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The stigma within: For Latinx college students, deep-rooted cultural barriers complicate mental health treatmentA Capstone Project Submitted in Partial Fulfillment of theRequirements of the Renée Crown University Honors Program atSyracuse UniversityColleen FergusonCandidate for Bachelor of Artsand Renée Crown University HonorsFall 2019Honors Capstone Project in Newspaper and Online JournalismAbstractThis long-form, newspaper journalism piece aims to shed light on a disparity in mental health perception, treatment and care among modern-day Latinx college students. Research shows that Latinx people experience higher rates of depressive symptoms, particularly first- and second-generation immigrants. As such, this piece aims to humanize the struggles faced by a significant sector of the American collegiate student body. Through a combination of insights from student interviews, compiling and analyzing existing research and insights from experts, the story provides a narrative framework through which to understand the lack of conversations about mental health in many Latinx homes. The narrative also explores common mental and emotional issues faced by this population, as well as the stigmas and cultural barriers that exist around mental wellness as a concept. The piece concludes with expert testimony exploring “resiliency factors” within the Latinx population and an outline of potential approaches to creating more culturally competent mental health care systems in a higher education setting. Executive Summary“The stigma within: For Latinx college students, deep-rooted cultural barriers complicate mental health treatment” combines insights from college students and recent graduates with data and expert interviews to depict the complexities in the relationship that many Latinx college students have with their mental health. Research shows that Latinx people experience higher rates of depressive symptoms, particularly first- and second-generation immigrants, than their black or white peers. As such, this long-form journalism piece aims to humanize the struggles faced by a significant sector of the American collegiate student body and present potential paths forward for healthcare providers at universities. Accompanying data comes from a 2015 American Psychological Association survey, epidemiological studies and a report synthesizing existing literature on Latinx youth.Initial data gathering for this story included researching previous articles written about the topic, both to locate potential sources and to see identify under- or over-reported points related to mental health. This helped to ensure the story was timely, informative and newsworthy. A list of relevant sources, including experts and students, was compiled with at least one form of contact information. Interviews, which were recorded and then transcribed by hand, were conducted with all sources over the phone or in person between September and November of 2019.?The piece generally argues that college-age Latinx students grew up with a lack of conversations about mental health at home, which made it difficult for them to seek the proper care. Researchers, mental health professionals and students said the stigma and barriers around Latinx individuals receiving mental health treatment are deeply rooted in the framework of what it means to be Latinx. The narrative alternates between data about Latinx people, expert testimony further analyzing that data, and personal anecdotes from Latinx college students or recent college graduates. Common mental and emotional issues faced by this population, and stigmas and cultural barriers around mental wellness as a concept, are also explored. The piece concludes with expert testimony discussing resiliency factors within the Latinx population and an outline of potential approaches to culturally competent mental health care systems in a higher education setting.If there is already a lack of conversations happening around mental health in Latinx households, not covering this issue and others like it in modern-day mainstream news media will only diminish the likelihood of those conversations happening. The story synthesizes anecdotal and data-driven research to give care providers a resource through which to understand clients. Moreover, news media outlets do not always elevate, or even fairly represent, the voices of people of color or marginalized groups such as immigrants. Providing balanced coverage includes providing inclusive health and culture reporting.Table of ContentsCapstone Project Body 6-12Critical Statement…………………………………………………………………………….13-22Sources Cited and Consulted…………………………………………………………………….23Appendix: Interview Transcriptions and Notes………………………………………………24-35Lindsay Carbonell dealt with depressive symptoms entirely on her own for more than six years before she started regularly seeing a therapist. It wasn’t until spring 2019 — nearly a decade after her symptoms first started — that she began to take antidepressants.Carbonell’s parents insisted she try everything she could on her own before seeking a doctor’s advice. Not knowing how to manage her symptoms led to Carbonell holding them in and quarantining herself for what she called her “daily cry,” which was longer and more intense the more she let the feelings of sadness, guilt, hopelessness and anxiety build, she said.After she went away to college, her Colombian father would encourage her to come home whenever she felt sad or down because he insisted that would make her feel better. More often than not, going home had the opposite effect, she said. She felt pressured to be in a better mood when she was home, since Latinx people place such value on family ties being “[the] ultimate source of joy” and a cure-all for any problems.“This is a very Latino thing, that family is very important and family can sort of heal you in a lot of ways, and that if we stick together as a family and we support each other, that we can overcome anything, including and especially mood disorders,” she said. “The biggest hurdle I had to overcome was the stigma I had within myself.”There’s a word in the Spanish language that’s used to describe someone with a mental disturbance: locura. The Spanish word for crazy — loca — is just a couple letters off. For many Latinx families, having mental health issues and being crazy are seen as one and the same.?Stephanie Pagan, a sophomore at Syracuse University who lived in Puerto Rico until last year, said that this was exactly the case in her household. If she were to share with her family the fact that she sees a therapist, they’d assume something was seriously wrong with her.?“The idea [I’ve always had] was that you’re, like, batsh*t crazy,” she said, referring to how her family felt about people who see therapists.Carbonell and Pagan are among half a dozen college students or recent graduates who said they grew up with a complete lack of conversations about mental health at home, which made it difficult for them to seek the proper care. Researchers, mental health professionals and students said the stigma and barriers around Latinx individuals receiving mental health treatment are deeply rooted in the framework of what it means to be Latinx.A 2014 epidemiological study of Hispanic health in the United States found that Hispanic and Latinx women are twice as likely to experience high rates of depressive symptoms as their male counterparts. The study, which involved screening people at four centers across the country for depressive symptoms, also found that about one in four participants ages 18 to 44, both male and female, exhibited these symptoms.?Andrea Corona, whose parents are both Puerto Rican, recalled conversations at home that centered around her father and his bipolar disorder. Although her mother, who studied psychology in college, made a point of talking with Corona and her siblings about her father’s disorder and medication, she said that that’s normally where the conversations ended.“It was never a conversation of ‘your father has this condition and he’s being medicated,’ it was like ‘well, you know what, Dad is a little sick and we don’t really talk about it,’” said the 2018 graduate of SUNY Purchase College. “It’s a little more of a taboo subject [with Latinx men] to admit that you’re seeking help.”Her grandfather felt that anyone living a healthy lifestyle did not need therapy and would call anyone who sought it out “crazy,” she added. She’s watched her male siblings struggle with anxiety and depression and seen how tough it was for them to ask for help. However, she said in recent years it’s become less controversial to bring up the subject of therapy. Her father has taken more ownership over his treatment and condition — partly because his mental health struggles were a factor in Corona’s parents’ divorce, she said.“That’s something that is now verbalized, so I think that even that is a huge improvement,” she said.One of the most common reasons Latinx people, particularly men, may feel a reluctance to go to therapy has to do with machismo, or hypermasculinity, said Felix Kury, a licensed therapist and professor of Latina/Latino studies at San Francisco State University. Plenty of men only seek help when they feel their world is coming to an end around them, especially because they live in such a patriarchal society, he said.?Psychology as a practice needs to be decolonized, Kury added, for professionals to understand that hypermasculinity is an issue with men across cultural groups.