Chapter 6 Mental Health Care for Hispanic Americans These include simpata (kindness), personalismo (friendliness), and respeto (respect).25 Simpata emphasizes politeness and conflict avoidance. Adding to the language barrier is the pitfall of false fluency, when physicians mistake the meaning of a Spanish word because of unfamiliarity with cultural or linguistic subtleties. They Hear You is SAMHSA's underage drinking prevention campaign that helps parents and caregivers start talking to their children early about the dangers of alcohol. hispanic methods of treatment Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. Talk. Hispanics' experience with discrimination or being treated unfairly varies greatly by age. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. For instance, Latinos highly value family. This inequality puts these communities at a higher risk for more severe and persistent forms of mental health conditions, because without treatment, mental health conditions often worsen. Plants are used on their own, or mixed together to form herbal remedies. About 23 percent of Latinos in the United States live in poverty.2. Complementary and Alternative Medicine (CAM) and Healers - Geriatrics Approximately 11.8 percent of Latinos older than 20 years and 13.3 percent of Mexican Americans have diabetes. These instructions can be studied by the patient or translated when time permits. 1Elizabeth M. Grieco and Rachel C. Cassidy, "Overview of Race and Hispanic Origin 2000," Census 2000 Brief, U.S. Census Bureau, March 2001. A chaperone is often appreciated if a same-sex physician is not available. 50 percent of those with no usual health care provider are at least high school graduates. Lower rates of hypertension awareness, treatment, and control have been observed in Hispanics/Latinos compared with non-Hispanic whites. The ethnic terms Latino or Hispanic refer to a diverse population of Latin American descent that includes many nationalities and races. Yet Latinos are at particular risk for diabetes mellitus, tuberculosis, hypertension, HIV/AIDS, alcoholism, cirrhosis, and death from violence.4 There is also a disproportionately high prevalence of acute care in the treatment of Latinos; that is, too often patients delay medical care until their conditions worsen and necessitate immediate attention. SAMHSA Blog. hispanic methods of treatmentfeminine form of lent in french. needs and experience of less acculturated Latino clients who are mostly from Mexico and Central America, and represent a large segment of the Latino community in Southern California. 15Glenn Flores, "Culture and the Patient-Physician Relationship: Achieving Cultural Competency in Health Care," Journal of Pediatrics 136 (January 2000): 14-23; see also Maria R. Warda, "Mexican Americans' Perceptions of Culturally Competent Care," Western Journal of Nursing Research 22/2 (2000): 203-224. Respeto implies attentive concern for the patient and respect of his or her personhood and age, especially if the patient is older. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. While not considering Hispanics as a distinct race, the U.S. Census (utilizing federally delineated categories) defines someone "Hispanic" or "Latino" as "a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. Hispanic and Latino are often used interchangeably though they actually mean two different things. Specifically, to Latin America, to people from the Caribbean, South America, and Central America. Topics. The largest and fastest growing minority population in the United States today is commonly referred to as "Hispanic" or "Latino." Find treatment facilities confidentially and anonymously, 24/7, National Helpline1-800-662-HELP (4357) Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. Objective Breast cancer is the leading cause of cancer death among Hispanic women. Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of non-Latino whites. 15 supp. For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. 11Jennifer Aguayo et. Hispanic Health | VitalSigns | CDC While this has been a challenge across patient populations, it has been especially pronounced among the U.S. Latino population, which shows a rate of non-adherence almost 40% higher than the rate seen in the U.S. Caucasian population. Adding to the language barrier is the pitfall of false fluency, when physicians mistake the meaning of a Spanish word because of unfamiliarity with cultural or linguistic subtleties.4 Another barrier is inability to afford health insurance; nearly one-third of Latinos (30.7 percent) lack coverage.5 Yet another barrier stems from cultural mistrust coupled with a predisposition to seek alternative care first, thus delaying conventional treatment. They are also far more likely than whites to feel that they are treated unfairly by providers or by the