Latinx Mental Health: Culture, Stigma, & Barriers

September 6, 2022

Mental health concerns affect everyone, regardless of cultural or social identity. People in the Latinx* community also face unique barriers to care, which can lead to silent suffering and worsening symptoms of mental illness.

Systemic racism, cultural stigma, and other factors can take a toll on Latinx mental health and create mistrust in the mental health system. As a result of barriers, Latinx adults with mental health conditions receive treatment (35 percent) at a lower rate than the U.S. average (43 percent).

Barriers to Hispanic/Latino mental health

Some of the barriers to accessing mental health care in the Latino community include:

Mental health stigma in the Latino community

Due to stigma, talking about mental illness in Latino culture can be viewed as taboo. Stigma can lead to a lack of information that makes it difficult to know how or when to seek help, as well as cultural messages that discourage getting help. Two examples of these cultural messages are:

• Gender role expectations and distorted ideas of strength - Often, people feel they need to ignore or push away difficult feelings to be “strong.” This can be particularly true among Latino men, who may experience social messages that they must be strong or dominant to be a man. The presence of machismo, also known as toxic masculinity, can lead men to express themselves with dominant or aggressive behaviors rather than sharing their feelings. Similarly, Latina women may also feel the impact of marianismo, which can include beliefs that femininity equates to maternity, self-sacrifice, submission, and chastity. As a result, Latina women may feel they should be able to handle stressors on their own, without asking for help, which can prolong their distress.
• Keeping “family business” private - Another common cultural barrier to Latinx mental health is the belief that personal issues should stay within the family, behind closed doors. “La ropa sucia se lava en casa” is a common saying, which is similar to “Don’t air your dirty laundry in public.” If someone expresses a desire for mental health support, friends and family may discourage this type of personal disclosure for fear it could bring embarrassment or shame to the family. A belief in the concept of familismo (or interdependence, prioritizing family needs over individual needs, and seeking family support) may also make it less likely for people to get professional mental health support and instead turn to family members or other trusted figures like religious leaders. These and other cultural messages can contribute to mental health stigma in the Latino community.

Inadequate mental health education

Another factor that influences Latino/Hispanic mental health is the general lack of education and awareness around mental health in the U.S. When people haven’t been taught how to recognize the signs they need support or how treatment could help, they’re less likely to get care. For many people, it’s hard to see unhealthy or problematic aspects of their own lives. For example, dysfunctional relationship patterns can feel “normal” because they’re familiar or common.

Research also indicates that Latinx people are more inclined to seek care from a physician rather than a mental health professional. This is in part due to the fact that Latinos are more likely to present with physical symptoms of mental distress, such as dizziness and unexplained body aches. As a result of seeking care from a physician, Latinx people are more likely to receive pharmaceutical treatment over referrals to mental health services.

Difficulty with access and affordability

A disproportionate number of Latinx Americans live at or below the poverty level, or lack insurance coverage to receive affordable health care, including mental health services. People of lower socioeconomic status can also have a tough time finding providers in their community. It’s even harder to find services that are affordable. This is made even more complicated and pronounced when considering issues related to immigration status. As a consequence, many people live with undiagnosed and untreated illnesses.

Lack of culturally competent care

One of the most notable barriers to Hispanic/Latino mental health is finding culturally competent care. The search can be even more discouraging when trying to find a mental health professional who speaks Spanish and is knowledgeable about the cultural context surrounding their issues. Given that only 5 percent of mental health providers identify as Hispanic, finding a bilingual or bicultural provider can be a real challenge.

Religion as a replacement for mental health services

Another common obstacle to mental health in the Latino community is the belief that people must choose between their religious beliefs and their desire to receive mental health services. While religion can help promote good mental health, it can also contribute to mental health stigma in the Latino community. Often, prayer and pastoral counseling are seen as a replacement for therapy when in reality, they serve different purposes and aren’t mutually exclusive.

