Mental Health Issues in Hispanics: A New Challenge for North Carolina

1
Mental Health Issues in Hispanics A New
Challenge for North Carolina

• Antonio E. Puente, Ph.D.
• University of North Carolina at Wilmington
• 910.962.3812
• puente_at_uncw.edu
• www.uncw.edu/people/puente
• 1508 Military Cutoof Road 303
• www.clinicalneuropsychology.us
• New Hanover Regional Medical Center
• Interdisciplinary Grand Rounds
• January 16, 2003

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Demographics

• Growth
• Fastest growing ethnic group in US
• Will be or is the largest ethnic group in US
• Approximately 15 of the population
• Could represent the majority group in 2050
• Probably undercounted
• North Carolina
• One of the fastest growing states for Hispanic
• Southeastern NC particularly sensitive,
  especially rural areas with agriculture and
  livestock

3
Hispanic Statistics

• Percentage of Population
• - In US 12.5
• In NC 4.7
• - 36 are from Latin America
• - 30 are from Mexico
• Anticipated Growth
• In US Births will outpace immigration
• In NC 273 growth

4
Psychological Literature

• Psychology
• 457,827
• Hispanics
• 6,384
• Hispanics and Mental Health
• 731

5
Sources of Mental Health Problems

• Language limitations
• Culture and Acculturation issues
• Family dysfunction
• Ineffective social support
• Low self esteem
• Limited education
• Financial limitations
• Religious affiliation
• Documentation

6
Language Problems

• English
• Variations of Spanish
• Spanish as a second language
• Anxiety associated with learning English
• Children as translators for parents
• Children choosing English over Spanish as primary
  method of communicating

7
Culture and Acculturation

• Understanding the majority group culture
• Maintaining culture of origin
• Being bi-cultural
• Some basic differences
• Family above all (and extended family)
• Time to be enjoyed not conquered
• Cooperation versus competition
• Religion as source of support and socializing
• Keep ones problems to themselves or family
• Less material
• More emotional

8
Family

• Defining Family
• Nuclear
• Extended
• Double
• Functional
• Divided Families
• Economics
• Geography
• Politics

9
Ineffective Social Support

• Medical
• Religious
• Educational
• Financial
• Social
• Marital

10
Low Self Esteem

• Productivity and Materialism
• Connectivity
• Self-Effacing Presentation
• Self-Fulfilling Prophecy

11
Education

• Typical Educational Background
• What it Means to be Educated- the difference
  between schooling and education

12
Financial Related Limitations

• The Limits and Hazards of Being Undocumented
• Type of Vocational Opportunities Corresponding
  Pay
• Banking Issues
• Saving for Retirement
• Drivers License

13
Religion

• Predominantly Catholic, but not Exclusively
  (fundamental)
• Importance of Religion and Related Social Support
• Church and Related Services in Spanish

14
Documentation

• Education
• Medical
• Legal
• Tax ID Numbers
• Social Security Numbers
• Drivers Licenses
• Aliases

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Outcome of Problems

• Anxiety 13
• Substance abuse 8
• Depression 5
• Violence ?
• Ethnic identity issues
• Poverty and marginalization

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Gender Issues

• Males vs Female
• Males 27
• Females 17
• Heterosexual issues
• Clashing of cultures
• Availability of partners
• Prostitution
• Sexual Identity Issues
• Childhood Sexuality Abuse

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A Simple Model for Addressing Mental Health
Concerns

• Communication Narrative Approach
• Rapport and Trust
• Questioning
• Symptom Identification
• Empowerment
• Solution Focus
• Follow-up

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Suggestions for Health Issues

• Style/Rapport
• Translation
• Family
• Documentation Status
• Interpretation of Information
• Follow-up

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Personnel and Servicesin Southeastern NC

• OAKS SEMHC Others
• SEMHC (1?)
• Titleson Clinic (first Wednesday)
• Catholic Ministries (1?)
• Private sector personnel
• Psychologist- 1
• Psychiatrist- 1
• Social Worker- 1 (?)

20
Related Support

• Radio and Television
• 1 Program?
• Newspaper
• 1?
• Organizations
• Centro Latino/Amigos Internacional

21
Cultural Matrix

• ISOLATED VS ACCULTURATED
• MAINSTREAM VS ASSIMILATED

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From Isolation to Assimilation

• Isolation Acculturation Assimilation
• Income 20,500 36,100 37,000
• Size 3.9 3.6
  3.1
• Time in US1st gen. US born 4th Gen.
• Locale Inner City Suburbs ? Suburbs
• Values Hispanic Partial Hispanic Anglo
• Language Spanish Bilingual English

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The Future

• Clashing Curves and Cultures
• Financial Social Slavery
• Pay Now or Pay Later
• What is North Carolina and New Hanover Going to
  Do?