medical system.8, These gaps and dissatisfactions become even more troubling in the context of significant disparities in access to health insurance and to the health care system in general. Bilingual posters and medical literature are an important starting point. Traditionally, conditions may be referred to as either "hot" or "cold". Mexican Americans are much less likely to be treated for hypertension than non-Latino whites (35 versus 49 percent).11 Targeted public health campaigns are needed for hypertension, diabetes prevention, and weight control. The cultural value of familism has important implications for the successful treatment of a child with AD/HD. Delgado melvin activities and hispanic groups issues The American Psychological Association (APA) found that only one percent of psychologists identified themselves as Hispanic even though Hispanics represent 20 percent of the U.S. population as a whole. Today, one in three farm workers are newcomers to the United States, with most of these coming from Mexico. 3 Essentially, a curandero or curandera removes mental, emotional, physical and spiritual illnesses or imbalances. Switch to Chrome, Edge, Firefox or Safari. Addressing patients properly can be another challenge. Visit SAMHSA on Instagram Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Latino healing traditions include curanderismo in Mexico and much of Latin America, Santeria in Brazil and Cuba, and espiritismo in Puerto Rico.19 Curanderos, traditional healers, distinguish between hot and cold illnesses (Table 220 ) and occasionally between natural and unnatural (sorcery-related) diseases.19,20 Patients may seek out the care of brujos or brujas (wizards or witches) for the latter conditions. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. Interferon gammarelease assays are preferred to tuberculin skin testing in immigrants with a history of BCG vaccination. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. Information. Among Hispanics ages 18 to 29, 65% say they have experienced discrimination or unfair treatment because of their race or ethnicity. Identifying Eating Disorders in Latinas - The Society for the Recent immigrants often feel lonely and can have culture shock, fears of deportation, and financial problems; depressed mood may manifest as headaches and somatic symptoms. Mental Health In The Latino/Hispanic Community Contact USA.gov. Hispanics generally use multiple methods to treat themselves which involve prayer, folk medicine, prescription medications left over from friends as well as new medications prescribed by physicians. Use of Folk Remedies in a Hispanic Population | JAMA Pediatrics | JAMA In this article I will make use of both terms, relying more heavily, however, on "Latino. New Drugs For Treating Fatty Liver Disease And Cirrhosis , may be one strategy to increase treatment . Have a question about government service? One suggestion she readily agrees to is to include nopales (prickly pear cactus pads), a favorite from her childhood in Mexico. Instituting more culturally competent care is likely to improve treatment adherence and health outcomes. There are also differences in drug use within the Hispanic population as shown in Figure 1. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. A wide array of herbs offered at La Botanica Orquida in northeast Georgia. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. using as treatment, if they remained open-minded, and if doctors had an understanding of folk medicine.37 Another common barrier within healthcare delivery is that the alternative or traditional medicine within the Latino culture is deeply rooted in spirituality and religion.38 While in the United States, Although the program ended in 1964, the immigration trend has continued to the present day, and many of these immigrants work as migrant laborers in the U.S. agricultural system. Margaret E. "Group Methods and . Puerto Ricans have a 14 percent higher rate of hypertension-related mortality than other Latino groups. As with any circumscribed ethnic group, there is, of course, enormous cultural heterogeneity among Latino patients-to the point where it seems almost ludicrous to try to identify broad cultural tendencies across such diversity. 9Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica Smith, "Income, Poverty, and Health Insurance Coverage in the United States: 2006," Current Population Reports, U.S. Census Bureau, August 2007; and Mead et. The Bracero program, a guest worker program started in 1942, was designed to bring experienced agricultural laborers to the U.S. from Mexico and led to a huge influx of Mexican immigrants. Many Latino immigrants experience tremendous stress once they are in the United States. Missing data was handled using this carry-forward method. Hispanics have different degrees of illness or health risks than whites. Hispanic Culture - Sydney Ales Grand Canyon University 352: PSY Floren Latino culture has several normative values that must be recognized in clinical settings. Opioid and Illicit Drug Use Among the Hispanic/Latino Populations Substance Use and the Hispanic/Latino Population: What to Do? Roughly half of Black (49%), AIAN (49%), and NHOPI (51%) people are below age 34, compared to . Religion can be a protective factor for mental health in Latinx/Hispanic communities (faith, prayer) but can also contribute to the stigma against mental illness and treatment (demons, lack of faith, sinful behavior), so targeting religious institutions to help encourage good mental health and treatment-seeking is important. Cultural Health Beliefs and Practices Among Hispanic Parents 13 Kaiser, "A Provider's Handbook," 6-7. Spanish language handouts are available from several Internet sources.33 Recruiting Latino physicians and staff, and recognizing Latino holidays at the office (e.g., Cinco de Mayo), will open many doors to the Latino community.34 Office staff, as well as physicians, should be instructed in basic cultural sensitivity (Table 5).34,35 Hospitals can include culturally appropriate foods in their menus. Substance Abuse Treatment for Latino and Hispanic Adults The Immigration Reform and Control Act of 1986 granted amnesty to immigrants who came to the U.S. before 1982; but the northward trend from Mexico and other parts of Latin America has continued since then, and many who have crossed the U.S.-Mexican border now live in the United States illegally. Culturally Competent Care for Latino Patients Rue for earache. As Hispanics continue their ascent as the largest and fastest growing minority group in the U.S., tension points between the healthcare and the Hispanic communities are growing as well, fueled by the lack of outreach from the former to the latter. PDF Folk Medicine and Traditional Healing Basics - NATIONAL CENTER FOR Latinos comprise the largest minority group in 20 of the 50 states. Prevalence, Awareness, and Treatment of Hypertension in Hispanics Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Latinos often lack access to healthcare and have poor - Brookings Asian or Hispanic ancestry. Still, at the risk of oversimplifying, several trends emerge: -simpatia-politeness and the avoidance of hostile confrontation -personalismo-the value of warm personal interaction -respeto-the importance of showing respect to authority figures, usually including health care providers -familismo-collective loyalty to extended family and commitment to family obligation; -fatalismo-the belief that individuals cannot do much to alter fate15. Rather than operating on the ideal of an informed, active individual who makes decisions based on his or her own personal good, many Latino cultures consider as paramount the individual's obligation to the family and broader community. The cases and reflections illustrate the kinds of challenges patients and health care professionals face when they come from different cultures and speak different languages. placed on religious beliefs in the maintenance of health and the treatment of illness. Her face lights up when you share this. The same is also applies to the substance abuse treatment. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. Working With Hispanic and Latino Families - Child Welfare Maria needs to eat fruit; she should also consume more fiber to counteract her high-carbohydrate diet. Materials are available in English and Spanish. Trauma-Focused CBT for Effective PTSD & Trauma Treatment Delgado Melvin Activities and Hispanic Groups Issues and Suggestions Social from FIL. Methods: Data from the National Mental Health Services Survey conducted in 2014 (N=13,015 facilities) and 2019 (N=12,345 facilities) were used to measure changes in the proportions of facilities that offered treatment in Spanish overall and by year, state, and proportion of Hispanic residents. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. 17.4% were Hispanic, and 49.1% were White. The progress made in expanding health insurance coverage for Latinos is now at risk, because of the COVID-19 economic recession's disproportionate impact on Latino workers. 