Latinx mental health in the workplace

There’s a lot employers can do to address barriers to care and help Latinx employees get the care they need. Supporting Latinx employees starts with understanding their experiences and the unique stressors they face. In addition to the barriers described above, here are some of the issues surrounding Hispanic/Latino mental health at work.

Lack of representation

White men make up 85 percent of company executives, despite only comprising 38 percent of the overall U.S. workforce. The lack of Latinx representation in company leadership can lead to a number of issues, such as:

• Tokenism, or hiring people of a certain social identity as merely a symbolic effort to be inclusive
• Isolation in the workplace
• Lack of cultural understanding of employees on the part of employers
• Potential for microaggressions and other sources of race-related stress in the workplace that impact Latinx mental health

On top of these challenges, Latinx people may also develop imposter syndrome, which can happen when high-achieving people who are objectively accomplishing a lot systematically receive messages that the opposite is true. This phenomenon can suggest that these places of employment have not historically been diverse or inclusive of Latinx people. For example, in academic medicine, if the pictures lining the halls are of older, white, male doctors, a young doctor of color may draw the conclusion they don’t belong. Lack of representation also creates a dearth of mentorship for Latinx people, putting the responsibility on them for trailblazing in their professions or workplaces.

Bias, discrimination, and microaggressions in the workplace

Discrimination can be subtle and ambiguous, as in the case of microaggressions. For example, a Latinx person might be “complimented” on speaking English well, when it’s their first language. Or a colleague might express surprise about an accomplishment, as if Latinx people are not expected to excel.

Discrimination can also be more overt and significant such as when someone is:

• Excluded from promotions
• Left out of meetings
• Talked over during meetings
• Mistaken for another person of color or called the wrong name
• Labeled in performance evaluations with coded language such as “unprofessional” or “argumentative”

Both microaggressions and more obvious signs of bias can add to the imposter syndrome already fueled by a lack of representation.

Exhaustion from code-switching at work

In linguistics, code-switching refers to alternating between languages, dialects, or speaking styles. In the context of cultural expectations, it’s the idea that a person of color has to change their mannerisms, the way they dress, their hairstyle, and more to “fit in”—for example, speaking less enthusiastically or straightening curly hair. This idea of fitting in often overlaps with whitewashed expectations of professionalism.

Acculturation stress

About one-third of Latinx people in the U.S. are immigrants. After arriving in the U.S., they tend to have better health, including mental health, compared to their American-born counterparts (including U.S.-born Latinx and non-Latinx groups like white and Black Americans). This phenomenon is known as the “immigrant paradox.” There have been many hypotheses about why this happens, and a prominent one has to do with the innate sources of resilience within this population.

But in fact, the longer immigrants live in the U.S., the worse their health becomes, eroding any initial health benefits this group may experience. There are many reasons for this, including:

• Acculturation: As Latinx immigrants adapt to life in the U.S., they adopt both positive and negative aspects of the “mainstream American” culture. For example,
  they may adopt behaviors like living a more sedentary lifestyle, binge drinking, eating fast food, and eating less fresh produce.
• Acculturation stress: The stress that comes from the process of immigration and adaptation can have negative health consequences for immigrants and their children. To cope with this stress, Latinx immigrants may engage in behaviors that may have short-term benefits but long-term health consequences like binge drinking, emotional eating, and smoking.

More caretaking responsibilities

A key source of resilience within the Latinx community is strong relationships with family and fellow community members. Latinx people often make decisions and set priorities based on their community’s needs, not just their own. These strong community ties can buffer against stress and improve Latinx mental health, but the additional caretaking responsibilities may also fuel stress.

These complex and compounding issues deeply impact Latinos and mental health, especially if workers feel a lack of employer support.

How employers can support Latinx mental health

There are several steps employers can take to make a difference in ways that not only provide Latino mental health resources, but also create a more equitable, welcoming work culture. Here are a few strategies to consider.

