Cultural Considerations for Mental Health Communications

May 22, 2020 Mari Goetz

The Coronavirus pandemic is having a devastating impact on the Hispanic population in the United States. Throughout the country – and most notably in cities and areas of dense populations – Hispanics are suffering  a higher incidence of illness and death. In Massachusetts, towns with large Hispanic populations are seeing fatality rates that can be up to 20 times higher than neighboring towns with lower numbers of Hispanic residents. In New York City, Hispanics “comprise 19% of the population but have suffered 27% of the deaths.” As the pandemic pushes on throughout the country, the number of Hispanics affected continues to rise, since Hispanics are less likely to be able to work from home and have a higher representation in the essential work force.

But the casualties go beyond illness and loss of life. A Pew Research Center poll found that “around half (49%) of Hispanics say they or someone in their household has taken a pay cut or lost a job – or both – because of the COVID-19 outbreak, compared with 33% of all U.S. adults.” It comes as no surprise then that the Hispanic community is facing a tremendous increase in reports of psychological stress. Dr. Margarita Alegria, the head of the Disparities Research Unit at Massachusetts General Hospital, warns that we need to be prepared for “the post-mental health challenges that will come after the virus,” even as the physical dangers of the pandemic start to wane. While offering information on resources that will ease anxiety about food and shelter may help in the short term, the need for mental health services to help with lingering fears and the emotional shock of loss and uncertainty will need to be comprehensive and ongoing.

Addressing issues of mental health within the Hispanic community, however, is not always straightforward. Seeking help for mental health problems can still carry a stigma for many Hispanics. According to the National Alliance on Mental Illness (NAMI), this stigma may derive from a lack of information and access to mental health care. In fact, NAMI suggests that many Hispanics do not seek treatment because they may not recognize the signs and symptoms of mental health conditions or know where to find help. Language barriers and privacy issues may further complicate the possibility of reaching out for assistance. For instance, many providers offer interpreting services, but when a person is already feeling vulnerable and distrustful, they may not want to add a third party to the conversation.

The Hispanic community needs to know how to seek mental health services that will offer relief and support. According to NAMI, cultural competence can play a significant role. Simply put, cultural competence is “the ability to understand, communicate with and effectively interact with people across cultures.” Any kind of communication focusing on mental health must take into consideration the Hispanic population’s views on the subject, and must acknowledge the trepidation with which this community approaches this issue. NAMI also suggests primary care providers as initial sources of help and guidance because a sense of trust may already exist, which would allow PCPs to serve as excellent liaisons with someone seeking care and mental health services. Community-based organizations may also provide some guidance. A Modern Healthcare opinion piece recently suggested that community-based organizations may serve as a valuable asset to improve population health. Hispanics often turn to their own community for help, and these organizations provide a much needed level of trust for those seeking mental health resources.

Finally, when providing digital resources, it’s important to reassure Hispanics that links and information are available in Spanish. There are many crisis help lines available, but not all have multilingual resources. If they do, the links are sometimes difficult to find. For example, SAMHSA’s Disaster Distress Hotline (Substance Abuse and Mental Health Services Administration) offers the option to text “Háblanos” to connect with a crisis health counselor in Spanish, but the instructions initially appear in English. In moments of extreme distress, this may only cause further confusion to non-English speakers.

The wave of mental health challenges that Dr. Alegria warns about needs to be addressed now more than ever, and helping the Hispanic community navigate a system that is often confusing to them is an essential part of this challenge. This can be done by taking into account Hispanic perceptions of mental health issues and remaining sensitive to these views. During these times of deep concern and anxiety, any information provided should be easily accessible and delivered in a manner that reassures the Hispanic population that they are not alone and that help is at hand.

 

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