General Considerations and Risk factors
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Hispanics/Latinxs have experienced an increase in discrimination in recent years
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Childhood risk factors:
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Almost 80% of Hispanic/Latinx American youth have a history of “adverse childhood experiences”—poverty, neglect, abuse or household dysfunction and at significant risk for mental health problems, and in many cases at greater risk than white children. (Consider using ACE questionnaires to assess these experiences. ACE: adult, teen, or child)
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Symptom expression:
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Somatization and physical symptoms are common presentations of depression and anxiety in Hispanic/Latinx American populations.
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Hispanics/Latinxs with a mental health concern are twice as likely to consult a PCP rather than a mental health provider. Hispanic/Latinx are more likely to report poor communication with their health provider.
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“Ataques de nervios” or attack of the nerves is a cultural bound syndrome of distress which may present as uncontrollable screaming, crying, trembling, sensations of heat rising in the body, and/or dissociative experiences.
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Immigration impact:
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Hispanics/Latinxs may be recent immigrants who migrated from countries experiencing wars and economic and social instability
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Language:
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Consider the impact of language on treatment. Several studies have found that bilingual patients are evaluated differently when interviewed in English as opposed to Spanish and that Hispanics/Latinxs are more frequently undertreated.
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(SCRIPTS) Questions to help assess and intervene around mental health concerns:
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People often understand their problems in their own way, which may be similar to or different from how doctors describe the problem. How would you describe your problem?
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How would you describe your problem to your family or friends?
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What troubles you most about your problem?
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Why do you think this is happening to you? What do you think are the causes of your problem?
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Note: Latinos have strong family networks. Family support can help alleviate the stigma of a mental disorder. Encourage my patients to bring their parent, spouse or child to their appointments
Recommendations:
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Cognitive Behavior Treatment (CBT) for mental health issues.
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Cognitive Behavior Treatment (CBT) has been the most studied psychotherapy intervention in Hispanic/Latinx American populations.
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Resources
Comprehensive Michigan COVID-19 Pandemic Resource Guide is available in Spanish. It provides information on how to access various resources aimed at supporting Michiganders through the coronavirus pandemic and related economic slowdown.
