Mexican Americans and mental health: A selected review and recommendations for mental health service delivery

Abstract

Eight working assumptions are generated from the literature in three problem areas and evaluated with recently published quantitative data, paying particular attention to variation within the ethnic group. Assumptions that Mexican Americans have few emotional problems, primarily use a folk medical system, do not rely on clergymen for emotional support, and have negative attitudes toward mental health services are rejected. Two assumptions are qualified: Mexican Americans have some emotional problems at different rates than Anglos and some Mexican subgroups are relatively unaware of mental health services. There is confirmation of the Mexican American extended family support system and mental health policies which variously discourage utilization by Mexican Americans. Implications for mental health service delivery are discussed.

Maternal Trauma and Children’s Functioning: The Role of Kinship Social Support

“…In African American families, the extended family network can provide additional support for single-parent families and during times of crisis (Hall, 2008). Similarly, familism, which outlines a strong identification, attachment, and loyalty to extended family, has been documented as an important source of emotional support for Latino families (Altarriba & Bauer, 1998;Keefe & Casas, 1980;Sabogal, Marín, Otero-Sabogal, Marín, & Perez-Stable, 1987). To tailor treatment to meet the needs of diverse families, it is important to better understand multiculturally relevant factors that might mitigate the effects of trauma within the family.…”

Recruiting and retaining low-income Latinos in psychotherapy research.

“…Similarly, the theory that Latinos underutilize formal services relative to Whites because of their greater use of traditional healers or family members as sources of help has not been supported ( Barrera, 1978 ). In fact, Keefe, Padilla, and Carlos (1978) found that only 2% of 666 Mexican Americans surveyed in Los Angeles had consulted a curandero, who dispenses herbal medicines and potions, for emotional problems in the previous year. Of course, use of traditional healers may be underreported because of social desireability ( Comas-Diaz, 1981a, 1981bDe La Cancela & Zavala, 1983 ).…”

Barriers to treatment for eating disorders among ethnically diverse women

“…An example question was: Did you not know where to seek treatment or what resources were available? These questions were based on the existing literature on barriers to mental health care utilization (see reviews by Keefe & Casas, 1980;Marin et al, 1983).…”

“…These proposed barriers can be viewed from an "individual" or from a "system" perspective (Escovar & Kurtines, 1983). Individual or person variables include feelings of shame and fear of stigma (Kline, 1996); cultural perceptions of psychiatric disturbance (O'Sullivan et al, 1989), specifically, minimizing or interpreting differently problems that others would consider to be serious psychological problems or not identifying psychological problems as such (Acosta, 1979;Kline, 1996); the belief that seeing a therapist is a sign of character weakness and that one should be able to help oneself (Keefe, 1979;Poma, 1983); turning to family or other informal support systems in times of need (Escovar & Kurtines, 1983;Keefe, 1979;Poma, 1983); turning to alternative forms of therapy such as folk healers (Acosta, 1979;Poma, 1983); discomfort about being separated from one's family (Kline, 1996); not viewing counselors as credible sources of help (Buhrke & Jorge, 1992); expectation that counselors will be hostile or cold (Keefe, 1979); and unfamiliarity with mental health services (see review by Keefe & Casas, 1980). Examples of system barriers are language barriers (Acosta, 1979;Marin, Marin, Padilla, & de la Rocha, 1983); financial difficulties and lack of health insurance (Marin et al, 1983;Wells, Golding, Hough, Burnam, & Karno, 1988); inaccessible health care facilities, time conflicts and long waits (Marin et al, 1983); lack of transportation and lack of child care (Marin et al, 1983); and lack of ethnically representative professional staff (Acosta & Cristo, 1982).…”