Well, hello again! Natasha here!
Welcome back to another blog which, in my opinion, is pretty important. Barriers to mental health services is an important topic! I mean, how can we help our community if we do not know the reasons that are preventing them from accessing services? Right?!
My research on this topic goes way back to graduate school, where I started writing papers and doing presentations about this topic. I realized over the years, how much people avoided anything dealing with mental health. Trying to overcome these barriers, can help increase the outreach for this community and help them find the resources to meet their needs. After my years of working in the field, these are the top 7 barriers to mental health services for Latinos that I consistently come across.
Barrier 1: Stigma
Many still refuse to go see a therapist because they are not ‘crazy.’ That is the most common reason I hear. They would rather say the person needs to just eat something, sleep, and basically get over it. Sadly, these comments create more shame and make the person feel worse.
Mostly, we will look for help either from a pastor, folk healer, and most commonly our doctors. We will often take months or even years of our doctors encouraging us to go to therapy before we finally make an appointment with the therapist.
Overcoming Stigma:
Community events like health fairs, can be a great way to get information out. We may need to be creative and not necessarily put ‘mental health’ on our informational posters since it will be a repellant, but we can still help provide resources. Therapists making these connections and building relationships with community leaders can also help spread the word about benefits of these services.
But really the best way to fight stigma, though, is to talk about our struggles. Being transparent can help support one another, so we can be more willing to seek help.
I often encourage my clients to be open with trusted ones about their own therapy, because they would be surprised at how often the other person is either in therapy already or been considering it.
Barrier 2: Language Barriers
When going through a hard time emotionally, it’s difficult to find the right words to express oneself, much less in their second language. Having a close family member translate for you, also, may decrease your chances of being completely open. Imagine a man that is the head of the household having his young teenage daughter translate for him, which can reverse the parental roles and be uncomfortable for both of them. Now imagine that same girl translating for her dad with her school and twisting the truth around, so she won’t get into trouble. It’s complicated!
Overcoming Language Barriers:
Having bilingual family or friends call to help you make an appointment, is a great idea. If possible, have them ask if the office has translation services, if needed. Often schools, hospitals, and offices have translators that they contract with that can be scheduled ahead of time to translate. For example, several schools have bilingual staff members that can help translate for families that want their child to see the school counselor that is on staff.
And as far as therapists, thankfully the number of bilingual therapists continues to grow in our Upstate area. This means that hopefully you will be able to find a therapist that speaks Spanish, if needed. Virtual appointments have also made it possible to see a bilingual therapist in a different city/state if needed.
Barrier 3: Machismo
Men are often seen as the head of the household and must be strong and show no sign of weakness. Culturally speaking, they are ‘tough,’ don’t cry, and don’t express their feelings. This is not healthy, because they have feelings and pains just like everyone else. They learn to bottle up their feelings, not express them and often this can result in unhealthy coping skills like excessive drinking, substance use, anger problems, domestic violence, and more.
Overcoming Machismo
We honestly need more men being open about going to therapy and showing this as a sign of strength and resilience. I hope men can start seeing that taking care of themselves, will help them take care of others. In my opinion, the biggest way to overcome this machismo, is Hispanic men in strong leadership positions to be open with their experience in therapy and struggles.
Barrier 4: Familism
This is having a strong attachment and identity with one’s family where what’s best for the family is put before the individual needs. This can be good in a lot of ways, but because of this, they often will not get help outside the family. There is so much emphasis on privacy and keeping things in the home, that often they feel guilty if they do talk to someone.
Overcoming Familism
Educating yourself and finding resources online, in the schools, work, etc. can help you start to understand that getting the help you need will help you be an even better family member. Getting help outside the family can even help you get an outside perspective, especially since stressors can often be from within the family. Keep in mind that if your mental health is deteriorating, something needs to change which may be to talk to a professional outside the home. Maybe consider talking to someone that is in therapy already and ask about their own experiences.
Barrier 5: Acculturation
Acculturation is the assimilation (or accepting) to a different culture, typically the dominant one. In our case in the Upstate, the dominant culture is the American culture. People that have low acculturation, where they are stuck with their old life in their home country and do not embrace their new culture, tend to have more challenges with their mental health. If we stay stuck in our past lives, we risk falling into a depression.
In regard to therapy, this would be when one prefers only Hispanic therapists and perceive an inability to find a non-cultural person to be effective. They stick to only the culture they know, and do not adapt well to another culture. On the other hand, a monolingual therapist may misinterpret their client’s resistance, if they do not understand their client’s culture. The result may be prematurely closing the case.
Overcoming the Fear of Acculturation
When it comes to acculturation, embracing the new culture can help you find a balance of loving your home country while accepting the new one - being bicultural and bilingual! Having more of a balance with both cultures can positively impact our mental health. So, try and challenge yourself…. ask your friendly non-Spanish neighbor over for coffee, take English classes, try all different types of recipes, volunteer and meet all kinds of people!
With therapy, focusing on finding a therapist that understands you (instead of asking, "Are they Hispanic?") can help therapy outcomes. I know several amazing therapists that do not speak Spanish but have a passion and understanding for working with the Hispanic community. It’s more important to find a therapist that you feel understands you, versus someone that is from your home country.
Barrier 6: Financial
This can include transportation, paying fees, or taking time off from work for an appointment. Therapy costs money and is a process so it’s not a quick, easy fix. This can take a lot of investment that in the long run, though, will be worth it. Unfortunately, a lot of times we are struggling financially so adding another expense can be hard.
Overcoming Finances
When it comes to transportation and taking time off, virtual appointments are becoming increasingly available since COVID. Most therapists that I know, including myself, have been seeing more clients virtually versus in-person. This will help with finding transportation, and with taking time off from work.
Churches and nonprofit organizations are often great with connecting people with resources. For example, The Julie Valentine Center often helps connect victims of crimes that do not have insurance, with resources that will cover their therapy appointments. Some clients even will see me once a month versus weekly due to finances, and still gain a lot from it. Mental health centers also often provided reduced rates and have a variety of resources, like school-based services where many schools have a therapist that sees clients there.
Barrier 7: Fear for Privacy and/or Law
Many fear the legal system for a variety of reasons, including deportation. For this reason, many people will be hesitant to try to access a variety of resources, like therapy. They may be worried about their information being made public, their information not being confidential, fear of losing their children if they are depressed, or more. There also is the concern that they may not be able to do therapy if they are undocumented.
Overcoming Fear for Privacy
With therapy, your legal status does not matter to get your case opened. Our focus is on helping you with your goals, so we could care less about if you are documented or not. We also are mandated to keep all your information confidential and cannot share any of your information unless someone’s life is in danger. And regarding therapy for parents struggling with mental illness, this is often looked upon in a positive way since the parent is accessing help.
So, here you go! Barriers to mental health services for our community, as well some ideas to help overcome them. Even though my focus is on mental health barriers, I think many would agree that these barriers are the same in many areas including education, health, and more.
So please share this blog with your friends and family.
Let’s start talking about this "taboo" topic!
Until next time…. stay safe and continue to be each other’s companions in healing!