“Machismo is not just an issue for Latino men, because this society is really machista [male chauvinist] in general,” he said.Rolando Cabral, a Syracuse University sophomore, said he was raised to believe that if you “do well in life,” mental and emotional wellness should come naturally. He began seeing a therapist when he got to college, which is something he hasn’t shared with his entire family. His siblings are open to mental health treatment, as is his stepfather, but his mother and family in the Dominican Republic still have a negative perception about people seeking treatment, he said.Families in the Dominican Republic, or families who have fairly recently come to the U.S. from the island, tend to not be as accepting or forward thinking about mental health issues, Cabral said. Their mentalities may change once they’re exposed to American culture, or educated about the benefits of mental health care, but correcting behaviors that are cemented in generations of cultural beliefs isn’t easy.?“There’s generations worth of just having a specific thought process that would have to be broken in order for real change to happen,” he said.Part of this thought process in Latinx families is the need to always succeed and be resilient — superar in Spanish — according to Patricia Foxen, director of research at UnidosUS, the country’s largest national Hispanic civil rights and advocacy organization. But being resilient and successful can be a challenge for Latinx people dealing with acculturation stress, a term for the mental and emotional challenges that come with adapting to a new culture.?Acculturation stress is a top factor behind the high suicide rate for young Latina girls as well as a host of behavioral problems for Latinx youth, Foxen said. Latinx youth often adjust to American cultural norms more rapidly than their parents, causing conflict at home.?However, this conflict can look quite different among subgroups of Latinx people. Sylvia Wassertheil-Smoller, a professor Emerita at the Albert Einstein College of Medicine who led the 2014 epidemiological study, said one of its most important findings was to shed light on the differences among specific Latinx subgroups and mental health. The study reported the highest and lowest rates of depressive symptoms among Puerto Ricans and Mexicans, respectively.?Based on the study results, Wassertheil-Smoller stressed how important it is for university health service centers to be aware of patient background when it comes to treatment, since different groups experience different stressors.?“Everything is both genetic and environmental, so I think that here in this case it’s an example of [how] there’s a big environmental influence,” Wassertheil-Smoller said.Several students and recent graduates said that being first- or second-generation college students made navigating the college experience difficult in regard to mental health. Wassertheil-Smoller’s study found that first- and second-generation Latinx immigrants were significantly more likely to have depressive symptoms than those born outside the U.S. mainland. Data from a report Foxen published in 2016 showed that Latinx youth have more persuasive feelings of sadness and hopelessness, which are known predictors of clinical depression, than their peers. The rate for Latinx youth was 35% versus 29% and 25% for white and black youth, respectively.?A 2017 study that analyzed data from more than 75,000 people about rates of mental health care use among immigrants showed higher rates of mood disorders like depression among first-generation Hispanic — defined as people of Mexican, Central American, Cuban, South American and Spanish-speaking Caribbean or West Indian origin — and Puerto Rican immigrants compared with second-generation immigrants from the same backgrounds. The same pattern was consistent among Asian/Pacific Islander immigrants.Among the struggles first-generation Latinx college students might encounter is the fact that many still have financial or emotional responsibility to their families even when they’re away from home, Foxen said. Depending on their background, some Latinx students may also find themselves behind the curve academically when they get to college, which further contributes to an uneven graduation rate for Latinx students.Corona described the added pressure as a desire to make your family proud and accomplish something, particularly when a first- or second-generation student’s parents have made sacrifices to ensure education is accessible to them. Jay Juarez, who graduated from the University of Houston in 2017, described the feeling as isolating, since no one else in his family has gone to college and been through what he was experiencing.?Juarez has not yet seen a therapist because he can’t afford to. Many of his friends and family members are in similar situations, so he’s not entirely sure where to start looking for affordable options.“It’s really tough for people like me who are struggling or were struggling,” he said.That’s why in 2018, licensed marriage and family therapist Adriana Alejandre founded LatinxTherapy, a platform to connect Latinx mental health professionals and potential patients. Alejandre said her organization, which connects mental health care professionals and patients, encourages Latinx people not to wait until they’re at their worst to seek help — even though, as Carbonell described, these individuals are taught to push through barriers on their own.“Culturally speaking, it’s a very silent journey that they’re on because they can’t really talk about it with anybody else,” she said. “I think many of the stigmas come from not being able to talk about it, talk about feelings.”?Many young Latinx people find themselves unable to share with their family members that they’re going to therapy because doing so causes tension, with parents making their child’s mental health into an issue within the whole family. Parents tend to make it about themselves, questioning where the family went wrong and comparing their immigrant story with their children’s’ lives in America, she said.When Pagan began experiencing anxiety attacks in high school, she was told to “just deal with it.” When she told her mother she wanted to see a therapist at 16, her mother didn’t understand why Pagan wouldn’t just talk to her family about her issues. It’s taken Pagan a while to get comfortable talking about herself in therapy because she initially felt it wasn’t okay for her to do so, she said.Alejandre stressed the importance of using different treatment methods when treating Latinx college students with mental health issues, because they’re not going to open up right away and because their issues are multifaceted. This includes asking open-ended questions to allow the patient to process and narrate their story.“Latinx individuals specifically have complex stories, and it’s not just a single element that brings them anxiety,” she said. “It’s a host and a village of experiences, and sometimes they’re not even linkable.”Alejandre said that common themes among the young Latinx people she sees include intergenerational trauma and its underlying anxiety and depression. Bea Gonzalez, who’s worked in higher education for more than four decades and is currently in student affairs at Syracuse University, said that the intergenerational trauma in her Puerto Rican family is “the sense of never being good enough.” She, her five siblings and her parents have all experienced instances of racism and racist name-calling, and many of her family members have tried to overachieve to push back against the hate, she said. Gonzalez has held various positions at SU for the last 35 years, and she’s recently facilitated conversations with the university’s counseling center staff to encourage them to hire counselors who are better poised to understand these student experiences.Foxen’s report outlined some of the methods that would be most effective, which include ways to engage a patient in a culturally sensitive manner. For therapists, this means taking into account instances of marginalization or discrimination and being able to intervene in a patient’s life in a way that’s considerate of social, cultural and historical factors. It also requires therapists to reflect on how their own behaviors are influenced by cultural assumptions, attitudes and practices. Research in the report shows that mental health providers often interpret youth behaviors differently based on race or ethnicity. This can result in a cultural misunderstanding where a therapist might misdiagnose Latinx youth with mental illnesses like depression as having anger problems or conduct disorders — a diagnosis that misses the underlying problem.Mental health services for Latinx college students need to make students feel comfortable talking about stressors like acculturation stress, Foxen added. Hiring Latinx therapists is a good step, and if that’s not possible, therapists need to be trained to understand the intersection of culture and family dynamics for a Latinx student.?Even if someone’s primary spoken language is English, their cultural roots and deep feelings might be in another language, which makes it difficult for Latinx people to feel understood by medical professionals, said Jane Delgado, president of the National Alliance for Hispanic Health. For Corona, this disconnect made the process of communicating her feelings in therapy difficult. She “didn’t feel represented” by the professional she was seeing, given the differences in their backgrounds, native languages and lived experiences.