Abstract
This chapter provides an overview of major challenges faced by Latina/o clients in need of mental health services. First, an overview of the research on barriers to access (e.g., culture, language, medical insurance, etc.) and service utilization (e.g., poor service quality, improper screening and diagnosis) are presented. Important cultural issues related to Latina/os engaging in treatment are integrated, including issues of citizenship status, cultural values, stigma, and discriminating. Second, recommendations are offered for policy- and decision-makers to implement, re-design, and assess the effectiveness of integrated care with Latino populations. Special attention is given to the need for more clearly outlined, and enforced, policies that improve language accessibility and screening practices, support training, funding and development of culturally competent research, scholarships, and workforce. Medical providers, mental health professionals, and social workers, all bring significant areas of expertise, and must all be directly involved in the development, planning, and execution of policies, guidelines, and protocols. Infused throughout the chapter is the importance of advocating for policies that promote social justice, equity, and equality in all systems of care to help us move toward active commitment to culturally responsive treatment, research, and policies.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Acosta, H. (2006). The current status of Latino mental health in the United States. Paper session at National Association for Mental Illness’ Eliminating Disparities: Multicultural Strategic Summit, Washington, DC.
Agency for Healthcare Research and Quality. (2009). Program brief: Mental health research findings. Rockville, MD: Author.
Alegria, M., Mulvaney-Day, N., Torres, M., Polo, A., Cao, Z., & Canino, G. (2007). Prevalence of psychiatric disorders across Latino subgroups in the United States. American Journal of Public Health, 97, 68–75.
American Psychological Association (2001). Guidelines on Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists.
American Psychological Association. (2014). 2014 Mental health parity survey. Washington, DC: Author.
American Psychological Association. (2015). Consumer guide: What you need to know about mental health coverage. Washington, DC: Author.
Anda, R. F., Brown, D. W., Dube, S. R., Bremner, J. D., Felitti, V. J., & Giles, W. H. (2008). Adverse childhood experiences and chronic obstructive pulmonary disease in adults. American Journal of Preventive Medicine, 34(5), 396–403.
Anda, R., Tietjen, G., Schulman, E., Felitti, V., & Croft, J. (2010). Adverse childhood experiences and frequent headaches in adults. Headache, 50(9), 1473–1481.
Arredondo, P., Gallardo-Cooper, M., Delgado-Romero, E. A., & Zapata, A. L. (2014). Culturally responsive counseling with Latinas/os. Alexandria, VA: American Counseling Association.
Barreto, M., & Sanchez, G. (2013). New national Latino health care survey results. Latino Decisions. Retrieved from http://www.latinodecisions.com/blog/2013/05/01/New-National-Latino-Health-Care-Survey-Results.
Benish SG, Quintana S, & Wampold BE. (2011). Culturally adapted psychotherapy and the legitimacy of myth: a direct-comparison meta-analysis. Journal of Counseling Psycholy V58(3):279–89. doi: 10.1037/a0023626.
Bower P,& Gilbody S. (2005). Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ;330(7495):839–42.
Bustamante, A. V., Fang, H., Rizzo, J. A., & Ortega, A. N. (2009). Heterogeneity in health insurance coverage among US Latino adults. Journal of General Internal Medicine, 24(3), 561–566. doi:10.1007/s11606-009-10697.
Cabassa, L. J., Zayas, L. H., & Hansen, H. C. (2006). Latino adults’ access to mental health: A review of epidemiological studies. Administration and Policy in Mental Health, 33(3), 316–330. doi:10.1007/s10488-006-0040-8.
Campón, R. R., & Carter, R. T. (2015). The appropriated racial oppression scale: Development and validation. Cultural Diversity & Ethnic Minority Psychology, 21(4), 497–506.
Carter, R. T., Forsyth, J., Mazzula, S. L., & Williams, B. (2005). Racial discrimination and race-based traumatic stress. In Carter R. T. (Vol. Ed.), Handbook of racial-cultural psychology and counseling: Practice and training Vol. 2 (pp. 447–476). New York, NY: Wiley & Sons, Inc.
Carter, R.T., Mazzula, S. L., Victoria, R., Vazquez, R., Hall, S., Smith, S., … Williams, B. (2013). Initial development of the race-based traumatic stress symptom scale: Assessing the emotional impact of racism. Psychological Trauma: Theory, Research, Practice, and Policy, 5(1), 1–9.
