Mental Healthcare Disparities in Latino Youth by Dr. Alfonso Mercado
According to the American Psychiatric Association (2000), it is estimated that 20-30% of children in the United States have a mental health disorder; however, many of those children never receive any type of mental health care (Kataoka, et al., 2002). Children and adolescents significantly underutilize mental health services and of greatest concern is that ethnic minorities, including Latino youth who may be at higher risk of having a mental health disorder, are even less likely to receive mental health care (Garland et al., 2005; Gerdes, et al. 2013; Kataoka et al., 2002) or receive evidenced-based services (Niec, et al., 2014). Latinos form the largest minority group in the U.S. with a population of 50.5 million and the number of Americans identifying as Latinos is expected to increase to 97 million by the year 2050 (U.S. Department of Health and Human Services, 2001). National estimates suggest that Latino adolescents have higher rates of suicidal ideations, internalizing symptoms, such as anxiety and depression, and are more likely to drop out of high school, according to the Center for Disease Control and Prevention (1999). Given the growing population of this cultural group and knowing that Latino children have greater rates of unmet needs (Flores, et al. 2010; Kataoka et al., 2002) and are at higher risk of developing mental health problems, it is essential to understand the barriers Latino families and their children face in regards to mental health care and understand the help-seeking behaviors that play a role in treatment initiation, access and treatment availability.
This evident disparity between Latino youth having high rates of mental health disorders and being less likely than any other ethnic group to receive mental health care has been identified by many (Flores et al., 2002; Garland et al., 2005; Kataoka et al, 2002; Lopez et al., 2008; U.S. Department of Health and Human Services, 2001). Even though high rates of mental health illnesses exist in Latino youth, they are less likely than any other group to receive clinical or school based treatment and are less likely to receive medication (Garland et al, 2005). For examples, Garland et al. (2005) identified significant racial differences in utilization of mental health services among high-risk youth who were identified from various social service entities, such as child welfare, juvenile justice, alcohol and drug abuse, mental health and public school special education programs for youths with serious emotional disturbances. These youth had an increasingly high rate of mental health services use, including outpatient, 24-hour services, and informal services. However, Latino youth had lower rates of outpatient service use as compared to non-Hispanic white youths. This study reinforced the concerns of racial/ethnic disparities in mental health care continue to remain a public health problem.
Although studies on barriers to mental health care initiation and help seeking for Latino youth and their families’ are limited, a common theme of the studies reviewed center on the importance of addressing Latino cultural values in the services provided. Addressing the predisposition to service use, such as culture, can aid in mental health treatment initiation. The literature suggests employing culturally specific components to mental health services and having bi-cultural and bilingual clinicians, which may help increase mental healthcare service access and treatment initiation with Latinos. Treatment programs need to make modifications, such as including enabling factors that would impact treatment initiation and engagement. For instance, in order to combat the stigma of mental illness in the Latino community we must do a better job educating Latino parents on what are the specific roles of mental health professionals and provide psychoeducational resources, at the primary care setting, on mental illnesses to increase awareness. Doing so, Latino families’ perception of need will increase as utilization of mental health services. Addressing these barriers in utilization of mental health care within Latino communities is a priority, and having public health campaigns may greatly aid in ensuring more culturally-sensitive services.
Dr. Mercado, originally from Los Angeles, California, currently is an Assistant Professor at the University of Texas-Rio Grande Valley and a Licensed Psychologist.
He provides psychological services to children, adolescents, and adults. His current research lab focus on Latino mental health, clinical treatment outcome studies, and multicultural interventions. In addition to his professional career, Dr. Mercado also serves his community in several capacities. He is Board of Trustee for the Texas Psychological Association and the South Texas Psychological Association.
Search for a psychologist near you by filling out the blue box on the right or top of your screen, starting with "Search by City or Zip." Once you pinpoint a location for your search, you can filter your results by a psychologist’s areas of expertise, languages spoken, name, and other options.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, (4th ed.). Text Revision. Washington, DC: American Psychiatric Association.
Alegria, M., Canino, G., Lai, S., Ramierz, R., Chavez, L., Rusch, D. (2004). Understanding caregiver’s help seeking for Latino children’s mental health. Medical Care, 42 (5), 447- 455. DOI:10.1097/01.mlr.0000124248.64190.56
Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance-United States, 1999. Morbidity Mortal Weekly Report (MMWR) 2000, 49, 1-96.
Flores, G., Fuentes-Afflick, E., Carter-Pokras, O., Claudio, L., Lara, M., McLaurin, J.A., Patcher, L., Ramos-Gomez, F., Mendoza, F., Burciaga-Valdez, R., Villarruel, A.M., Zambrana R.E., Greenberg, R., & Weitzman M. (2002). The health of Latino children: urgent priorities, unanswered questions, and a research agenda, Journal of the American Medical Association, 282, 82-90. DOI:10.1001/jama.288.1.82
Garland, A.F., Lau, A.S., Yeh, M., McCabe, K.M., Hough, R.L, & Landsverk, J.A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youth. American Journal of Psychiatry, 162, 1336-1343. DOI: 10.1176/appi.ajp.162.7.1336
Gerdes, A.C., Lawton, K.E., Haack, L.M., Scneider, B.W. (2013). Latino parental help seeking for childhood ADHD. Administration Policy and Mental Health, 41, 503-513. DIO: 10.1007/s10488-013-0487-3
Kaota, S.H, Zhang, L., & Wells, K.B. (2002). Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548-1555. DOI: 10.1176/appi.ajp.159.9.1548
Lawton, K.E., Kapke, T.L., & Gerdes, A.C. (2015). Understanding parental locus of control in Latino parents: examination of cultural influences and help-seeking intentions for childhood ADHD. Cultural Diversity and Ethnic Minority Psychology. Advanced online publication. http://dx.doi.org/10.1037/cdp0000022.
Lopez, C., Dewey-Bergen, M., Painter, S.G. (2008). Latino disparities in child mental health services, Journal of Child and Adolescent Psychiatric Nursing, 21, 137-145. DOI: 10.1111/j.17446171.2008.00146.x
Niece, L.N., Acevedo—Polakovich, I.D., Abbenante-Honold, E., Christian, A.S., Barnett, M.L., Aguilar, G. (2014). Working together to solve disparities: Latina/o parents’ contributions to adaptation of a preventive intervention for childhood conduct problems, Psychological Services, 11(4), 410- 420. DOI: 10.1037/a0036200
Rastogi, M., Massey-Hastings, N., & Wieling, E. (2012). Barriers to seeking mental health services in the Latino/a community: a qualitative analysis. Journal of Systematic Therapies, 31 (4), 1-17. DOI: 10.1521/jsyt.2012.31.4.1
U.S. Department of Health and Human Services. (2001). Mental health: culture, race, and ethnicity: 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.
Yeh, M., McCabe, K., Hough, R.L., Dupuis, D., & Hazen, A. (2003). Racial differences in parental endorsement of barriers to mental health services for youth. Mental Health Services Research, 5 (2), 65-77. DOI: 10.1023/A:1023286210205