“Relaying information about yourself and your emotional self in a second language is different,” she said. “I felt like I had to explain a lot about myself all the time to give them context about where I come from and how my head works.”Corona often found herself wishing she could speak Spanish during therapy to express her emotions. Finding a Spanish-speaking therapist isn’t too common: roughly 1 in 20 therapists surveyed by the American Psychological Association reported being able to provide services in Spanish, according to the APA’s 2015 survey of psychology health service providers.?For Carbonell, the intersection of cultures in her household caused identity issues. She often felt distanced from her Colombian family and roots growing up, yet still felt a pressure to keep her heritage alive as she tried to assimilate to American ways of life. Delgado said this a common theme with Latinx students, particularly if they’re also first-generation.?“On top of all those normal pressures and all the hormonal changes, you also have to find a way to mingle and marry two different cultures,” Delgado said regarding the pressure put on Latinx youth by things like acculturation stress. “That’s even more that you have to navigate.”When Foxen’s report was published, Donald Trump had just been elected President and hate speech and bullying directed at Latinx youth was on the rise. The shock of the trauma has worn off for these individuals since then, but that’s because the fear has manifested in tangible ways, Foxen said.“Now it’s not just the hate speech and the fear that Donald Trump instigated, it’s actual, real policies that have had real-life implications for [the Latinx community],” she said.Delgado echoed that sentiment, saying that the amount of negative speech directed at Hispanic and Latinx people from the current Presidential administration is an environmental trigger that can exacerbate the pressures and anxieties already affecting Latinx people in the U.S. She described the Latinx cultural approach to mental and emotional wellness as “very bootstrap,” meaning that people are expected to solve all their own problems themselves and find a way to “just get over it” if they are sad or depressed.?There’s a constant call to aguantar — suck it up. This is true regardless of country of origin, she said, and it stems from the fact that Hispanic people are known for being good workers and not needing to ask others for help.Still, several experts said that younger generations are dealing with these stigmas less or in different ways. Destigmatizing the issue starts with providing culturally accessible services and normalizing the process of seeking mental health treatment before students go away to college, Foxen said.Foxen’s 2016 report, which synthesized existing research and literature on Latinx youth, highlighted best practices and programs for effective treatment. These therapy methods must be trauma-informed, culturally relevant and culturally appropriate, per the report. Cuento therapy, which draws on cuentos — “stories” in English — and cultural folktales to increase a family’s connections to its heritage and to its members, can help bridge U.S. mainstream culture with Latinx culture. This is considered an effective method particularly for Puerto Rican youth dealing with anxiety or post-traumatic stress related symptoms, per the report. Dichos therapy is often effective with adults, where therapists use widely accepted proverbs and metaphors known as dichos – “sayings” in English — to guide the therapy process.Risk factors like poverty, violence and discrimination, all of which are associated with Latinx students, can complicate their likelihood of dealing with mental health issues. However, it’s often overlooked that these same students also have many protective factors that enable them to succeed, Foxen said. Among these are the strong ties many Latinx students have to their community and extended family.Cabral knows that he’s supported by his entire family, even those who may not understand his choice to see a therapist.“Dominican people, and just my family in general, at its core, there’s love there,” he said.Foxen said it’s essential for healthcare professionals working with Latinx students to look beyond the problems they have and to not pathologize them. These professionals need to help students see their own strengths. Foxen recalled that when she conducted a project related to resilience among Latinx youth and interviewed students, many of them had never been asked about the positive aspects of their lives.“There’s this tendency to always see the negative with those students, because they’re seen to be at risk and in fact, they really have a lot of strengths that we need to help them build on,” she said.Healthcare professionals have this responsibility to young people as a whole, Delgado said.“We have a responsibility as a society to tell our young people it will get better, and you can have the life that you want to lead,” she said. “Things are going to be tough but with skills you can get through it, and you don’t have to do it alone.”Critical StatementWhile I knew how much I loved to read, write and communicate, my choice to go to journalism school wasn’t very calculated. I’d had little to no exposure to the field prior to starting college and simply figured I’d try it, see if it was a good fit, and switch majors if necessary. I attended the first staff meeting of SUNY Purchase’s online news publication The Phoenix and picked up an assignment. As I reported and wrote, I was already sure of one thing even as a freshman: this was indeed what I wanted to do. My natural curiosity and extroverted nature made the process of finding sources or identifying story angles fun and exciting. Journalism gave me the opportunity to pinpoint something unique about a problem, movement or person and explore it.?Four years later, my byline is on more than 100 pieces of work across several different publications. I don’t consider myself a “student-journalist,” and virtually any student-age journalist that produces original work will say the same thing. There is no student journalism — it’s simply journalism. The Phoenix and SUNY Purchase gave me my start, and covering campus events at a state school taught me a lot about my peers. Purchase was more or less my first exposure to other students with different cultural or socioeconomic backgrounds than me: my central New York high school was (and still is) more than 95% white, with virtually every one of my classmates being part of a typical middle-class, nuclear family. Being surrounded by people who had been raised so differently than me at college made me further realize how different someone’s lived experiences could be based on something as trivial as skin color. While I felt gratified being able to tell stories and share them with others, I also began feeling a deep sense of responsibility to use the privilege I have as a white, middle-class woman to elevate the voices of those less privileged than me.This idea drove me to continue my Spanish education from high school, where I’d taken a couple college-level language courses and excelled in them. I wanted to have a command of another language in order to use it in my reporting. I developed connections with other language and culture students and professors, even spending a month in Spain the summer after my freshman year. While in Spain, I had the opportunity to interview sources, and write an article, entirely in Spanish. After just two semesters of formal training, tackling this was admittedly me biting off more than I could chew — but I took great pride in the fact that I did it at all. I remember thinking, “most of the rest of the students in my program couldn’t do this.” That became my goal: telling the stories that matter to diverse audiences, in a manner that is consistently responsible and accessible.After a few semesters at Purchase, I felt I’d exhausted the opportunities I had as a storyteller there. My decision to transfer to Syracuse University was based on a variety of reasons, but the main one was that I wanted a larger playing field. I wanted to be around more curious, story-hungry journalists like myself. I found that almost instantly when I walked through the paint-chipped, creaky red door of 744 Ostrom, the (now former) home of The Daily Orange. The staff of just one section had practically more people than the entire staff I managed at Purchase. I watched in awe as the content creation, fact-checking, digital and print designing took place around me one fall afternoon in September. The first-ever story I wrote for The D.O. was for Hispanic Heritage Month, about one of the multicultural programs for local youth located just off campus. The editors there, impressed with the quality of my unedited work, offered me