1. Boost representation in your workforce

   Recruiting and hiring a diverse pool of people is essential. It begins with a holistic perspective on what you want from job candidates. For example, consider broadening your definition of a “qualified applicant.” Traditional definitions of what makes a candidate successful can limit opportunities for racial representation. If lived experience could be more relevant to a job than a specific degree or title, then requiring a certain degree could mean missing out on stand-out employees.

   Another key to inclusive recruitment and retention is ensuring salary equity across job functions, regardless of race or gender. This will help your company compete for the best, most diverse talent. While intentional hiring can increase diversity, there should also be intentional support given to these Latinx hires to avoid burnout and the burden of representation.

2. Provide mentorship to foster career advancement

   To support a diverse workforce, it’s important that employers provide mentorship and leadership training to their Latinx employees. This can help workers advance their careers and contribute to better representation in company leadership. Offering mentorship opportunities helps reinforce that the company is invested in Latinx employees’ career success.

3. Give consistent positive feedback for good work

   When there’s a lack of representation and minimal accountability for bias in a workplace, Latinx employees may start to internalize the idea that they don’t deserve to be there. Providing consistent, encouraging feedback about employee strengths and performance can help counteract any feelings of being undervalued, misplaced, or unrecognized in the workplace.

   This doesn’t mean giving Latinx employees special attention or overlooking poor performance—in fact, it’s important to avoid tokenization. But positive reinforcement for top performers can mitigate a lack of representation and boost retention efforts. It can also help elevate employees’ voices and inspire them to keep expanding their skills.

4. Create a bias-reporting mechanism in the workplace

   Retention may be an issue if Latinx employees face bias, discrimination, or microaggressions and there’s no established infrastructure for prevention or intervention in your company. Since people may fear retaliation for reporting discrimination, you can encourage employees to report these instances by creating policies that affirm their safety and protection. For example, you can outline how to file anonymous reports. Also, consider sending out recurring, anonymous surveys that give you a “pulse check” on the work environment and take action where necessary.

   For prevention, companies can implement bystander and upstander training to help employees understand what to do when witnessing prejudice or discrimination in the workplace. This can empower all employees to be more accountable for addressing bias, discrimination, and microaggressions, not just those who are impacted by it.

5. Be aware of institutional betrayal

   Government systems and institutions are not built to support diversity and inclusion, and often fail to support marginalized populations like women and Black, Indigenous, and people of color (BIPOC). There is a long history of traditional institutions harming BIPOC people that continues today. This is known as institutional betrayal.

   Changing these long-entrenched problems requires participation from all levels of an organization, not just individual employees. Rather than relying on your Latinx employees to educate you on their needs, spend some time researching and understanding the nuances of this community, particularly the obstacles to mental health care and Latinx mental health resources that are available. Once you’ve built a foundational understanding of Latinx experiences, be sure to also ask Latinx employees what they need in order to provide relevant and tailored support.

6. Offer comprehensive, culturally responsive mental health benefits

   Implement support systems that allow employees to practice regular self-care and access mental health providers who are trained in culturally responsive care. A mental health benefit should have a diverse network of providers who can offer adequate representation for employees and, in some cases, care in their preferred or native language. This also eliminates some of the barriers to mental health in the Latino community.

   It’s also important for employers to support requests for personal wellness days that give employees time to attend to their emotional (not just physical) well-being.

7. Build a culture of mental well-being

   There’s an old saying that if a fish is sick, you don’t treat the fish, you change the water. What’s happening in the waters of your workplace that might be considered unhealthy for employees of all backgrounds? You may be able to improve employee mental health with strategies like cutting workloads, offering flexibility for alternative schedules, and other changes that create a more supportive, inclusive environment.

Make Latinx mental health a priority at your organization

Steps like these can go a long way toward communicating to Latinx employees that you hear them, value them, and want to be an organization where they can thrive. Contact Lyra to learn more about supporting diversity and inclusion, including Latino/Hispanic mental health, at your organization.

*Latinx is the gender-neutral term for people of Latin American ancestry. Recognizing that the Latinx community is diverse, we use a variety of terms people in this community may identify with, including Latino mental health and Hispanic mental health.