inclusive to groups like Brazilians, who speak Portuguese, not Spanish, the word Latino came into the lexicon. This term takes the focus off the the Spanish colonizers and onto thee indigenous people of these regions. In 2004, Latinx became a gender neutral term. Recently, Latine became a gender neutral option that also follows along with the grammatical rules of the Spanish language.

Machismo: An exaggerated sense of masculinity wherein men must provide and protect their family.

Marianismo: A form of toxic femininity in response to machismo where women strive to be pure and moral like the Virgin Mary.

Limpias: A Mexican spiritual cleansing practice used to heal from emotional and spiritual imbalances, or after acute shock and trauma to support the spirit and emotional body. 

Familismo: A cultural foundation that emphasizes connectedness and a strong attachment and duty to one’s family.

Acculturation: The level of a person’s acculturation, how thoroughly they have embraced or adopted the predominant culture of the place they live, can play a role in mental health and access to care. Acculturation has been found to predict use of health care services, with a higher level of acculturation resulting in higher utilization. Hispanic/Latinx communities have an added risk of experiencing mental health issues because of the stress of facing discrimination while also trying to navigate between different cultures.

Let’s Get Into It

Background

• Unlike the newsletters about the Black and American Indigenous communities, the Latinx community is so massive, from so many various regions, that it’s impossible to create a succinct history that encompasses all perspectives. Instead, here is a brief and inclusive background based in shared culture.

• The Latinx community has always struggled with stigma—both in and outside of the United States. The reasons are as varied as our our cultures’ pressure due to machismo, a heavy reliance on faith versus therapy, and a general lack of education when it comes to what psychology and psychiatry can do for us. And that doesn’t even take into consideration the financial and language barriers that cause many to view therapy as a “waste of money” or “something for white people.” (Oprah Magazine)

• A 2019 NPR story revealed that Latinx youth are struggling more than ever with their mental health—in part due to the rise of the current anti-migrant rhetoric by Donald Trump and the previous administration. Additionally, a study in JAMA found that there’s been an uptick in the number of premature births among pregnant Latinx persons since the 2016 election.

• There is the very real damage currently being inflicted upon immigrant families who are being separated at the border and across the country due to a rise in deportations. Even the American Psychological Association has spoken out about the traumatic effects these separations will have on the mental well-being of parents and children alike.

• Language barriers, lack of health insurance, lack of financial ability, lack of cultural competence—meaning a doctor unfamiliar with Hispanic culture is more likely to misdiagnose, immigration status, acculturation and stigma are the main barriers to mental health services for the Latinx community. (NAMI)

Facts & Figures

• Approximately 34% of Hispanic/Latinx adults with mental illness receive treatment each year compared to the U.S. average of 45%. (NAMI)

• Among Hispanic American immigrants experiencing mental health issues, fewer than 1 in 20 use services from mental health specialists. (NCBI)

• Only 5.5% of psychologists here in the States are able to give care in Spanish. (APA)

• According to Pew Research, 84% of Latin Americans were raised Catholic, and 77% of Latinxs overall identify as Christian. This affects the stigma around seeking mental health care when most families rely on the church for this support. There is some similarity and overlap here with the Black community.

• 15.7% of Hispanic/Latinx people in the U.S. live in poverty (compared to 7.3% of non-Hispanic whites). This impacts access to healthcare. (NAMI)

• In 2018, 19% of Hispanic people had no form of health insurance. (NAMI)

Over the last few weeks, I think we have learned that overall in POC communities, mental health is often stigmatized, or when folks seek help, they can be misdiagnosed or discriminated against due to culture and language barriers. Unfortunately, I couldn’t find many resources that support mental health in the Latinx community, but I did find one organization that’s definitely worth mentioning. #MenOfColorSmile pushes back against toxic masculinity and explores “the intersection of Masculinity, Vulnerability, and Mental Wellness—together.”

Continue learning about the nuances between various Latinx ethnicities. Just because someone is European, we don’t assume Italians and Swedes have the same culture. In the same way, remember that Puerto Ricans and Mexicans, Cubans and Ecuadorians, Colombians and Dominicans, are different ethnic groups with rich and multifaceted histories.

“We are the ones we’ve been waiting for, we are the change we seek” — With love and light, Taylor Rae

Mental Health in the Indigenous Community

Hi Friends!
Welcome to Issue 19 of this newsletter. This is our second consecutive week talking about Mental Health. Today we turn our attention to the Indigenous communities of the United States. The native community in America has endured the traumas of foreign disease, discrimination and genocide. Let’s discuss a brief history of their experiences and talk through some statistics. Let’s get into it!

Key Words

American Indian, Native, Native American, Indigenous American: All of these terms are acceptable. The consensus, however, is that whenever possible, Native people prefer to be called by their specific tribal name. In the United States, Native American has been widely used but is falling out of favor with some groups, and the terms American Indian or indigenous American are preferred by many Native people.