Carter, R. T., Yeh, C. J., & Mazzula, S. L. (2008). Cultural values and racial identity statuses among Latino students: An exploratory investigation. Hispanic Journal of Behavioral Sciences, 30(5), 5–23. doi:10.1177/0739986307310505.
Chapa, T. (2004). Mental health services in primary care settings for racial and ethnic minority populations. Rockville, MD: U.S. Department of Health and Human Services, Office of Minority Health.
CofresÃ, N., & Gorman, A. (2004). Testing and assessment issues with Spanish-English bilingual Latinos. Journal of Counseling & Development, 82, 99–106.
Corso, P. S., Edwards, V. J., Fang, X., & Mercy, J. A. (2008). Health-related quality of life among adults who experienced maltreatment during childhood. American Journal of Public Health, 98, 1094–1100.
Delgado-Romero, E. A., Glavan, N., Maschino, P., & Rowland, M. (2005). Race and ethnicity: Ten years of counseling research. The Counseling Psychologist, 33, 419–448.
Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., & Anda, R. F. (2004). Insights into causal pathways for ischemic heart disease: Adverse childhood experiences study. Circulation, 110, 1761–1766.
Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune disease. Psychomatic Medicine, 71, 243–250.
Ell, K., Katon, W., Cabassa, L. J., Xie, B., Lee, P. J., Kapetanovic, S., & Guterman, J. (2009). Depression and diabetes among low-income Hispanics: Design elements of a socio-culturally adapted collaborative care model randomized controlled trial. International Journal of Psychiatry in Medicine, 39(2), 113–132.
Ell, K., Katon, W., Xie, B., Lee, P. J., Kapetanovic, S., Guterman, J., & Chou, C. P. (2010). Collaborative care management of major depression among low-income, predominantly Hispanic subjects with diabetes. A randomized controlled trial. Diabetes Care, 33(4), 706–713.
Ell, K., Xie, B., Kapetanovic, S., Quinn, D. I., Lee, P. J., Wells, A., & Chou, C. P. (2011). One-year follow-up of collaborative depression care for low-income, predominantly Hispanic patients with cancer. Psychiatric Services, 62(2), 162–170.
Hugo Lopez, M., & Gonzalez, A. (2013). What is the future of Spanish in the United States? Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2013/09/05/what-is-the-future-of-spanish-in-the-united-states.
Humensky, J., Santiago, B., Gill, R., Mazzula, S. L., & Lewis-Fernández, R. (2014). Life is precious: Reducing suicidal behavior in Latinas. Ethnicity and Inequalities in Health and Social Care, 6(2), 54. doi:10.1108/EIHSC-10-2013-0027.
Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: The National Academies Press.
Leyro, S. (2015). Legal violence: Crimmigration and the violent effects of deportation. Paper session at the 32nd annual Winter Roundtable, Teachers College, NY
Linenkugel, N. (2001). Integrated health networks are not created equal. Frontiers of Health Services Management, 17, 41–44.
Marin, G., & Marin, B. V. O. (1991). Research with Hispanic populations. Newbury Park, CA: SAGE Publications.
Mazzula, S. L., (2013, August). Chair. Race and culture in psychology publications: A call to action in research, theory and practice. Symposium at the American Psychological Association 121st Annual Convention, Honolulu, HI.
Mental Health America (YR). Position statement 15: Mental health parity in health insurance.
Nadal, K., Mazzula, S. L., Rivera, D. R., & Fujii-Doe, W. (2014). Racial microaggressions and Latina/o Americans: An analysis of nativity, gender, and ethnicity. Journal of Latina/o Psychology, 2(2), 67–78. doi:10.1037/lat0000013.
National Alliance on Mental Illness. (2009). Grading the states. Arlington, VA: Author.
National Alliance on Mental Illness. (2013). New mental health coverage for Latino families. Arlington, VA: National Latino Behavioral Health Association.
National Alliance on Mental Illness. (2015). A long road ahead: Achieving true parity in mental health and substance use. Arlington, VA: Author.
National Child Traumatic Stress Network. (2005). Promoting culturally competent trauma-informed practices. NCTSN Culture & Trauma Briefs, 1(1).
