But the effort to recognize Hispanic Americans must also include increasing awareness of the mental health concerns of these individuals and their communities. There is so much to learn about their unique and vastly complex American experience, and their needs should not be overlooked. Luckily, culturally specific mental health resources are increasing, which may benefit some members of the diverse Hispanic community. While individuals can identify as both Hispanic and Latinx, it is worth noting that Hispanic refers to Spanish-speaking people from Spanish-speaking countries, while Latinx tends to mean individuals from Latin America, i.e., Mexico, Central America, South American, and the Caribbean.

Diverse Cultural Backgrounds

Culture and community can be complicated within the Latinx community for a variety of reasons. According to the Pew Research Center, more than 20 million Latinx individuals identified with more than one race on the 2020 census, while that figure was only 3 million a decade prior, which may be reflective of changes to the census form. Licensed mental health counselor and the coordinator of quality assurance and quality improvement at Community Health of South Florida’s behavioral health department, Celia Mion-Araoz, LMHC, who identifies as Hispanic, says, “I have grown up around Cubans in this country struggling to provide for themselves and also to provide for the families they left behind in Cuba.” Licensed relationship therapist Ana De La Cruz, LMFT, who identifies as Hispanic, says, “I was born in Guatemala and my ancestors were from Spain. Most of my family speaks Spanish and my culture and traditions have been kept at home. Although I was raised in the U.S., I have always been part of a huge Hispanic family.” Clinical psychologist with MindPath Care Centers, a Community Psychiatry Practice, Ana Ortiz Lugo, PsyD, HSP, who identifies as Latina, says, “I think that the Latinx community has come a long way.”

Strong Family Connections

De La Cruz says, “One of the biggest strengths in my community is the family unit. The Hispanic community puts a lot of emphasis on keeping the family together, and family does not just include mom, dad, and siblings but also includes, abuela (grandma), abuelo (grandpa), tio/a (uncle/aunt), primo (cousins), and in-laws (aunt Juanita who married uncle Juan). The family is a big deal in the Hispanic community as they serve as resources for the survival of all the individuals involved.” Mion-Araoz shared similar sentiments, as she reflected on the difficulty of being relatively safe while your family members back home are anxiously waiting for anything from the U.S. “Despite these challenges, the Cuban community in the U.S. continues to work hard, make progress, give back to their community, and hope for the best,” she says.

Experiences of Struggle

Ortiz Lugo says, “Every day is a challenge when you decide to leave your family, friends, climate, and food far away, to dream for a better future. Not having permits to work, not knowing the language is a great barrier for the first generation of immigrants. The part of acculturation that identifies who I am, where I live, how I look, etc. is a major struggle for first-generation immigrants.” De La Cruz also highlighted how there can be discrimination against people who do not speak English well, and even if the person speaks English but has an accent, they may be seen as less intelligent, which can impact opportunities, and contribute to isolation and depression. “Hispanics are very strong people. They continue to move forward no matter what, they are very resilient in bad situations,” she says.

According to the Pew Research Center, 72% of Latinx individuals spoke English proficiently, which is up from only 59% in 2000. Mion-Araoz says, “Even in Miami, which has such a high population of Hispanics and people who identify as Latinx, we are still discriminated against for speaking a different language. The language issue is one that I and my family have struggled with the most. Even though we are fluent in English, there are times when others hear us speaking Spanish and are offended.” For others, language may pose a barrier within families. De La Cruz described how many elderly members of her community were never able to learn the English language and the younger population are not being taught Spanish. Ortiz Lugo says, “As a therapist when I started working in the States, I found it very curious that children of first-generation immigrants refuse to speak in Spanish to their parents or at home or even in therapy.”

Challenges with Immigration

According to the Pew Research Center, 80% of Latinx individuals living in the country were U.S. citizens in 2019, which has increased from 74% in 2010. Mion-Araoz says, “One of the principal challenges faced by undocumented immigrants is fear, fear of not being able to work, fear of being separated from their families, and of being deported back to a country they may have fled due to violence or poverty. I’m grateful to be able to work at a facility that provides health and mental health care, mitigating the stress of that fear for these undocumented migrants who contribute so much to our economy and community.” De La Cruz echoed that feedback, as she delved into the challenge of no clear path to naturalization, as many undocumented immigrants will die being undocumented because there is no law that allows them to become “legal” without having to go to their country of origin for 10 years. “It is heartbreaking to see many of their children who were born here, married here, and have children of their own not being able to help their parents become legal immigrants because there is no law that says that a child can request their undocumented parents without them having to leave the country for ten years,” she says.

Barriers to Care

According to the National Alliance on Mental Health (NAMI), about 34% of Hispanic/Latinx adults with mental illness receive treatment annually, which is less than the average US rate of 45%.  De La Cruz elucidated how stigma can be a barrier to accessing mental health support within the Hispanic community. “I encourage my community to continue to break the bias against mental health services. Let’s continue to work hard to normalize that it’s okay to ask for help. Asking for help will help us thrive and not just survive,” she says. Ortiz Lugo says, “They may struggle to find someone that can speak and can understand where they come from. Also, Latinx tend to express their mental illness through somatization like headaches or other types of pain or discomfort. I think my community still needs to break the stigma of mental health illness. Continuing with education on prevention and sharing more information in general within the communities is still very important.”

Factors of Resilience

Ortiz Lugo says, “As I was preparing to be a clinical psychologist at the Ponce School of Medicine in Puerto Rico, I used the assessments to evaluate ADHD and ADD, created by Jose J. Bauermeister. I also see as a mentor and a great psychometrics professor Leida Matias, a pioneer on developing evaluations for children and adolescents.” Mion-Araoz says, “Thankfully, being in Miami, I am surrounded by many mental health professionals that have shaped my professional life. Many of the people that I seek guidance from throughout my time working in the field of mental health have been Hispanics and Latinx, and part of my community. I have leaned on them for guidance, and they have never failed me as a resource. The people that surround us, these family and friends, provide a source of support that can help each other manage life stressors and provide resources to manage mental health challenges.”

Challenges During COVID-19

De La Cruz says, “At the beginning of the pandemic, there was a lot of denial in the Hispanic community. Many Hispanics in the community did not take the news as seriously as it should have been taken. Many people have died in the community due to not being fully informed of the seriousness of this virus. Many have suffered several losses, leaving the rest of the family with anxiety, fear, and grief.” Ortiz Lugo also expressed concern for her community with respect to the pandemic, especially for those in poverty. According to NAMI, 15.7% of Hispanic/Latinx people in the U.S. live in poverty, more than double the rate of non-Hispanic whites, which may put them at greater risk of mental health challenges. “Sadly, my community at present still needs more information about COVID. I think in order to cover all bases with my community in person. Prevention is very important,” she says. Mion-Araoz says, “It has been my experience that Hispanic and Latinx communities lean on their families and extended families for support. Even during times of quarantine during the COVID pandemic, Hispanic families found ways of keeping connected. I know of elderly grandparents that learned to use technology such as Zoom just to ensure that they were connected to their family. Family and a good support system, to the Hispanic and Latinx community, is key to mental health and well-being.”