Historical Trauma: This theory purports that some Native Americans are experiencing historical loss symptoms (e.g., depression, substance dependence, diabetes, dysfunctional parenting, unemployment) as a result of the cross-generational transmission of trauma from historical losses (e.g., loss of population, land, and culture). The current problems facing the Native American people may be the result of “a legacy of chronic trauma and unresolved grief across generations” enacted on them by the European dominant culture.

Let’s Get Into It

A Brief History

Boarding Schools for Native Children

• For the last 500 years, individuals from the dominant European cultures have engaged in behaviors that have resulted in the purposeful and systematic destruction of the Native American people (Plous, 2003). Native Americans have been subjected to traumas that have resulted in specific historical losses. These losses include loss of people, loss of land, and loss of family and culture.

• The population of Native Americans in North America decreased by 95% from the time Columbus came to America in 1492 and the establishment of the United States in 1776. (TPC)

• Mourning practices were disrupted when an 1883 federal law prohibited Native Americans from practicing traditional ceremonies (Brave Heart, Chase, Elkins, & Altschul, 2011). This law remained in effect until 1978, when the American Indian Religious Freedom Act was enacted. This disenfranchised grief has resulted in the Native American people not being able to display traditional grief practices. As a result, subsequent generations have been left with feelings of shame, powerlessness and subordination (Brave Heart & DeBruyn, 1998).

• President Andrew Jackson approved the Indian Removal Act of 1830, forcing the relocation of as many as 100,000 Native Americans.

• By 1876, the U.S. government had obtained the majority of Native American land and the Native American people were forced to either live on reservations or relocate to urban areas. Being relocated to urban areas removed Native American people from all the lives they were familiar with. Leaving their domestic lands led to a decline in socioeconomic status as they were not able to provide for their families, and the families became dependent on goods provided by the U.S. government. These relocations resulted in the death of thousands of Native Americans and the disruption of families. (TPC)

• The intent was to force the Native American people to fully assimilate to the dominant European-American culture and completely abandon their own culture. In 1871 the U.S. congress declared Native Americans wards of the U.S. government, and the U.S. government’s goal became to civilize Native Americans and assimilate them to the dominant White culture. (TPC)

• Government and church-run boarding schools would take Native American children from their families at the age of 4 or 5 and not allow any contact with their Native American relations for a minimum of 8 years. In the boarding schools, Native American children had their hair cut and were dressed like European American children. All sacred items were taken from them and they were forbidden to use their Native language or practice traditional rituals and religions. Many children were abused physically and sexually and developed a variety of problematic coping strategies (e.g., learned helplessness, manipulative tendencies, compulsive gambling, alcohol and drug use, suicide, denial, and scapegoating other Native American children). (TPC)

• The removal of children from their families is considered one of the most devastating traumas that occurred to the Native American people because it resulted in the disruption of the family structure, forced assimilation of children, and a disruption in the Native American community. (TPC)

• Given the substantial historical traumas Native Americans have experienced, experts believe they would be at greater risk of developing physical and emotional concerns related to re-experiencing these traumas. (TPC)

Lack of Culturally Appropriate Messaging

• The Western concept of mental health illnesses may not correspond with the beliefs and interpretations of Native cultures. The words “depressed” and “anxious” are absent from some native languages where alternative expressions such as “ghost sickness” or “heartbreak syndrome” are present. (ADAA)

• Many Indigenous tribes embrace a worldview that encompasses the notions of connectedness (with the past and with others), strong family bonds, adaptability, oneness with nature, wisdom of elders, meaningful traditions and strong spirit that may serve as protective factors when it comes to mental health. (ADAA)

• According to the Anxiety and Depression Association of America, “Native/Indigenous people may express emotional distress in ways that are not consistent with standard diagnostic categories.”

• Native people who meet the criteria for depression, anxiety, or substance abuse disorders are much more likely to seek help from a spiritual and/or traditional healer than from specialty or other medical sources. (ADAA) This reminded me of the connection between the church and the Black community as a solution to mental illness facilitated by the community.

• Lack of awareness about mental health issues and services that are available and a lack of programs and providers that are sensitive to native and indigenous culture can prevent Indigenous people from receiving treatment.