National Institute of Health. (2015). Current programs in the Division of Training, Workforce Development, and Diversity (TWD). Rockville, MD: U.S. Department of Health and Human Services, Division of Training, Workforce Development and Diversity. Retrieved from http://www.nigms.nih.gov/Training/Pages/TWDPrograms.aspx.
New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America, Executive summary. Rockland, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http://store.samhsa.gov/product/Achieving-the-Promise-Transforming-Mental-Health-Care-in-America-Executive-Summary/SMA03-3831.
Ngo-Metzger, Q., Sorkin, D. H., & Phillips, R. S. (2009). Health care experiences of limited-English proficient Asian Americans. The Patient: Patient-centered Outcomes Research, 2(2), 113–120.
Rios-Ellis, B. (2005). Critical disparities in Latino mental health: Transforming research into action. Retrieved from http://www.nclr.org/index.php/publications/critical_disparities_in_latino_mental_health_transforming_research_into_action/.
Rogers, A., & Sheaff, R. (2000). Formal and informal systems of primary healthcare in an integrated system: Evidence from the United Kingdom. Healthcare Papers, 1, 47–58.
Sanders Thompson, V. L., Bazile, A., & Akbar, M. (2004). African-Americans’ perceptions of psychotherapy and psychotherapists. Professional Psychology: Research and Practice, 35, 19–26.
Satterfield, M., & Dover, M. (2012, January). AAP mental health toolkit addressing mental health concerns in primary care a clinician’s toolkit. Presentation at the NC Center of Excellence for Integrated Care 2010.
Unutzer, J., Schoenbaum, M., Druss, B. G., & Katon, W. J. (2006). Transforming mental health care at the interface with general medicine: Report for the President’s Commission. Psychiatric Services, 57, 37–47.
U.S. Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity—A supplement to mental health: A report of the surgeon general. Executive summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
U.S. Department of Health and Human Services. (2010). Movilizandonos por Nuestro Futuro: Strategic Development of a Mental Health Workforce for Latinos Consensus Statements and Recommendations. USDHHS Office of Minority Health and the National Resource Center for Hispanic Mental Health.
U.S. Department of Health and Human Services. (2014). Fact sheets: The affordable care act and Latinos. HHS.gov/HealthCare, U.S. Department of Health and Human Services. Retrieved from http://www.hhs.gov/healthcare/facts/factsheets/2012/04/aca-and-latinos04102012a.html.
U.S. Department of Health and Human Services Office of Minority Health & Hogg Foundation for Mental Health. (2012). Eliminating disparities through the integration of behavioral health and primary care services for racial and ethnic minority populations, including individuals with limited english proficiency. A literature review report.
Umaña-Taylor, A. (2003). Language brokering as a stressor for immigrant children and their families. In M. Coleman & L. Ganong (Eds.), Points and counterpoints: Controversial relationship and family issues in the 21st century: An anthology (pp. 157–159). Los Angeles, CA: Roxbury.
Vitullo, M. W., & Taylor, A. K. (2002). Latino adults’ health insurance coverage: An examination of Mexican and Puerto Rican subgroup differences. Journal of Health Care for the Poor and Underserved, 13(4), 504–525. doi:10.1353/hpu.2010.0653.
Weinick, R. M., & Jacobs, E. A. (2000). Hispanic healthcare utilization: The role of ancestry, language, and duration of residence in the United States. Abstract of the Academic Health Services Research Health Policy Meeting.
Yeung, A., Shyu, I., Fisher, L., Wu, S., Yang, H. Y., & Fava, M. (2010). Culturally sensitive collaborative treatment for depressed Chinese Americans in primary care. American Journal of Public Health, 100(12), 23972402.
Zayas, L. H. (2011). Latinas attempting suicide: When cultures, families and daughters collide. New York, NY: Oxford University Press.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Mazzula, S.L., Torres, A. (2016). Latino Trends and Health Policy: From Walking on Eggshells to Commitment. In: Benuto, L., O'Donohue, W. (eds) Enhancing Behavioral Health in Latino Populations. Springer, Cham. https://doi.org/10.1007/978-3-319-42533-7_5
Download citation
DOI: https://doi.org/10.1007/978-3-319-42533-7_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-42531-3
Online ISBN: 978-3-319-42533-7
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)