Introduction

About 60.5 million people identified themselves as Hispanic or Latino in the 2019 US Census Bureau population estimate, or 18.4 percent of the US total population. Latinos are an ethnically and racially diverse group made up of people descended from a number of countries, including Mexico, Puerto Rico, Cuba, El Salvador, Guatemala, Nicaragua, Peru, Chile, Argentina, and several other Central and South American nations. In 2019, Mexican Americans made up the largest percentage of the US Hispanic population (61.4 percent), followed by Puerto Ricans (9.6 percent).

The term “Hispanic” refers to those persons having Spanish ancestry and was first used in the United States Census in the 1970s. The term “Latino” is derived from American Spanish and is embraced by many in the Latino community because it refers to their Latin and American heritage. The US government officially adopted the term “Latino” in 1997 and used it to replace the designation of Hispanic on the census forms. Not all Latinos use this term to self-identify. Although “Latino” is becoming the preferred terminology for referring to this group, the terms “Latino” and “Hispanic” are often used interchangeably. Neither term refers to a racial category because Latinos come from diverse racial and ethnic backgrounds. However, society often treats Latinos as both an ethnic minority and a racial group. Like members of racial groups, Latinos are often subjected to discrimination.

Latinos are a growing segment of the population. By the first decade of the twenty-first century, they had become the largest ethnic minority group in the United States. They represent 50.5 percent of US population growth since 2000. This is partially attributed to higher birthrates. Latinos are also a young population. According to the Pew Research Center, the Latino population in 2012 had a median age of 27 years compared with 37.6 years for the population as a whole. About one-third of the Latino population was under the age of eighteen in 2012, compared with about one-fourth of the total population.

The history of Latinos in the United States varies by group. For example, the Mexican War (1846-1848) ended with the Treaty of Guadalupe Hidalgo, by which Mexico gave Texas, California, New Mexico, Nevada, and parts of Colorado, Arizona, and Utah to the United States. Most of the Mexicans who owned land in these areas lost it and ended up working for the new white landowners. The resulting tension between the United States and Mexico has never been fully resolved. Many Mexicans migrated to the United States from the early 1920s to 1940s to work on railroads, mines, and farms. They were paid less than their white counterparts and were often forced to live in segregated housing.

Puerto Rico became a territory of the United States in 1898 as a result of the Spanish-American War, but Puerto Ricans were not allowed to become citizens of the United States until 1917. The federal government mandated that English was to be the language used in schools, although few Puerto Ricans spoke English at the time. Puerto Ricans began emigrating to the United States in the 1940s and 1950s to find employment and better economic opportunities. They were actively discriminated against by American society and not viewed as US citizens. Puerto Rico became a commonwealth in 1952.

Most Cubans came to the United States as a result of political unrest in Cuba. The Spanish ruled Cuba for more than four hundred years, but the US government was also interested in Cuba because of its proximity. Cuba’s exports were highly desirable and included tobacco, sugar, and molasses. In 1848, the United States offered to buy Cuba from Spain, but the Spanish were not interested in selling. The United States briefly occupied Cuba from 1898 to 1902, when Cuba gained its independence from Spain. US-Cuban relations deteriorated after World War II, and reached a low point when Fidel Castro seized power in 1959 and Cuba became a communist nation. Cubans left their home country for political reasons in three distinct waves from the 1960s through the 1980s.

Although the majority of Latinos in the United States are native born, a significant number—about two in five—are immigrants. Many undocumented Latinos leave their home countries to work in the United States. Historically, Latinos have faced discrimination in the United States. They frequently have menial jobs, are mistreated, and are generally viewed negatively. These negative influences have affected the way in which mental illness in Latinos has been viewed, diagnosed, and treated.

Latino Mental Health

Latino mental health is influenced by multiple factors, including immigrant versus nonimmigrant status, the absence or presence of a familial support system, acculturative stress (psychological stress associated with adapting to a new cultural group and new cultural values), socioeconomic status, access to health care and other basic resources, and exposure to trauma. Mental health issues may manifest differently in native-born than in immigrant Latinos. Immigrant Latinos have been found to experience fewer mental disorders than their native-born Latino counterparts do. Higher rates of affective disorders, anxiety disorders, and chemical use and dependency have been found among native-born Latinos than in immigrants.

