Higher levels of depression, anxiety found among region's Hispanics
It’s tough getting an appointment with Dianna Rodriguez, a behavioral health clinician at the Community Health Center’s New London clinic.
“My schedule is always full,” said Rodriguez, the only Spanish-speaking mental health counselor at the clinic, and one of only a few in the greater New London area. “We could definitely use more Spanish-speaking clinicians.”
The high demand for Rodriguez’s services is one manifestation of a problem identified in the 2016 Community Health Assessment recently completed by Lawrence + Memorial Hospital and Ledge Light Health District. Based on surveys of more than 1,200 residents of the region, the report found that 18 percent of Hispanics report frequent feelings of depression or hopelessness — about twice as high as other groups — and similar levels of anxiety. The survey solicited responses from residents of 10 towns in L+M's service area: Lyme, Old Lyme, East Lyme, Montville, Waterford, New London, Ledyard, Groton, North Stonington and Stonington.
Community representatives asked about the findings suggested the situation is caused by multiple factors, according to the report. For Hispanic immigrants, homesickness and concerns about their own or a family member’s immigration status is one of the main reasons. There is also a lot of stigma about seeking mental health care, the report states.
“We have heard that mental health is considered a very private matter,” said Laurel Holmes, director of community partnerships and population health at L+M. “They also report high levels of social isolation. We need to reduce the stigma and create a stronger safety net.”
A group of public health experts and Hispanic leaders are at the beginning of an effort to address the finding with concrete actions. First, though, more analysis is needed of both the local situation and the bigger context.
“The goal is to understand why,” said Russ Melmed, supervisor of health education and community outreach and epidemiologist at Ledge Light.
Nationally, Hispanics show significantly higher levels of depression and other mental health distress compared to other groups, with poverty cited as one of the main contributing factors, according to the federal Department of Health and Human Services’ Office of Minority Health.
In its initial response, a local group led by the Hispanic Alliance of Southeastern Connecticut has begun compiling mental health resources that can be tapped by local Hispanics. Judelysse Gomez, assistant professor of psychology at Connecticut College, is a one of the members of that group.
“These are trends that have been going on for a long time, so I wasn’t surprised at all,” she said in an interview Friday. Before joining the faculty at Conn last April, Gomez worked and conducted research at clinics with large Hispanic patient rosters in Providence and Miami, learning firsthand about some of the obstacles this group faces in getting treatment for mental health problems. Some of them are logistical, like lack of transportation to get to appointments, while others are financial, like lack of health insurance or child care.
The stigma is an additional factor, she said, and one way of counteracting it is to use more welcoming terminology. Instead of “mental health counselors,” for example, some providers are reaching out to Hispanics by using the phrase “promotores de salud mental” — promoters of mental health — instead.
But an even larger issue, she said, is the shortage of counselors who are “culturally competent” — with the language skills and understanding about the unique stresses this group faces. More Spanish-speaking counselors are needed, but even English-speaking Hispanics are too often discouraged when they seek treatment, Gomez said.
“There’s a level of mistrust towards medical providers and mental health providers,” she said. “A lot of patients said they had been in treatment, but didn’t feel like they were understood by the providers. If you go for treatment and don’t find culturally competent choices, it’s hard to connect. The chances you will stick with treatment are low.”
Counselors don’t necessarily have to be Hispanic themselves to provide effective care, she said, “but you need to know about people’s history and immigration waves and current perceptions about immigrants. They need to understand that the Hispanic community is heterogeneous. We need providers who are keeping themselves informed about all these things.”
Programs in other communities that have been successful at getting Hispanics to access and continue mental health treatment, she said, are often embedded within primary care practices. In the New London community, Gomez said she would like to be part of working with Hispanic churches, schools and other community groups to foster more recognition of mental health needs and encouraging people to seek care, as well as developing more resources.
Ignoring the issue, she said, hurts not just Hispanics, but the entire community.
“There’s a financial cost, because people are going to access the ER for suicide-related behaviors and other preventable problems at a higher rate, and they have lower productivity at work, and if people aren’t working, they’re not spending,” she said. “But for me, it boils down to an ethical issue. What are our values as a nation if we ignore it? We’ll continue seeing disparities.”