This Hispanic* Heritage Month, let’s take a moment to talk about Latino mental health.
The latest Census data puts the Latino population at around 63 million, representing 18.9% of the total US population. It’s a very large and diverse group.
While there’s no precise definition of “Latin America,” Latinos in the US have familial origins in at least 20 different countries. In the US, the most common country of origin is Mexico (60%), followed by Puerto Rico (9%), El Salvador (4%), Cuba (4%), and the Dominican Republic (4%).
Latinos are also diverse with respect to race. They can identify (and be identified as) White, Black, Asian, Indigenous, or mixed race. Latinos can also be immigrants or born in the US as second-, third-, fourth- (and beyond) generation Americans. (Two thirds of Latinos today were born in the US.)
All of this makes it very difficult and unreasonable to talk about a general “Latino” mental health. The mental health of a third-generation Nuyorican can be shaped by forces that are irrelevant to the mental health of a recently immigrated Nicaraguan in Arizona.
For this reason, I (a second-gen Puerto Rican and Honduran woman) want to use this Progress Note to take a more nuanced look at the mental health of Latinos in the US.
When looking at psychological distress (defined by a high reported frequency of experiencing six symptoms), we see that Puerto Rican adults report higher rates than adults of Mexican, Cuban, and Central or South American origin. This may be partly due to Puerto Rico’s unique status as a US territory with little political representation in the federal government but subject to its policies, which has been economically devastating for Puerto Ricans.
A study examining Latino racial identification and psychological distress found that Black Latinos had an almost 40% greater risk of experiencing moderate psychological distress compared to White Latinos. Looking within Latino subgroups, this risk only appeared for Latinos of Mexican and Cuban origin, but not for Puerto Rican and Dominican origin.
There is also the famous immigrant paradox, in which US-born individuals tend to do worse across various outcomes compared to their immigrant counterparts. Latinos who were born in the US or have lived here longer generally have higher rates of mental health conditions compared to immigrants and those who have lived here less time. However, the existence of this paradox depends on the Latino subgroup and on the condition in question.
The legacies of colonialism in Latin America and racism in the US are probable common factors across all of these findings.
If we look at overall mental health service use, Latinos with mental health needs are accessing care less often than non-Latino White, Black, and Native Americans.
When Latinos do get care, they appear most likely to get it from general healthcare providers and not mental health professionals, especially for Mexican-origin adults.
As a whole, Latinos are the racial/ethnic group with the lowest rate of insurance coverage in the US. But there’s variability here, too. Mexicans, Central Americans, immigrants, and predominantly Spanish speakers are less likely to have insurance coverage.
Let’s also look at the supply of appropriate services. As a Latina psychologist, I’m one of just 7-9.5% of the mental health workforce that identifies as Latino. I’m also one of only 5.5% of psychologists who speaks Spanish. Unfortunately, the availability of Spanish mental health services only seems to be decreasing.
As tends to be the case, the most vulnerable among Latinos are facing the biggest barriers to mental healthcare.
As we can see from the stats, a generalized view of Latino mental health would yield an overly simplistic and inaccurate understanding of this diverse group’s needs. It would also impede the discovery of effective solutions to their challenges in accessing care.
You can’t solve problems you don’t understand.
Because Latinos are such a large and diverse segment of the US population, their challenges are everyone’s challenges. The solutions to our mental health crisis will necessarily involve addressing Latinos’ barriers to care.
I hope the information presented above helped deepen your understanding of Latino mental health. There’s still much more for us to learn collectively about needs and access to mental healthcare among Latinos. But if you leave this Progress Note with a healthy skepticism of population-wide discussions of Latinos, then that’s a solid foundation for more learning.
Let’s learn and make progress together.
*I don’t generally use “Hispanic” but I like the alliteration.
This edition of Progress Notes was first published in our quarterly newsletter.