Acculturation refers to the level of competency an individual from another culture or ethnic group gains in a second culture. Becoming acculturated, however, does not mean abandoning the original culture. Usually, the old and new culture and values are blended. Research suggests that as Latinos from various backgrounds become more acculturated, they often experience a decline in mental health. This can be the result of stressful experiences during the process of acculturation, such as loss of a familial support system, discrimination by society, intergenerational conflict, loss of Latino cultural values, devaluation of Latino cultural values by society, feelings of isolation, and attempts at developing a bicultural identity as an American and a Latino. Latinos who have a supportive family tend to cope more effectively with acculturative stress. Additionally, having a positive view of being Latino has been demonstrated to be a protective factor against some of the negative consequences of discrimination.

Other stressors contributing to mental health issues for some Latinos are a lack of adequate health insurance and health care, inadequate knowledge of the health-care system, inadequate English language skills, family members living in different countries, and limited access to educational resources. Additionally, undocumented immigrants experience the constant threat of deportation. It is important to note that the experiences of nonimmigrant Latinos and immigrant Latinos may differ significantly.

Scientific study of Latino mental health is relatively new. Previous models of Latino mental health were negatively influenced by the view that cultural differences were negative and pathological. Mental health professionals have come to embrace the differences model of mental health, which promotes acceptance of cultural differences and seeks to incorporate a more culturally sensitive view in the diagnosis and treatment of mental illnesses. This model examines how social, cultural, political, and economic factors affect mental illness. This model has ushered in psychology’s fourth force, multiculturalism. Appropriate models of treatment for this population and longitudinal statistical data regarding mental health disorders among Latinos need to be examined through empirical study. Additionally, the field needs more Latino mental health professionals, who could positively affect empirical analysis of this population and the treatment of mental health issues among it.

Contributing Socioeconomic Factors

It is important to understand the social, political, and economic factors that influence Latinos in the United States. These factors significantly affect the types of mental distress experienced by this population. Although most Latinos are not poor, a disproportionate number are impoverished relative to their numbers in the population. According the Pew Research Center, about 25 percent of Latino families—compared with about 16 percent of American families as a whole and 11 percent of non-Hispanic whites—lived in poverty in 2012. Latinos also have higher unemployment rates (2.3 percent) when compared with whites (0.9 percent). There is a correlation between socioeconomic status and diagnosed mental health disorders. Higher rates of mental illness are correlated with poverty, rates of violence, and little attention to mental health treatment. Approximately 29 percent of Latinos do not have health insurance, which limits their access to adequate health care, according to the Pew Center. These demographic conditions significantly affect rates of mental illness within the Latino population.

Latino utilization of mental health services varies. Immigrant Latinos use mental health services less than their nonimmigrant counterparts do. Latinos are more likely to seek mental health services from clergy or general health-care practitioners and far less likely to seek services from mental health professionals. However, when community-based mental health resources are available, Latinos are more likely to use these services.

Rates of Mental Illness

According to the National Alliance on Mental Illness, Latinos are identified as a high-risk group for depression, anxiety, and substance abuse. Latino women have a higher rate of depression (46 percent) than Latino men (19.6 percent). Rates of mental illness, especially substance abuse, among US-born and long-term US residents are higher than those in recently immigrated Latinos. Management of depression in the Hispanic/Latinx community is hampered by disease literacy, cultural barriers and financial barriers. Early interventions from primary care practitioners results in better treatment.

Low use of antidepressants, poor doctor-patient communication and persistent stigma are barriers to depression treatment. Recent studies have shown that individuals with depression are at greater risk for other diseases such as diabetes and heart disease. Treating the depressive symptoms and the comorbid conditions provide a quality benefit. Hispanics have a considerable burden of mental health disease; relapse rates are high and response to treatment may be slow resulting in discontinuation of treatment.

Latino youth are more likely than white or African American youths to have experimented with alcohol and binge drinking. Latino youth also are more likely than their counterparts in other ethnic groups to consider or to commit suicide. Finally, domestic violence is also an issue faced by this population, although specific rates are not known.

The death rate from suicide for Hispanic men is four times the rate of Hispanic women in 2018 but is less than half the rate of the non-Hispanic white population. In Hispanics age fifteen to thirty-four, suicide is the second leading cause of death.

Health Disparities

Latinos are diagnosed with diabetes and cardiovascular disease at significantly higher rates than those of their white counterparts. These medical conditions have been linked to genetic factors as well as the high levels of stress often experienced by Latinos. According to the US Centers for Disease Control, in 2009, stroke was the fourth leading cause of death among male and female Latinos. In addition, although Latinos make up only 17 percent of the US population, they accounted for approximately 21 percent of all new infections with the human immunodeficiency virus (HIV) in 2010. HIV and AIDS have been found to contribute to depressive symptoms and other mental health issues in this population.

References