a job a month later. I started off editing online stories for AP style, and by my second semester at SU I had secured a job with the paper as feature editor. Next thing I knew, I was in charge of five other staffers, and we were working together to curate all the content for the features section of the paper.?To say I jumped in quick is an understatement, and the knowledge I absorbed during my three semesters working at The D.O. spanned far beyond what I could ever have envisioned. The two seniors that led the paper as managing editor and editor-in-chief during the 2017-2018 school year were instrumental in that process, particularly because one was a Latinx woman. They helped me understand what diverse and inclusive journalism can, or should, look like, and my team and I got plenty of practice in creating those pieces of work. During the month of February I spearheaded the paper’s first-ever Black History Month series, highlighting outstanding black people and communities in the area. I wrote more stories focusing on Latinx issues, and had the opportunity to get them critiqued by the rest of The D.O. staff so I learned how to better approach these issues next time. Another major influence was simply the conversations I had with my friends of color. One of my closest D.O. friends is Dominican, and we often had discussions about the differences in our lived experiences. These talks made me look at seemingly ordinary issues in a different light — I had never been challenged to think about the systemic social, financial and other barriers in place in this country that affect how Latinx people live their lives.?During the summers of 2018 and 2019, I had the opportunity to intern in two different newsrooms in very different areas of the country. My first summer as a commuter reporting intern with a daily newspaper in White Plains, New York taught me to keep my head on a swivel and, more than anything else, taught me to be persistent. The job usually involved me walking up to commuters at crowded subway stations or train platforms and interviewing them for transit-related stories. Of course, the vast majority of commuters in the greater New York City area have a reluctance to idle chatting while they get to and from their place of business, which meant that I’d find myself having worked up the courage to talk to someone only to get huffed away by that same person moments later. As the weeks went by, I developed a knack for reading the room. I could walk into a train car, spot people that I thought might be friendly and cultivate a source for a story, all in just a few minutes since if I took longer than that, I was going to be stuck on a train to Poughkeepsie or Connecticut. In hindsight, one of the other valuable skills I got from that summer was the knowledge that sometimes, just when you think you’ve got enough sources for a story, that last interview you do on a whim ends up being the best one. I also learned that summer to push myself, not stopping the reporting process once I met my bare minimum of required sources for an assignment.?The following summer, I worked at a non-daily newspaper company in Houston, Texas that focused its editorial practices on community-based, hyperlocal news. This was my first time living or working outside of New York state, and I was doing so at a time when our country’s borders were a hot-button topic of conversation. Working for a company with such a community focus taught me the value of being a reporter that learns about, understands and is embedded to a healthy extent in the area they cover. I watched the way my colleagues cultivatedI picked up almost immediately on the number of advertisements along virtually every major freeway with information on immigration lawyers. Driving by those billboards in the immediate aftermath of the El Paso shooting that August, I felt my heart sink even more than usual. That shooter expressed anti-immigrant sentiment for people he didn’t know, yet so adamantly hated — but then again, I asked myself, did I understand the immigrant experience? I didn’t then, and I don’t now, but I want to. While I wasn’t able to use my Spanish skills in the field much over the summer, I’m headed back to Houston for a job with the same company after graduation. I’m hoping to use the skills I built on with this capstone to bring my community some hyperlocal stories that shed light on the Latinx experience in the greater Houston area.Being around other journalists and young professionals that come from different walks of life, as well as getting the chance to work in the industry for two summers, helped me realize that there’s a lot of gray area in the topics that news reporters are covering every day. There’s almost always an angle related to how non-white Americans relate to or interact with a problem, movement or person. Given my Spanish skills and my interest in culture reporting, one of my major professional goals is to help elevate the voices of Latinx people in a responsible way, one that helps encourage a shift in the conversation around how media professionals cover Latinx issues.According to a Washington Post analysis, coverage of Latinx issues in the news is changing. The analysis found that just over half of the articles, out of the 185,000 examined, contained words related to three prominent negative themes: criminality, economic threat and illegal immigration. Two-thirds of all articles mentioning criminality are negative, and the average negative article mentioning Latinx crime is highly negative — more negative than 7 out of 8 randomly selected newspaper articles, per the analysis. However, the analysis also found that more than half of the 185,000 articles were positive, noting Latinx excellence and social contributions. It’s worth noting, though, that negative coverage can often leave a more lasting impression on readers than positive coverage, so while the positive coverage is out there, it’s likely not offsetting the negative coverage. WaPo’s analyst pointed out that the front pages of newspapers are likely to include much of the negative coverage — in keeping with the television news slogan “If it bleeds, it leads”— while the sports, arts and features inside sections are still a more common home for much of the positive cultural coverage.? My goal with this story is therefore to integrate coverage of Latinx issues into an everyday setting and topic: mental health. Millions of Americans suffer from some form of mental health disorder, yet not everyone’s experience treating their mental health is the same. Having a story in the mainstream news media that highlights this fact and goes into detail about the roots of those differences is a vital first step towards a greater cultural competence for both newsmaker and news consumer.After identifying that this was a story I wanted to pursue, my first job as a storyteller was to research my topic both within and outside of a news media context, in order to see which conversations had already been started about my topic and where they’d been happening. Given that this is an underreported issue, I really only had one major news outlet’s story to go off of. However, that USA Today piece gave me a useful starting point to begin collecting data and research. The author took a wider approach to Latinx mental health and angled his story a bit differently, more around the lack of accessible therapists than around the roots of the mental health stigma. I saw an opportunity there to use the reporting he’d collected, build on it with my own fact finding and interviewing, and address what’s happening — or not happening, in this case — in Latinx communities before a potential patient even tries to see a therapist in the first place.Finding potential sources for my story also started with my research. I browsed through various studies about my target population, which meant looking through data and research on college students, Latinx people and immigrants (or a combination of these when possible). I started a spreadsheet for myself with names and contact information for any experts, study authors, psychologists and mental health professionals whose names I’d come across at least once in my searches. I worked my way through that list as part of my reporting process, while simultaneously trying different avenues to find non-expert sources. I tweeted asking for any Latinx college student or recent graduate, between the ages of 18 and 24, who had struggled with their mental health at any point, to get in touch with me. I also reached out to leaders of multicultural organizations at SU, and professors with ties to Latinx communities in the Syracuse area, letting them know about the story I was working on and providing my contact information in case they knew anyone interested in speaking with me.?While this was semi-helpful and did help me make contact with groups like SU’s Puerto Rican Student Association, I got to witness firsthand the power of the social media age when I tweeted out my call for sources, as that proved the most lucrative. I began receiving numerous direct messages and emails as the tweet reached different corners of the internet. It’s fairly common nowadays for journalists to use avenues similar to this when looking for sources, but it’s also pretty common for those calls to fall on deaf