Reducing Stigma Against Mental Illness in Latino Communities

This is part two in a three-part series.

As I navigate a new diagnosis of dyslexia and the need for intervention for my child, loved ones have asked me why I would like to "label" my child when it could negatively impact his ability to thrive. This is a complex issue that requires thoughtful conversations, as there are certain "labels" that can be harmful. However, without a diagnosis, support and interventions cannot be provided. Take a moment to reflect on whether you would tell your child they have a diagnosis of diabetes or epilepsy when you know they will be receiving medical treatment. It's true that, for many, a mental health diagnosis causes fear, hesitancy, and concern. But mental health diagnoses can also be liberating and help people to recognize why they have struggled so much in certain ways throughout their lives. Personally, I know that understanding my anxiety diagnosis was key to learning what supportive mechanisms, including therapy and non-clinical supports, would empower me through my journey.

A "shared language" that invites understanding, support, and empowerment, and that reduces shame, exclusion, and punishment, is needed to reduce the stigma against mental illnesses. In this SNL sketch with Bad Bunny, Marcello plays the son who had depression. Pascal's character, the protective mother, demonstrates understanding of her child's struggle from a young age, saying "He tried to get it when he was a kid...he said, Mami, I'm depressed." Yet, this "protective" mother deliberately requested that the child "don't do that...do something else."

This scenario, perhaps not as funny as is presented on SNL, is not an uncommon one encountered by child and family mental health clinicians—not just those serving Latino communities. Although we are tasked to treat the child, our job requires that we mindfully address the whole family's needs, as many parents continue to hold stigma against mental illnesses and clinical care. Clinicians who are not only passionate but also skilled at working with families are in dire need to help us address the children's mental health crisis.

To help me delve deeper into this topic, I spoke with an amazing Latina Child and Adolescent Psychiatrist and public health expert, whom I am lucky to call a friend and mentor. Dr. Lisa Fortuna, a Child and Adolescent Psychiatrist, Addiction Psychiatrist, and Chair of the Department of Psychiatry at UC Riverside, shares that she finds it is still taboo amongst some of her Latino friends and family members to speak about mental health issues. She notes that this stigma often spills over into the child-parent relationship, resulting in families suppressing the “idea that youth are experiencing stress or distress.” This can show up in different ways depending on the family’s immigrant status. For example, Dr. Fortuna notes that many immigrant parents see their children as having many opportunities they did not have, and when youth experience something like depression, it may be perceived by the immigrant parents as something that is “capricious or insensitive.”

Dr. Lisa Fortuna / Used with. permission

Her journey into Child and Adolescent Psychiatry was not easy. She shares that in her family, “Psychiatry was seen as a medical speciality based on fiction. It was irrelevant to cultural understandings of distress, and therapists and psychiatrists were likely going to be ineffective if you did go to see them. In some ways I think psychiatry was seen as counter-cultural.” This speaks to the prevailing stigma that is still present in so many families across the country, and Latino families are not an exception. The notion of being “loco or loca” is perceived as a threat, especially when it exposes mental illness or trauma in the family.

Regarding her clinical practice, Dr. Fortuna shares that she sees patients who have tried many things, such as seeking support from their local church, trying to manage with family support, or trying to help the youth or family member experiencing mental illnesses. These families often come to see her when they have reached a point of desperation. This sometimes delays care quite substantially.

I asked her what we can do to continue working to decrease stigma against mental illnesses and mental health care in our community. Dr. Fortuna told me that she has observed an increase in awareness about mental health in Latino communities, including among recent immigrants. She finds it helpful to work with churches and community based organizations to create opportunities to develop or find a common language about mental health—these can help dismantle some of the barriers. She highlights the importance of increasing the bilingual and bicultural mental health workforce to continue addressing mental health inequities in Latino communities. She highlights how at the end of the skit, “once the girlfriend starts speaking the same "language" as the mother and tia, when she tells the boyfriend "you need to eat," then they can finally get along and talk to one another. Maybe mental health is a little like that as well; we need to find a common language.”

If you are seeking opportunities to grow your understanding of mental health in the Latino community or growing your toolkit for developing this “shared language,” I hope you will join us for an upcoming Cafecito, Perreo and Salud Mental event on 12/6 or 12/13. These are virtual spaces hosted by Zocalo Health to foster community and offer education and resources promoting Latino mental health.