Facts & Figures

• Approximately 1.3% of the U.S. population, or roughly 4.2 million Americans, identify themselves as having Native American or Alaska Native heritage. (Mental Health America)

• Native/Indigenous people in America report experiencing serious psychological distress 2.5 times more than the general population over a month’s time. (Mental Health America)

• Suicide rates among Native Americans are 3.2 times higher than the national average. (TPC)

• Native/Indigenous people in America start to use and abuse alcohol and other drugs at younger ages, and at higher rates, than all other ethnic groups. (Mental Health America) Native American adults reported that in the last 30 days, 44% used alcohol, 31% engaged in binge drinking, and 11% used an illicit drug. abuse of alcohol by Native individuals may be related to loss of cultural identity, history of abuse and neglect, self-medication due to feelings of hopelessness, and loss of family and tribal connections. (TPC)

• Compared to non-Hispanic whites, nearly 3 times as many Native/Indigenous people had no health insurance – 5.9% compared to 14.9%. Approximately 43 percent of Native/Indigenous people in America rely on the Medicaid or public coverage. (Mental Health America)

• Domestic violence and physical and sexual assault are three-and-a-half times higher than the national average in Native American communities. (TPC)

• Fewer Native Americans have a high school education than the total U.S. population; an even smaller percentage has obtained a bachelor’s degree: 11% compared with 24% of the total population. (TPC)

• Almost 26% of Native Americans live in poverty compared to 12% for the entire U.S. population. (TPC)

Action Steps

Learn about the Indigenous community! If we’ve learned anything this year, it’s that a lot was missing from our grade school textbooks, and the atrocities committed against the Native community has been, and continues to be, heinous. Learn about what has happened in the past and what continues to happen to these vulnerable communities today.

Next week, we close out of conversation on mental health by discussing the Latinx community. As a Puerto Rican and Dominican person—Black, Spanish and Indigenous Taino—I find myself at the intersection of all of these identities and am really glad we focused on each specific group in more detail. See you next time!

“We are the ones we’ve been waiting for, we are the change we seek” — With love and light, Taylor Rae

Mental Health in the Black Community

Hi Friends!
Welcome to Issue 18 of this newsletter! I decided to turn this into a series on mental health in BIPOC communities. BIPOC refers to Black, Indigenous or people of color. And while this term does have some controversy around inclusivity and specificity, I think it applies here. This week, we will focus on Mental Health in the Black Community. From generational trauma to coping mechanisms and stigmas, there is a lot to dive in to. Let’s get into it!

Key Terms

Generational Trauma: This is trauma that isn’t just experienced by one person but extends from one generation to the next. In 1966, Canadian psychiatrist Vivian M. Rakoff, MD, and her colleagues recorded high rates of psychological distress among children of Holocaust survivors, and the concept of generational trauma was first recognized. Trauma affects genetic processes, leading to traumatic reactivity being heightened in populations who experience a great deal of trauma.

Sterilization: A process or act that renders an individual incapable of sexual reproduction. Forced sterilization occurs when a person is sterilized after expressly refusing the procedure, without her knowledge or is not given an opportunity to provide consent.

Lobotomy: Lobotomy was an umbrella term for a series of different operations that purposely damaged brain tissue in order to treat mental illness. It is is a neurosurgical operation that involves severing connections in the brain's prefrontal lobe.

Post Traumatic Slave Syndrome: P.T.S.S. is a theory that explains the etiology of many of the adaptive survival behaviors in African American communities throughout the United States and the Diaspora. It is a condition that exists as a consequence of multigenerational oppression of Africans and their descendants resulting from centuries of chattel slavery. A form of slavery which was predicated on the belief that African Americans were inherently/genetically inferior to whites. This was then followed by institutionalized racism which continues to perpetuate injury.

Let’s Get Into It

A Brief History

• In 1848 John Galt, a physician and medical director of the Eastern Lunatic Asylum in Williamsburg, Virginia, offered that “blacks are immune to mental illness.” Galt hypothesized that enslaved Africans could not develop mental illness because as enslaved people, they did not own property, engage in commerce, or participate in civic affairs such as voting or holding office. According to Galt and others at that time, the risk of “lunacy” would be highest in those populations who were emotionally exposed to the stress of profit making, principally wealthy white men.

• Dr. Benjamin Rush diagnosed Negritude which he described as the irrational desire by Blacks to become white.

• Dr. Samuel Cartwright, a pro-slavery physician diagnosed Drapetomania, a disease that caused enslaved blacks to flee their plantations and Dysaethesia Aethiopia, a disease that purportedly caused a state of dullness and lethargy, which would now be considered depression. He argued that severe whipping was the typically the best “treatment” for both conditions.

• Most pre-Civil War mental health facilities in the South usually barred the enslaved for treatment. Apparently mental health experts believed that housing Blacks and whites in the same facilities would detrimentally affect the healing of the whites.

• In 1895, Dr. T.O. Powell, the superintendent of the Georgia Lunatic Asylum observed an increase in insanity and consumption (tuberculosis) among Black people which he attributed to three decades of freedom. He argued that when the former slaves got their freedom, it caused them to have little or no control over their appetites and passions and thus led to a rise in insanity.

