While Mental Health Awareness Day was observed earlier this month on October 10, the issue is often front-and-center for many Latinos and family members who support them.
Fred Sandoval, president of the National Latino Behavioral Health Association (NLBHA), spoke with CALÓ NEWS on the importance of educating and spreading awareness about mental health to the Latino community.
The NLBHA was established in 2000 with the mission to be a national voice for Latinos in the behavioral health field and to bring attention to the great disparities that exist in areas of access, utilization, practice-based research, and adequately trained personnel.
NLBHA originated from a federal group called the National Hispanic Mental Health Congress, which was held in 2000 in Los Angeles. Sandoval said that the congress was organized by the Substance Abuse Mental Health Services Administration (SAMHSA) and it convened about 100 Latino leaders in behavioral health research and mental health advocates from across the country.
The congress developed recommendations on what the SAMHSA should be looking at to help address mental health disparities among Latinos living in the United States.
Sandoval was a member of that congress and said that one of the recommendations they made was the formation of the NLBHA, which was formally established a year after that congress.
Sandoval received his master’s degree in Public Administration from Northern Arizona University in 1992 and his bachelor’s degree in University Studies from the University of New Mexico in 1980. He has been in the behavioral field for 40 years and has worked in a wide range of capacities in the field. He was a mental health director for two community health centers early in his career. He has served as First Vice President of the National Alliance on Mental Illness. He also served as a member of SAMHSA Health Care Reform Community of Practice, advising on effective outreach and enrollment of uninsured Latinos.
He has received the SAMHSA Administrator Award, the Cerro Grande Fire Hero Award, the Con Alma Health Foundation Health Hero Award and numerous national recognition for his work in and with Latino communities.
Sandoval, who’s sister suffers from chronic paranoid schizophrenia, also hasa substance abuse history in his family and has been a mental health advocate locally, regionally and nationally for the last 30 years.
Responses have been edited for clarity and brevity.
WHY IS MENTAL HEALTH AWARENESS IMPORTANT?
It’s important largely because all of us as human beings are affected by the conditions that affect our mental health. Mental health is the well-being aspect of our emotional and psychological self. The importance of bringing awareness is to help make up for what society or educational systems are unable to do or fail to do to help inform and educate members of society as to the importance of taking care of their mental well-being. The reason they fail is because they want to improve their mental health. Unknown mental health illnesses have always been treated as second-class disorders, so they are not at parity with health conditions. That means that mental health issues tend to be under researched, underfunded, and there are less of them even though mental health is health and mental health affects all people. The system is pretty archaic in terms of its origins, and what I mean by that is that health centers and health programs were more adequately funded to begin with, and mental health programs were adequately funded less.
The reason why we bring awareness is because we want, to the greatest extent possible, is to prevent mental health conditions or mental health illnesses from beginning to adversely impact individuals. The best way to do that is through early detection assessment prevention and other early interventions that help reduce the risks of people developing mental health conditions.
Awareness is one step in bringing society up to a speed, where they can learn more about what mental health is, what mental illness looks like, and what we can all do to help reduce the problems that are caused by mental health conditions.
WHY IS IT IMPORTANT TO STOP THE STIGMA SURROUNDING/ AROUND MENTAL HEALTH?
It’s probably one of the top three barriers to getting good mental health services. That means that when society stigmatizes people, it’s another way of saying they are less than others, that they’re inferior or unable to be in full health, and that equates to being treated as less than others. That’s a social problem because most of society has continued to look upon mental health and mental health illnesses as things that are not worthy of the same level of treatment or not worthy of the same level of support as other mental health conditions. Stigma creates barriers for people willing to ask for help. Stigma is another way of preventing people from getting help. Stigma is also another way of telling people that they should say nothing and suffer in silence. Stigma is another way for people to be told that what they are experiencing is their fault. Stigma is an old way of treating people in a way that is unfair, inequitable, and actually does harm.