6Kaiser Permanente National Diversity Council, "A Provider's Handbook on Culturally Competent Care: Latino Population," 2nd ed. In fact, the number of Latino physicians dramatically lags behind Latino population growth; and, according to cross-cultural health care expert Larry Purnell, Latinos are the most underrepresented major minority group in the entire U.S. health care workforce.5 This discrepancy contributes to many different linguistic and cultural hurdles for Latino patients, as well as for their health care providers. Although most Latinos living in the U.S. do speak at least some English, 60 percent of Latino adults speak primarily Spanish at home.6 According to the U.S. Census, more than half of U.S. Latino residents age 5 and older speak English "very well," but a nevertheless significant number of Latino adults speak English "not well" or "not at all. Downward National Trends in Mental Health Treatment Offered in Spanish Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Older patients should be addressed as seor or seora rather than by their first names. Substance Abuse/Addiction Among Hispanic-Latina/o Americans Indeed, such a patient's silence might best be interpreted as an indirect and nonverbal form of disagreement. 5Larry D. Purnell and Betty J. Paulanka, "Mexican-Americans," chapter in Transcultural Health Care: A Culturally Competent Approach (Philadelphia: F.A. Again, it is imperative to stress that these values represent broad generalizations that may or may not apply to any individual patient or in any given situation. Responding to health and social needs of aging Latinos in new-growth In some studies, the rate of non-adherence ranges between 31% and 44% among Latinos (Lanouette et al., 2009). Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. Stigma of psychological treatment, belief that problems should be addressed at the family level (familismo), a misunderstanding or belief that treatment will not help with a child's behaviors, a . 4 Another. Compared with non-Latino whites, Mexican Americans have up to a three times higher incidence of diabetes mellitus and a three times higher prevalence of obesity, but hypertension-related mortality is only 4 percent higher (not a significant difference). Moreover, 32.7 percent (nearly one-third) of all U.S. Latinos completely lacked health insurance that year, compared with 15.3 percent in the general population; and nearly half of Latinos reported being uninsured at some point during the previous year.9 Latinos are nearly two and a half times more likely than whites to report that they have no regular doctor.10 Even among many insured Latinos, coverage and care are far from adequate. A total of 31.2% received care from health care professionals assigned to ETC participation, and 33.6% had Medicare fee-for-service . The toolkit includes tips and techniques to overcome challenges and increase effectiveness when working with Latino populations. Yet the call for cultural competence can-at its best-urge practitioners to adopt instead a stance of cultural "humility": one which encourages an open mind, and a recognition that each one of us sees the world through our own very distinctive cultural lenses. Generally speaking, Latino cultures include a more family-centered decision making model than the more individualistic or autonomy-based model embraced by modern mainstream biomedical culture in the United States. Additionally, when a woman gets married, her husband's name may be appended to her father's name. Key Facts on Health and Health Care by Race and Ethnicity SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. However, the most useful technique is teach back or show me: having patients repeat their care instructions until they do it correctly. Similarly, a patient's silence when presented with a difficult treatment plan, rather than conveying agreement, may in fact indicate that patient's desire to maintain a polite relationship with the health care provider and avoid difficult or conflictual situations. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. Background Patients who are members of minority groups may be more likely than others to consult physicians of the same race or ethnic group, but little is known about the relation between. Text: 435748 Underwriting for these materials was provided by a generous anonymous donor. Cultural Barriers to Treatment and Compliance. One way of describing the distinction is that modern Western doctors are primarily trained to diagnose and treat diseases (in a purely biomedical sense), while traditional healers approach the patient as one suffering from an illness-that is, a culturally located experience of sickness.12 Among some Latino subcultures, folk illnesses such as empacho (a digestive ailment), mal de ojo (the "evil eye"), mollera caida (fallen fontanelle), susto (fright illness), and nervios (vulnerability to stressful experiences) are commonly described; and traditional healers range from curanderos (Mexican healers) and sobadores (traditional masseuses and bone setters) to yerberos (herbalists) and espiritistas (spiritual healers).13 Reliance on folk medicine certainly is not to be found in every, or even most, Latino communities; but it does exist as part of the health care landscape and is found among many patients from Mexico, as well as from various other regions within Latin America.
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