• In the 1930s Black Americans diagnosed as insane were the most widely sterilized group. Although sterilization lost some of its appeal when it was discovered Nazi Germany embraced the practice on a wide scale, by the 1970s some states in the South, including notably North Carolina and Alabama. In North Carolina in the 1960s, for example, more than 85% of those legally sterilized were Black women.

• Black Americans were victims of lobotomies from the 1930s to the 1960s.Dr. Frank Ervin, a psychiatrist, and two neurosurgeons, Drs. Vernon Mark and William Sweet ignored the systematic oppression, poverty, discrimination, and police brutality of the 1960s and argued that this violence was the result of a surgically-treatable brain disorder and promoted their agenda as a specific contribution to ending the political unrest of the period. While never widely accepted and practiced, some lobotomies were performed on Black children as young as five years old who exhibited aggressive or hyperactive behaviors.

• Today, Black Americans have a distrust of the medical system due to historical abuses of Black people in the guise of health care, less access to adequate insurance, culturally responsive mental health providers, financial burden, and past history with discrimination in the mental health system. (Columbia)

Generational Trauma

A growing body of research suggests that traumatic experiences can cause profound biological changes in the person experiencing the traumatic event. Cutting edge researchers are also beginning to understand how these physiological changes are genetically encoded and passed down to future generations. (Columbia)

Watch this 5 minute video for some truly amazing insight to generational trauma and what Dr. Joy DeGruy calls Post Traumatic Slave Syndrome.

Stigma

Instead of seeking mental health care, useful strategies including religious coping and methods such as pastoral guidance and prayer often are the most preferred coping mechanism in the Black community. These ideas often lead people to believe that a mental health condition is a personal weakness due to negative stereotypes of instability and attitudes of rejection. Individuals may be more likely to believe that since they’ve survived so much adversity, they’re strong—and no one has a right to tell them that there is something wrong with them. (Columbia)

Due to a reasonable distrust of the medical system stemming from all of the past history discussed earlier, the church was consistently a place to go when there was nowhere else for Black people to seek refuge. Moreover, given that the Black community exists at the intersection of racism, classism, and health inequity, their mental health needs are often exacerbated and mostly unfulfilled. (Columbia)

The Black community, in particular, is at significantly increased risk of developing a mental health issue due to historical, economic, social, political influences that systemically expose the Black community to factors known to be damaging to psychological and physical health. Research consistently shows that these disparities are not a new phenomenon and have been present for generations. (Columbia)

Facts & Figures

• 25% of African Americans seek mental health care, compared to 40% of whites. (McLean)

• The adult Black community is 20% more likely to experience serious mental health problems, such as Major Depressive Disorder or Generalized Anxiety Disorder than their white counterparts. (McLean)

• The Black community comprises approximately 40% of the homeless population, 50% of the prison population, and 45% of children in the foster care system. (McLean)

• Only 1 in 3 Black Americans who could benefit from mental health treatment receive it. (McLean)

• Black individuals are less frequently included in research, which means their experiences with symptoms or treatments are less likely to be taken into consideration. (McLean)

• They’re also more likely to go to the emergency room or talk to their primary care physician when they’re experiencing mental health issues, rather than seeing a mental health professional. (McLean)

• Black individuals are also more likely to be misdiagnosed by treatment providers. This can fuel the distrust toward mental health professionals as a misdiagnosis can lead to poor treatment outcomes. (McLean)

• Black individuals are more likely to have involuntary treatment, whether it is forced inpatient or outpatient treatment. This contributes to the stigma, hostility, and lack of willingness to voluntarily seek care. (McLean)

• In the 1990s, a public opinion poll found that 63% of African Americans believed depression was a personal weakness and only 31% believed it was a health problem. (McLean)

• Today suicide rates in African American children aged 5-11 years have increased steadily since the 1980s and are now double those of their Caucasian counterparts.

Action Steps

Bring awareness to the use of stigmatizing language around mental illness

Educate family, friends, and colleagues about the unique challenges of mental illness within the Black community

Become aware of our own attitudes and beliefs to reduce implicit bias and negative assumptions

Rescources

Through their partnerships with Therapy for Black Girls, National Queer & Trans Therapists of Color Network, Talkspace and Open Path Collective, Loveland Therapy Fund recipients have access to a comprehensive list of mental health professionals across the country providing high quality, culturally competent services to Black women and girls.

The Loveland Foundation

Next week, we continue to talk about the history, trauma and stigma that plagues people of color when it comes to seeking and being adequately treated for mental health concerns. Personally, I’ve been very transparent about my mental health care, and feel like psychotherapy has been a fundamental part to my processing, healing and growing through both personal and generational trauma. I’ll see you next week to talk about Mental Health in the Indigenous Community.

“We are the ones we’ve been waiting for, we are the change we seek” — With love and light, Taylor Rae