ears or just not gain any traction. I was therefore surprised when my tweet was shared two dozen times. One of the people who retweeted was a professional connection from Texas, which I’m pretty sure is the reason that several people from across the country (places like Chicago, South Carolina and various cities in Texas) contacted me with interest in the story.From there, my task was to connect with my sources in a way that helped them feel comfortable sharing ideas with me, even if they were ideas that I inherently would not be able to empathize with. I devised an open-ended set of questions that I used as a guideline when talking to anyone from my target audience, meaning 18-24 year old Latinx people. These questions were meant to communicate that I was simply a vehicle for my source’s thoughts, using language that allowed the source to elaborate however they wanted to when giving a response. I also began each interview by explaining to my source that I would record the conversation, and to let me know if there was anything they wanted off the record. My goal was to be as transparent about my intentions and my process as possible, because without that transparency there wasn’t any exchange of ideas between my sources and I. I wanted to have a conversation with each person involved in this process, which is different from an interview because it often meant me putting down my list of questions, listening, and responding like a human, not just listening to identify good follow-up questions.?A story like this is only as good as the anecdotes it presents and the emotions it displays. Moreover, it became evident to me early on that many of the sources I was interviewing had rarely been given an opportunity to talk about their mental health before. For some, me simply asking about their relationship to mental healthcare opened up a trove of memories, thoughts and feelings. While listening to so much at once was admittedly draining, it just reminded me why this story was important. I don’t want to be the only person asking Latinx youth about their mental health.I remembered thinking that, by leaving my interviews as open-ended as I did, I would end up having a difficult time finding a consistent narrative. Instead, the opposite happened: I interviewed 12 people, and all of them in some way, shape or form all gave insights that connected back to the same few points. This made writing the nut graf of my story — the sentence or sentences that act as a thesis statement in a journalistic story — fairly easy. To paraphrase that graf, many Latinx students grow up with a complete lack of conversations about mental health at home, which made it difficult for them to seek the proper care, and experts and students alike said the stigma around Latinx individuals receiving mental health treatment are a deep-set part of the culture. I used those ideas to shape the narrative of my story. If an anecdote, piece of data, technical definition, or piece expert testimony connected directly to those ideas in a way I could clearly articulate or defend, it stayed in the story. If I or one of my editors felt that it didn’t, it got cut.?I transcribed my story interviews by hand in a way that allowed me to move different pieces of my story around like puzzle pieces. I identified the anecdote that served as my lede, after having all of my anecdotal information in front of me, because it felt both the most compelling and also like it best showed the concepts I was trying to illustrate. From there, after inserting my nut graf and some opening statistics to immediately support that nut graf, my goal was to weave pieces of reporting, data, expert testimony or other more hard-news elements in with the humanizing, anecdotal evidence I got from my six student-age sources.?My primary editor, a Newhouse professor who is also a white woman, read over the story in detail and helped me determine when the structure made sense, where I needed to transition better between ideas and where I had pieces of information that were superfluous. After she read it over to ensure it was high-quality journalism, we agreed the responsible thing to do was to have a Latinx person read the story. I accepted my limitations as a young, white reporter and knew that there was a chance I had missed something in my reporting, writing or editing. My second reader, who is Latinx and also studies Latinx social issues, helped create a list that identified what she sees as some of the roots of the mental health stigmas. I went through that ten-point list and found that my story touched on nearly all of the points. My last round of edits was to strengthen the information I had or could find about any points that weren’t thoroughly covered, to ensure that my story was executed in the most responsible way possible.A piece of journalism is only effective with an audience, which is why I’m aiming to publish this capstone piece with a major news outlet as soon as possible. If there is already a lack of conversations happening around mental health in Latinx households, not covering this issue and others like it in modern-day mainstream news media will only diminish the likelihood of those conversations happening. My primary editor has ties to Vice, which is an online national news outlet with a typically left-leaning audience that prides itself on its coverage of issues that matter to young people. This includes identifying and executing stories about things that affect college students. Given that my piece does exactly this, the story is ideal for Vice’s audience, so I plan to start my pitch process with a Vice editor in 2020.?My story synthesizes anecdotal and data-driven research, which can give care providers a resource through which to understand clients. It is therefore my hope that care providers across the country, regardless of the area of medicine they practice, will be able to consume this story and use it to remind themselves of the importance of culturally competent medicine. I also hope that college-age Latinx students who see the story might read it and feel more understood and represented. The story may inspire them to take different ownership over their own mental health, but that’s not necessary for this piece of work to be considered successful. What is necessary is the start of new conversations, and that’s ultimately what I hope can come of me producing this piece.Sources Cited and ConsultedRelevant News Articles:-Albert Einstein College of Medicine news release: “Largest Study of Hispanics/Latinos Finds Depression and Anxiety Rates Vary Widely Among Groups”-PBS NewsHour story: “More Hispanics are going to college and graduating, but disparity persists”-USA Today story: “Habla Espa?ol? Hispanics face growing mental health care crisis”-Washington Post analysis: “Sure, a lot of newspaper coverage of Latinos is negative — but not when it comes to cultural achievements”Studies Consulted:2015 APA Survey of Psychology Health Service Providers (link)“Immigrant-based Disparities in Mental Health Care Utilization” (link) | Shawn Bauldry and Magdalena Szaflarski“Mental Health Services for Latino Youth: Bridging Culture and Evidence” (link) | Patricia Foxen“Perceived and Personal Mental Health Stigma in Latino and African American College Students” (link) | Stacie Craft DeFreitas, Travis Crone, Martha DeLeon and Anna AjayiSTUDENT QUESTIONS (used as a template):What were the conversations around mental and emotional wellness like for you growing up?Have they changed over the years?How do you think your immediate family looks at mental health care, and is this different from how you’ve come to view it?What were some of the challenges you faced, if any, when it came to taking care of yourself?Was this harder or easier when you were away from home?First/second-gen students are more likely to experience depression per 2014 study, what’s your response to that?*ask for elaboration on stigmas, intergenerational traumaEXPERT QUESTIONS (template):What are some of the most prevalent mental health issues you’ve seen among hispanic/latino college students?Can you give any insight as to the cultural factors at play that might affect how a student of this demographic views their own mental health?What are some specific environmental triggers that differ ?for hispanic/latino college students and could affect their mental health?How does this affect their likelihood to get treated?How does mental healthcare treatment need to be adjusted to best serve the needs of hispanic/latino populations?INTERVIEW TRANSCRIPTIONS AND NOTESAndrea Corona, whose parents are both Puerto Rican, recalled conversations at home about mental health that centered around her father and his bipolar disorder. Although Corona’s mother, who studied psychology in college, made a point to talk with Corona and her siblings about her father’s disorder and medication, she said that that’s normally where the conversations ended.