All of that comes from various systems of how people with mental illness have been treated. They used to be historically institutionalized, placed in prisons, in asylums. They were all separated and segregated from society. Instead of being inclusive, in other words, isolating them and treating them as if they shouldn’t be part of society because of the system’s inability to understand the complexities of mental illness.
HOW DOES MENTAL HEALTH AFFECT SOMEONE’S OVERALL HEALTH?
The good news is that mental health and physical health are rarely in their optimal form. If you have good mental health combined with good physical health, then that’s the optimal state for any human being. That is to be aware of the symptoms and conditions associated with disorders or diseases. Mental health and physical health are the goals that we are all trying to achieve.
What happens in the course of human life is that there are conditions that will affect a person’s emotional state or physical well-being and that causes an imbalance. Sometimes they can be severe enough to create a disorder or possibly a disease, and these are illnesses that cause the human body and the human mind to experience destruction in daily living and functioning. If they are untreated, they tend to become much more serious, and some individuals who don’t get adequate access to treatment could develop chronic conditions because those illnesses have to be treated in order to reduce those symptoms.
Life circumstances can be affected by things that are considered diseases. Brain illness is associated with mental illness and mental disorders, and where the mind betrays itself, it is actually affected by imbalances of biological nature, which means that what is normally a normal functioning brain can be impacted by things like dramatic experiences, brain injuries, and from other chemical imbalances in the brain. All of those are natural conditions, and they are very complex because the brain itself is complex, and we have yet to develop any type of cure for most mental health disorders. However, there are a large number of pharmaceutical treatments and medications that are used to help treat symptoms, but they also come with certain side effects that can be very harmful to individuals.
HOW IS MENTAL HEALTH VIEWED IN LATINO CULTURE?
For Latinos, there is a long history of why it is that mental illness particularly affects them. For instance, it’s seen more through a cultural lens as a person who is crazy, a person who is out of their mind, incapable of functioning in a way that is considered shameless. We tend to see those needs impact the ability of people to talk more openly about getting help and articulate whatever is happening in their minds because of the imbalances in their brains. We tend to see that Latinos, in general, have ways to call in order to deal with these kinds of issues; it’s much more culturally and family-focused and community-centered versus the mainstream approaches, which tend to be still stigmatizing. What I tend to see is that society in America tends to dismiss and disregard any person with a mental illness regardless of race, and in some ways, we are all treated equally in that way. The problem with that is that it does not encourage or promote well-being as much as it does. It actually does harm by getting people to remain quiet and isolated, suffering in silence.
WHAT ARE SOME COMMON MENTAL HEALTH CONDITIONS AMONG LATINO COMMUNITIES?
I can tell you what the top three are. In fact, I’m going to describe them that way because they are very commonly found because they have a lot of commonality in terms of the origins of these mental health conditions. The three most prominent are: anxiety, depression, and substance abuse. Oftentimes, all three can be present. Even though they each have their own definition and descriptions of symptoms, a person can actually have all three at the same time. They can have them to varying degrees at the same time or they may appear at different intervals in time. The three are significant for us to understand because each of them really tends to speak to what might cause people to have anxiety, depression, or substance abuse.
If we use those terms, we want to identify them in at least two ways. One is people who have been diagnosed with these conditions versus those who have these conditions and have not been diagnosed. For example, a couple of 21-year-olds talk about their life situations and describe similar experiences of what’s happening in their lives, but they’ve never seen a counselor. They’ve never been diagnosed or treated for an illness, but they’re describing the symptoms to each other. That’s not uncommon because the vast majority of people experiencing these things may not even be diagnosed, much less treated.
The reason why I use those terms is that the person who has those symptoms would then be considered to have anxiety, depression and substance use. If the person is not diagnosed with those things, then you can’t apply that term or label to that individual because that person has never been diagnosed that way. You have to clinically and professionally identify if that person meets the criteria for those kinds of conditions, and those are very common in the Latino community. A lot of this can be impacted by things such as being raised in a society where there’s a high level of assimilation and acculturation in a family. You may also be experiencing immigrant experiences that will influence how you may experience anxiety or depression because there is a lot of pressure in American society that causes a high level of stress.
