Breaking Down Barriers: Latinos and Mental Health


By Annika Darling,

The battle to break down the stigma associated with mental health, especially within the Latino community, has recently seen another victory.

Connecticut Governor Ned Lamont signed a parity bill at the beginning of the month (Monday, July 1), which is fitting as July is National Minority Mental Health Awareness Month. The bill states insurance companies must treat mental health issues the same as physical health issues, such as diabetes and heart disease. The law takes effect on January 1, 2020, and will bring Connecticut into compliance with the federal Mental Health Parity Act of 2008. 

Once in effect, insurance companies can no longer place more limits or restrictions on mental health and/or substance disorder benefits than they do on physical condition benefits. Furthermore, it will require coverage for treatment, such as addiction services, if ordered by a court. Lastly, the bill requires that insurance companies file annual reports with the state certifying that they are complying with parity. Insurance companies will need to file their first annual report with the state by March 1, 2021.

“Diseases of the brain should not be treated any differently than diseases of the body…”

Ned Lamont, Governor, Connecticut (D)

In a news briefing, Gov. Lamont said: “Diseases of the brain should not be treated any differently than diseases of the body, and Connecticut’s laws should reflect that. By signing this into law we are taking a major step forward toward removing the stigmatization that so many people with mental health and substance use disorders face, and knocking down barriers so they can get the treatment they deserve.”

Getting clear of the stigma surrounding mental health has many challenges when it comes to the Latino community, where the stigma tends to be more arresting. While Latinos are affected similarly with mental health issues as the rest of the population (where 1 in 5 people suffer from a mental health disorder), according to the U.S. Surgeon General’s report “Mental Health: Culture, Race, and Ethnicity” only 20 percent of Latinos with mental disorders talk to doctors about their disorders and only 10 percent seek actual treatment.

Carlos Rivera, Director of Behavioral Health Services for the Hispanic Health Council (HHC), says that Latinos cope with mental health issues differently because of how they perceive them culturally. “Latinos are typically taught that to seek out mental health treatment is equivalent to believing that you are loco, or crazy, so it’s nothing that you want to readily admit.”

Rivera says that when someone experiences trauma it can affect our brains in a way that is debilitating. Trying to deal with such experiences alone can feel isolating and make someone feel like they are abnormal. However, with education, the hope is that people will come to understand that this reaction is quite normal and no one has to deal with such difficulties alone.

A good example of this is all the victims of Hurricane Maria, Rivera explains. “[The victims] don’t readily associate when their lives are falling apart because they lost everything with mental health instability because they are traumatized, and they don’t know that there is something they can do. They just feel like their lives are out of control. So, someone in the Latino community might say they are having a nervous attack or an emotional overload, but they won’t see that as something they can get help with. So it’s about just letting the community know that there are services available to them that they can easily access and readily access, that is in their language and is culturally relevant.”

Rivera says the parity bill can help with reshaping the way Latinos approach mental health issues. He explains: “The Parity Act isn’t something new [federally], but being able to re-emphasis this locally is a good thing. The law makes it easier for folks in the way that if community leaders, such as ourselves, who are embedded in the community and who the Latino community tends to trust because they see us on a daily basis, if we educate them that having a mental health issue is no different than having a medical issue then they will be more at ease with associating it with a medical issues such as a headache or a cut or something.”

While the parity bill is a step in the right direction there are many other supporting actions that can be taken in conjunction with this that would greatly increase the efforts.

Kasandra Marbury, social worker and founder of ACT Services which caters to a 90 percent minority client base, says that, of course, the bill is a good thing, says, “I know before there sometimes was a maximum amount of times you could see a clinician, but that has only affected maybe two of my clients. Normally I don’t see that barrier. But I think [the bill] is a good idea. And it will be nice to see how this rolls out and what does that entail. Overall, yes, I think it’s good but I find there are many other barriers to mental health within the minority community.” 

Marbury is more concerned with barriers such as language, cultural sensitivity, cultural misconceptions, transportation and not having insurance at all. She says, “I think a lot of minorities choose me because I am a minority as well, it has to do with trust and maybe also my location. New Britain has a large Latino population and I think my location makes transportation easy for them. At first, I felt weird about being sought after because I am a minority, but then I began to embrace it and use it to become a voice of reason and help educate and break down barriers, bringing mental health to the forefront in a less threatening way.”

“Puerto Ricans are culturally distinct from Mexicans from Guatemalans from Hondurans from Colombians…”

Carlos Rivera, Director of Behavioral Health Services for the Hispanic Health Council (HHC)

“The cultural component is very important,” agrees Rivera, “and being Latino doesn’t guarantee that you are culturally competent because Latinos aren’t a monolithic group. Latinos come from different countries that are distinct from one another. Puerto Ricans are culturally distinct from Mexicans from Guatemalans from Hondurans from Colombians, so we have to educate ourselves in those cultures, too. And African Americans and even our Caucasian brothers and sisters, we have to be adept at identifying the cultural differences between all of these particular groups. So training is an important component of everything we do. Of course, [HHC] is good at Latino cultures because everybody in the office is a Latino and we put an emphasis on that right now, because our primary goal is to provide counseling to the Latino population but not at the exclusion of English speaking clients.

Further explaining the cultural barrier, Rivera says, “Some of the folks are folklorish and may believe in Cocos, which are ghosts, or Santería. Believing in ghosts of their ancestors might lead another professional to believe that they are hallucinating but [HHC] clinicians are familiar with these things and we understand it is just part of the culture and it’s not part of the pathology or part of the person’s problem. We understand it is more an embedded part of the culture. So it’s important to distinguish between those two things. …Transportation is also a big barrier as is language, although that is one barrier that [HHC] has overcome by the fact that everyone here speaks Spanish and we do therapy in Spanish and again we are culturally sensitive to their needs.”

Rivera emphasizes that everyone is welcome at HHC: the uninsured, the undocumented. He says everyone will receive the same quality of care. In fact, Rivera states: “That population is important to us because they wouldn’t otherwise have access to any care. We will take you regardless of your ability to pay. And whether you have great insurance, no insurance, we put an emphasis on quality care. We are very proud of that.”

Marbury says part of the solution to continuing to break down the stigma surrounding mental health in minority communities is to maintain an open dialog, to educate about it, to try to normalize it. This is why on Saturday, July 27, Marbury will be throwing a Minority Mental Health Awareness Month Q&A Panel Brunch. The brunch will have a number of speakers and have an open discussion platform. Marbury hopes this will keep the conversation going on mental health for the minority community and continue the battle of breaking the stigmas that surround it.