“It was always definitely hush-hush,” said the 23-year-old who graduated from Purchase College in 2018. “It’s a little more of a taboo subject [with Latinx men] to admit that you’re seeking help...it was never a conversation of ‘your father has this condition and he’s being medicated,’ it was like ‘well, you know what, Dad is a little sick and we don’t really talk about it.’”Her grandfather felt that anyone living a healthy lifestyle did not need therapy, and would call anyone who sought it out “crazy,” she added. However, she said as the family has grown older it’s become less controversial to bring up the conversation of therapy. Her father has taken more ownership over his treatment and condition — partly because his mental health struggles were a factor in Corona’s parents divorce, she said.“That’s something that is now verbalized, so I think that even that is a huge improvement,” she said.Corona started seeking mental health treatment in college because of the accessibility of on-campus therapists. The process of communicating her feelings in therapy wasn’t easy because she “didn’t feel represented” by the professional she was seeing, between the differences in their backgrounds, native languages and lived experienced.“Relaying information about yourself and your emotional self in a second language is different,” she said. “I kept wanting to speak Spanish to a therapist and that was never an option in the U.S...I felt like I had to explain a lot about myself all the time to give them context about where I come from and how my head works.”There’s a certain kind of pressure that comes with being first- or second-generation, she said. It’s a desire to make your family proud and accomplish something, particularly when a first- or second-generation student’s parents have made education accessible to them. She called it “an added weight.”Mental illness are really prevalent in the Latinx community, particularly among men, but there’s progress still to be made when it comes to men displaying emotion in Latin American countries.?She pointed to the amount of domestic violence and violence against women in Latin America and said the concepts of weakness and needing to be rescued are “included in the narrative” of being a Latinx woman.Corona has watched her male siblings struggle with anxiety and depression and noticed how tough it was for them to come out of their shells and ask for help.After Hurricane Maria hit, Corona had next to no knowledge about her Puerto Rican family’s whereabouts, which created a unique anxiety and tension for her. She brought up some of her anxieties in therapy, but in the immediate aftermath of the disaster she wasn’t attending sessions.--For Stephanie Pagan, a sophomore at Syracuse University who lived in Puerto Rico until last year, mental health and wellness were “untalked territory” in her house growing up. When she began experiencing anxiety attacks in high school, she was told to “just deal with it” on her own she said. It took 16-year-old Pagan telling her mother she wanted to see a therapist — and even then, her mother didn’t understand why she wouldn’t just talk to her family about her issues.“Growing up, she didn’t think that that was an important component for someone to have, and looking back at it, it’s so important,” she said of conversations surrounding mental health.Over the years, Pagan said her mother has become more open to the idea of therapy as mental health treatment, and her mother sees a therapist herself as does her older sister. Still, she said she rarely talks about any of her mental health struggles with her mother.“I knew I could talk to her about it, but I preferred not to because I don’t want [my family] to worry about me too,” she said.The conversations aren’t happening among her extended family, either. If she were to bring up her going to therapy with other family members, they’d think something was seriously wrong, Pagan said, because that’s the narrative she grew up around.“The idea that [I’ve always had] was that you’re, like, batsh*t crazy,” she said.It’s taken her awhile to get comfortable talking about herself in therapy for this reason, because she wasn’t used to talking about herself and initially felt it wasn’t okay for her to do so. The resources on the SU campus have encouraged her to continue taking care of her mental health, she added.—Rolando Cabral also said there were no conversations about emotional and mental wellness in his household. Instead he grew up around the idea that, if you “do well in life,” that should come naturally, he said.“It was kind of something that you just dealt with by yourself,” he said.There is a stigma surrounding people that go to therapy or take medication for mental health purposes, but Cabral said that even for his family who may not understand his choice to see a therapist, he still receives their support.“Dominican people, and just my family in general, at its core, there’s love there, so regardless of the situation, even if people don’t agree with what’s happening...they still will support you regardless,” he said.?He began seeing a therapist when he got to college, which is something he hasn’t shared with his entire family. His siblings are more open to mental health treatment, as is his stepfather, but his mother and family in the Dominican Republic have generally upheld the same stigma around people seeking mental health treatment, he said.“There’s a lot of weight that comes with being a first generation student. To get to college when you’re the first person in your family to go to college, it takes a different type of motivation...the system isn’t really for people of color,” he said. “There’s probably just a different level of struggle that comes with being a first gen student for probably a multitude of reasons.”Families from the Dominican Republic, or families that come from the island and haven’t been in the U.S. for a long time, tend to be not as accepting or forward thinking about mental health issues, he said. There’s a possibility that, once they’re exposed to American culture and educated about the benefits of mental health care, mentalities can change, but it’s not an easy fix.“There’s just...generations worth of just having a specific thought process that would have to be broken in order for real change to happen,” he said.--?When asked what the conversations around mental health looked like in his house growing up, Jay Juarez’s answer was simple: “none.” Mental health as a concept was — and is — nonexistent, he said, and although his parents are more open to the idea now, the topic is still difficult to bring up.Attending college at the University of Houston was the first instance where Juarez was exposed to large groups of other people that were also struggling with their mental health, which got him thinking about his own wellness. He’s just starting his mental health journey now that he’s graduated and is living on his own.There’s an added weight that comes with being first-gen, as well as an isolating feeling, when no one else in your family has gone to college and been through what you’re experiencing, he said. Having to worry about how he would pay for school every semester also put pressure on him.Juarez has not seen a therapist yet because it’s not accessible for him financially. Many of his friends and family members are in similar situations to his, so he’s not entirely sure where to start looking for affordable options.“It’s really tough for people like me who are struggling or were struggling,” he said.—Karlie Sanchez is a first-generation college freshman whose parents immigrated to the U.S. from Mexico 35 years ago. Although Sanchez and her parents were always very involved in their community, and compassion and empathy were highly regarded at home, the household lacked conversations about mental health and wellness.?She’s looking into a career in social work or something similar, so that she can be who she needed while she was growing up.“When the idea of going to therapy was brought up, it was just kind of laughed at by my family,” she said. “Because of the way that my family was raised, they didn’t have that opportunity to go to therapy to talk about their problems.”Once she went away to school, the process of caring for her mental health became easier, she said. But like Juarez, Sanchez said figuring out how to navigate college life was especially difficult being that she is first-gen. She’s still figuring it out day by day.—Lindsay Carbonell’s father immigrated to the U.S. from Colombia. Her mother is from Pittsburgh. There’s a history of mental illness on both sides of her family. Both parents are medical professionals not in the mental health field, and both feel that a change of mindset is all it takes to tackle a mental health issue, she said.“They don’t really see it as something that needs to be medicated most of the time,” Carbonell said of the way her father’s side of the family views mental health. “The way my parents specifically see depression and anxiety is it’s kind of in your head, and it’s something that you should be able to handle on your own if you have a positive outlook on life.”It takes a lot happening for her parents to feel that a mood disorder is not neurotypical, she said. One of her cousins had to go through a crisis for her extended family to understand that she was suffering from a mental disorder. Her father, who himself suffers from chronic back pain related to an injury, is very anti-medication for virtually all mental and physical disorders. He doesn’t take any medication for the pain.When Carbonell was in high school and began to deal with depressive symptoms, her parents encouraged her to do everything she could on her own before she sought help. The conversations were always centered around risk aversion and what she could do on her own to take care of herself.?Carbonell has only started taking antidepressants in the last few months, although she’s dealt with depressive symptoms for nearly a decade. She didn’t start going to therapy until six years after she began dealing with depressive symptoms, and didn’t begin taking antidepressants for another several years after that. Now, a combination of therapy, medication and self-therapy through cognitive behavioral techniques have helped her get to a better place.