HOW CAN ASSIMILATION BE A MENTAL HEALTH FACTOR FOR FIRST-GENERATION LATINOS?
This one is a huge one, and the younger generations are affected by it a lot. You have a lot of family and stressors associated with assimilation because you typically have situations where the adults and the parents of the older extended family members aren’t as knowledgeable or able to adjust to societal conditions. Where a younger person because of education and going to school and achieving the American dream of an education that’s being promoted by the family because the family wants you to be educated at a good school because they want you to graduate and do good in life.
So, you have that mixed message, yet the challenge is that oftentimes you’re the one who learns more English. So, then you’re being asked to help interpret or translate for family members. You’re being asked to make decisions as almost a young adult when you’re still a minor. One of those reasons is that you understand more about these complex American systems than the courts, for instance, the postal service and the education system, when dealing with the school board or school policies.
The younger generation is being subjected to all this pressure to assimilate quickly, which they do. Sometimes there’s tension because you know how to use all the social media devices, and what ends up happening is that families get very angry that you’re becoming more Americanized and losing more of your customs and traditions. What ends up happening sometimes is that you’re criticized for being more American than you are of Latin origin. The truth of it is this: because what is happening is you’re being exposed to other cultures, you’re assimilating to society to figure out how society works, but then you get criticized for not speaking more Spanish, or you’re losing your language, or two, you start bringing in friends that are less Hispanic and more White or even African American. So, all these things create stress and concrete tension between the families, and then they start to experience some level of complexity between each other in the way they communicate. For example, the younger generations always say, “you don’t understand what I have to deal with” or “you don’t know what I go through every day.”
GIVE 3 TIPS FOR ANY LATINO PERSON STRUGGLING WITH MENTAL HEALTH BUT AFRAID TO TELL SOMEONE?
Here are three things that would help. One of them is, if you’re experiencing these kinds of conditions, it is good to at least inform yourself about what those emotions and feelings are like, and the reason why? This is because all human beings experience them. It’s just that you don’t know that we all experience them, so it’d be good to learn just of your own volition about mental health so you can understand the wide range of emotions. So, you can see that, for the most part, what you’re experiencing is a normal situation.
Another would be that sometimes if you don’t have a person you can talk to about this, you can do a variety of things for yourself. You can start a journal and get it out of your head, get it on paper, and release it. You need to have some way of releasing the emotions and experiences that you’re having, and journaling is one good method. Writing poetry is another and also writing out a letter, for instance, about your experience, but you never really mail it. The whole idea is that you’re trying to release that and create an emotional outlet for the emotions you’re experiencing. Part of it is that you may be feeling isolated and you don’t want to tell anybody else, but there isn’t any reason for you not to express it and get those emotions out. You can do it through meditation, through writing, just anything that allows you to start to release this so that it doesn’t stay in your head and you’re not thinking about it all the time.
The other way is that there are new methods for reaching out for help that are confidential, and you can do these three things. There is a system called 988 and it’s open across the country. It’s a place to talk to somebody about how you’re feeling, and the information is confidential, which means you can do this in the privacy of your own house, your bedroom, or somewhere outside of your home where you feel safe. There’s also the crisis text line, which teens and young adults particularly like to use because you can text somebody what you’re experiencing and it is also confidential. These are systems that are in English and in Spanish.
Another thing that you can do is have someone you can confide in. Oftentimes it can be another peer that you trust. It can be a godmother, for instance. It can be your favorite aunt, just someone that you would ask to confide in. So that you’ll be able to sort this stuff out because it’s not that we’re not smart people, but we’re struggling with how to deal with situations we’ve never had to deal with before. It’s important to get another perspective and it doesn’t mean yours is right or wrong and it also doesn’t mean their view is right or wrong. It just helps us understand that we’re not in this by ourselves, and that tends to be very helpful because you can feel the emotional support of the person you trust.