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Department: Nursing in the Church

Helping Hispanics Surmount Hurdles in Mental Health Care

Schmidt, Karen

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doi: 10.1097/CNJ.0000000000000780
  • Free
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Healthcare professionals acknowledge that stigma is a primary reason many people cloak their depressive symptoms, nearly paralyzing anxiety, or other mental health illnesses. Among Hispanics, stigma is only one explanation for their reluctance toward or avoidance of care for mental health needs. In a 2019 study, Caplan pointed out that Hispanics use mental health services half as much as non-Hispanic White people, and that in addition to possible barriers of language, legal status, and lack of insurance, Hispanics' cultural and religious values are significant in their mental health care use.

As a culture, Hispanics often grow up in a family setting where people with mental illness may be characterized as crazy. Mental health symptoms, including those of depression and more serious conditions, are often concealed due to the stigma and ostracism that come with mental illness in their culture. Also common is the belief that mental health problems cannot be cured and the sufferer will always be afflicted or crazy.

Faith community nurses (FCNs) who recognize how their Hispanic clients and communities view mental health can be proactive in educating and advocating for them.

  • As the family is central in Hispanic culture, discussing the topic of mental health is best done with all the members of the family. Provide education about mental health and illness (Caplan & Cordero, 2015). Explain that depression and other diagnoses are diseases and can be treated, just as diabetes and infections are treatable conditions.
  • Dispel underlying fear that influences people's perspective of others by explaining that individuals with a mental illness are not demonized or crazy. They can be successfully treated with medication and counseling therapy.
  • Anaebere and DeLilly (2012) suggest developing social support and links to support networks where Hispanic clients can find health education and counseling that is culturally based.
  • Involve lay community health workers—promotoras—to build clients' trust with FCNs and to share their own or others' narratives that illustrate reframing mental health problems and care for positive outcomes.
  • Partner with church leaders, both pastoral and lay people, who are already trusted. Their involvement in FCN outreach will endorse Hispanic community members' confidence in your teaching and counsel about mental health needs. Engaging faith community leaders will also help Hispanics begin to accept that depression or mental illness is not a spiritual condition that is best managed with more prayer or stronger faith.
  • Expand your network of mental health professionals who are Hispanic or who at least are bilingual and culturally competent. Inquire about professionals in other Hispanic churches in the area. Clients are more likely to pursue counseling or treatment with professionals who share a similar faith background.
  • Dig deeply to discover community agencies that offer services in the Hispanic community; take initiative to recommend services your clients need that are not yet available.
  • Improve mental health literacy by engaging in conversations informally or with groups about how television, movies, books, social media, and other people's beliefs create misunderstanding and false beliefs about one's mental health. Provide accurate information and examples to counter incorrect ideas.
  • Integrate spirituality and spiritual care with mental health topics and discussion. Pray with clients as they show receptivity. Share Scripture as appropriate. Remember, however, not to directly equate the depth of one's faith, fervency in prayer, or spiritual stature with healing or recovery from mental illness.

Faith-based Hispanic people depend heavily on their churches and faith communities. Nurses who work in the community or in faith community nursing roles have excellent platforms from which they can impact the misunderstandings of this cultural population related to mental health, providing a path to improved health and fewer tragic outcomes.

References

Anaebere A. K., DeLilly C. R. (2012). Faith community nursing: Supporting mental health during life transitions. Issues in Mental Health Nursing, 33(5), 337–339. https://doi.org/10.3109/01612840.2011.631164
Caplan S. (2019). Intersection of cultural and religious beliefs about mental health: Latinos in the faith-based setting. Hispanic Health Care International, 17(1), 4–10. https://doi.org/10.1177/1540415319828265
    Caplan S., Cordero C. (2015). Development of a faith-based mental health literacy program to improve treatment engagement among Caribbean Latinos in the Northeastern United States of America. International Quarterly of Community Health Education, 35(3), 199–214. https://doi.org/10.1177/0272684X15581347
    InterVarsity Christian Fellowship