“There’s always been this sort of conflict within me between my dad wanting us to be assimilated into American culture and me feeling like I’m…[losing] some of [the Latinx] culture,” she said. “There’s always some degree of cultural conflict.”Feeling disconnected from some part of one’s heritage can cause a lot of identity issues, Carbonell said. Growing up, she often felt distanced from her Colombian family and roots, particularly because her parents seemed to start from scratch when it came to family traditions. She’s dealt with the imposter syndrome of not feeling Latinx enough, combined with the pressure of wanting to keep her culture alive, for years.“In the United States, people really focus in on your ethnicity and your heritage and what that means for your identity,” she said.?“This is a very Latino thing, that family is very important and family can sort of heal you in a lot of ways, and that if we stick together as a family and we support each other, that we can overcome anything, including and especially mood disorders,” she said. “The biggest hurdle I had to overcome was the stigma I had within myself.”After Carbonell moved out of the house, her father would simply encourage her to come home whenever she would express feeling sad or down because he insisted that would make her feel better. More often than not, going home had the opposite effect because she felt pressured to be in a better mood when she was home, lest she be seen as treating her family improperly, she said.—Sylvia Wassertheil-Smoller, a distinguished university professor Emerita at the Albert Einstein College of Medicine, led the largest-ever epidemiological study of Hispanic health in the U.S. in 2014. Participants at four centers across the country were screened for depressive symptoms, with high scorers being referred to mental health professionals, Smoller said. Although the study did not involve diagnoses, Smoller said it shed light on the differences among specific subgroups of Latinx people as it relates to their mental health.The study reported the highest and lowest rates of depressive symptoms among Puerto Ricans and Mexicans, respectively. About one in four participants ages 18 to 44 exhibited depressive symptoms, and first- and second-generation Latinx people were significantly more likely to have depressive symptoms than those born outside the U.S. mainland.?“Everything is both genetic and environmental, so I think that here in this case it’s an example of [how] there’s a big environmental influence,” Smoller said.Based on the study results, Smoller stressed the importance of university health services officials being cognizant of patient background when it comes to treatment, since different groups experience different stressors.?Another of the study’s findings was the relatively low use of antidepressant and anti-anxiety medications among Latinx people. Overall, just 5 percent of the study sample used antidepressants, even though depression affected 27 percent of this population.?--Patricia Foxen, director of research at UnidosUS, published a report shortly after Donald Trump’s election in 2016 that synthesized the best existing research and literature on Latinx youth. It was published around the time that hate speech and bullying, directed at Latinx youth, was on the rise, she said. The shock of the trauma has worn off since then, but that’s because the fear has manifested in tangible ways for many Latinxs, she said.“Now it’s not just the hate speech and the fear that Donald Trump instigated, it’s actual, real policies that have had real-life implications for [the Latinx community],” she said.Among the many struggles first-generation Latinx college students might encounter is the fact that many still have financial or emotional responsibility to their families even when they’re away from home. Depending on their background, some Latinx students may find themselves behind the curve academically when they get to college as well, which further contributes to a subpar graduation rate for Latinx students (find data).The report also assessed the role evidence-based practices play in the intersection of culture and mental health and highlighted best practices and programs that have been shown to be effective in the treatment of Latinx youth.?The question of stigma is not as pronounced as it used to be, so it’s now more of a question of making mental health services culturally accessible to students, Foxen said. A good place to start is by normalizing the process of seeking mental health treatment before the students go away to college.“Stigma is important but it gets overstated, and when you do provide the right services it’s not that hard to get rid of that stigma,” she said.“I think a lot of it is just the struggle of Latino families in general and sort of having to be resilient, always having to do well and get a good education and superar — succeed,” she said.?The mental and emotional challenges that come with adapting to a new culture, which are known as acculturation stress, are one of the top factors behind the high suicide rate for young Latina girls as well as a host of behavioral problems for Latinx youth, Foxen said. Latinx youth often adjust to American cultural tenets at a very different pace than their parents, causing conflict at home.?“Because we don’t have things in place in traditional mental health services that [deal with] that, that clash of cultures is not integrated into your standard American psychology services,” she said.?Mental health services for Latinx college students need to be designed to make students feel comfortable talking about things like acculturation stress, she said. Hiring Latinx therapists is a good step, and if that’s not possible, therapists need to be trained to be culturally competent and able to understand things like the intersection of culture and family dynamics for a Latinx student.Although Latinx students have a set of factors that put them at risk for mental health issues, it’s often overlooked that these same students also have many protective factors that enable them to succeed, Foxen said. Among these are the strong ties many Latinx students have to their community and extended family, which enable them to navigate their lives with support.“It’s really important for professionals who are working with those students to not pathologize them, to not just see them as having problems,” she said.These professionals also need to help students see their own strengths, she added. Foxen conducted a project related to resilience among Latinx youth, and said that when she interviewed students for the project, many of them had never been asked about the positive things in their lives.“There’s this tendency to always see the negative with those students, because they’re seen to be at risk...in fact, they really have a lot of strengths that we need to help them build on,” she said.--Patricia Study: “Studies have shown that Latino youth have the highest rates of depressive and suicidal symptoms of any ethnic group in the United States; rates of post-traumatic stress disorder (PTSD), substance abuse, and risk for anxiety and behavioral problems are also elevated among these youth. Unfortunately, young Latinos also experience multiple barriers to accessing adequate prevention and treatment services, thereby exacerbating mental health care disparities. Reasons for inadequate access include: cost of services, lack of health insurance, the stigma around mental health issues, and in many places, a shortage of accessible, culturally appropriate mental and behavioral health programs and providers that can effectively screen, diagnose, and treat Latinos. “We argue that to nurture a culture of health within the Hispanic community and among broader society, we must increase efforts to understand the particular needs of Latino youth—including the protective factors that contribute to mental and emotional well-being—as well as identify, support, and replicate high-quaality, effective, culturally appropriate mental health models and services. The report outlines the key elements recommended by Latino mental and behavioral health experts to improve the quality of mental health services for Latino youth. These strategies can help to narrow racial and ethnic gaps in care by encouraging Latino youth to access services; facilitate their participation in treatment; and help to promote healing and positive selfesteem.?These strategies include: ? Using a trauma-informed approach that recognizes the events, experiences, and effects of trauma (for at-risk Latino youth, trauma may stem from family migration, acculturation problems, domestic or community violence, or generational trauma related to discrimination). In practice, this approach emphasizes safety, trust, collaboration, choice, and healing, as well as the importance of cultural, historical, and gendered aspects of trauma. ? Providing access to culturally and linguistically appropriate services during all phases of service provision (outreach, assessment, treatment). Services should include bilingual staff, interpreters, and cultural brokers such as promotores and other community health workers, and communicate in a way that is culturally appropriate and respectful to better leverage patient engagement and care coordination. Integrating cultural values, beliefs, practices, sayings, and stories into interventions. Play therapy, music therapy, gardening therapy, and other innovative interventions can bridge cultural gaps and foster more positive environments and more productive services. ? Paying close attention to signs of acculturative stress (stress related to cultural integration), particularly as they relate to the youth’s dynamics with parents and family. Family-centered approaches should be strengthened in both the assessment and therapeutic processes for supporting youth. ? Integrating culturally enhanced versions of known evidence-based practices (EBPs) for mental health disorders such as depression, anxiety, and PTSD; using them within a therapeutic model that addresses environmental sources of suffering and distress. ? Training mental health practitioners in a comprehensive conceptual framework that provides an in-depth, non-stereotyping, assets- and healing-based approach toward treating Latino families.—Adriana Alejandre, a therapist and the founder of LatinxTherapy, said that she sees a lot of intergenerational trauma and underlying anxiety and depression among young Latinx people in her day-to-day work. Her organization, which connects therapists and professionals to patients, encourages patients not to wait until they’re at their worst to seek help — even though culturally, Latinx individuals are taught to push through barriers on their own, Alejandre said.“Culturally speaking, it’s a very silent journey that they’re on because they can’t really talk about it with anybody else, so I think many of the stigmas come from not being able to...talk about feelings,” she said.?Many young Latinx people find themselves unable to share with their family members that they’re going to therapy because when they do, there’s suddenly an issue with the family dynamic. Parents tend to make it about them, questioning where the family went wrong and comparing their immigrant story with their childrens’ lives in America, she said. Moreover, intergenerational trauma stemming from an older relative’s previous physical or emotional abuse gets passed on to the next generation, which is seen as normal.Alejandre stressed the importance of using different modalities when treating Latinx college students with mental health issues, because they’re not going to open up right away and their issues may be complex. This includes asking open-ended questions to allow the patient to process and also narrate their story.“Latinx individuals specifically have complex stories, and it’s not just a single element that brings them anxiety,” she said. “It’s a host and a village of experiences, and sometimes they’re not even linkable.”—“Going to see a healthcare provider is not something which usually happens, and when it comes to mental health, that’s even more so the case,” said Jane Delgado, president of the National Alliance for Hispanic Health.Depression is “a major problem” in the Hispanic community, with Hispanic teenage girls being the most likely group to attempt suicide, she said. Moreover, community mental health services are usually targeted towards the chronically mentally ill, making it less likely that someone experiencing symptoms of an episodic disorder would seek help from these services, she added.“This is all compounded by the belief in the community, regardless of country of origin, that we have to solve all our own problems ourselves,” she said.?Delgado described the Latinx cultural approach to mental and emotional wellness as “very bootstrap,” meaning that people are expected to solve all their own problems themselves and find a way to “just get over it” if they are sad or depressed. This is true regardless of country of origin, she said, and it stems from the fact that Hispanic people are known for being good workers and not needing to ask others for help.The amount of negative speech directed at Hispanic and Latinx people from the current Presidential administration is an environmental trigger that can exacerbate the pressures and anxieties already on Latinx people in the U.S., she said. Hispanic women make less than any other group of women, which also contributes to their likelihood of developing mental health issues.“It’s hard enough going from being a child to being an adult...but on top of all those normal pressures and all the hormonal changes, you also have to find a way to mingle and marry two different cultures,” Delgado said of the pressures on particularly first-generation students. “That’s even more that you have to navigate.”There’s a constant call to “aguantar” — suck it up.?While someone’s primary language may be English, their deep feelings or cultural roots may be in another linguistic framework. This makes it so that sometimes Latinx people encounter difficulty being understood by medical professionals, she said.Access to affordable services, combined with delivering accurate, realistic information to engaged people, is important when it comes to treating anyone with a mental health disorder, she said.Younger people don’t feel the stigma the same way because their friends are seeking help, which is a positive change, but the issue of stigma is still very prevalent, she said.“We have a responsibility as a society to tell our young people it will get better, and you can have the life that you want to lead, and things are going to be tough but with skills you can get through it and you don’t have to do it alone.”--Felix KuryStressors for Latinx college students in San Fran area: housing insecurity, food insecurity, depression, anxiety, trauma.?We need more people of color as psychotherapists“Latinos don’t want to go to therapy, or they don’t want to go to this place because of the machismo,” spanish word for exaggerated or excessive masculinityThere are men who seek help when they feel like the world is going to come to an end. System is patriarchal,?“By decolonizing psychology, as Martin Baró teaches, then we can begin to understand that machismo is not just an issue for Latino men because this society is really machista in general.”Needs to be channeled, but this generation is more flexible and self aware“I see a generation of young men who have organizations on campus, for example, where they have support and talk about some of the things.?“I think that most of the problems the students experience is being psychologized”Normalizing problems, not making students the source of pathology (?)Symbolic violence gets internalized (re: hate speech w/ Trump)It’s vital to support spaces where Latinx students feel safe to talk about whatever is going on in their lives, said Felix Kury, title here. He references his clinic - give brief definition of what goes on there.“There are at least 45 student that volunteer there, so they do have that space and I see the difference when people have that safety to talk,” Kury said.--Bea Gonzalez,Vice President for Community Engagement and Special Assistant to the ChancellorBeing the first fluent english speaker meant she did a lot of translating -? not just words, but cultural nuances too. Explaining why social norms were the way they wereMental health, if discussed at all, was derogatory — people were simply referred to as “la loca” — in her household growing up. Gonzalez didn’t begin seeking mental health treatment until she was in her 50s.Gonzalez, a Syracuse native, said that growing up in a segregated city caused trauma for everyone in her family. The oldest of six children, she recalled the trauma manifesting with various family members through substance abuse and emotionally or physically abusive behaviors. Her mother likely had undiagnosed mental health issues, and her father resorted to alcoholism to cope with his trauma, she said.Mental health assistance was received from religious organizations/institutions rather than doctors - church to deal with whatever was going onHumor as a tool, reflecting on life, sometimes resorting to self-helpThey came with social norms from their time, and social norms changed and they didn’t keep up -- on intergenerational traumaFor her, the intergenerational trauma is the sense of never being good enough. Experience of the name calling, her parents and her both experiencing it. Overachieve and overperform to push back against that. Gonzalez facilitated these conversations with the counseling center at SU to raise awareness and encourage diversification of counselors.Been at SU 35 years, in higher ed 43 yearsFor puerto ricans: partly has to do with their status - not a nation, always fighting to hold onto culture, public treatment is not good. Have never been their own people ................
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