Lali Moheno went to school in Texas as a kid. But she, her parents, and her six siblings would bus to Modesto, California every summers to work the fields. Then in late August or September, her parents would put her and her siblings back in a bus to Texas. Mohseno worked the fields all the way through graduating from the University of Texas.
"Life was hard," said Moheno said during a press conference at UC Davis. "We had three family members who had mental health issues. But of course, in our family, we didn't recognize it. They'd say, 'Ese? Esta un poquito loco [Him? He's a little crazy]. Don't pay attention to him. We don't know what to do with him. He just follows us into the migrant camps."
Moheno said her family didn't know that visiting a psychologist or psychiatrist was even an option. That's why she became a health activist working with farmworkers in Visalia. And that's why she participated in a series of community forums looking at Latino mental health care disparities.
The result of the forums is a UC Davis study released this week, Community-Defined Solutions for Mental Health Care Disparities. Researchers highlight a variety of methods to close the mental health care gaps for Latinos in California.
Latinos make up over one-third of the nation’s population, and they're the largest racial or ethnic group in California. But they're also one of the most under-served communities in the state when it comes to getting mental health care.
Access to health insurance, transportation and language services all play into it. As does stigma associated with getting mental health care. Access to care also fluctuates based on ethnicity: Latinos of Mexican descent are less likely to get mental health care than other Latino groups, like Puerto Ricans. The report says about eighty-five percent of Mexican immigrants who need mental health services remain untreated.
The study recommendations range from using social media sites like Twitter and Facebook, to producing fotonovelas -- stories using images and audio to promote a better understanding of mental health issues.
I spoke with Sergio Aguilar-Gaxiola, the lead author and Director of the UC Davis Center for Reducing Health Disparities, about the study's recommendations on how to reduce these mental health disparities. We focused on two methods in particular: training school personnel working with young Latinos about possible mental health issues in their students; and teaching families and religious leaders about mental health problems and stigma -- so that they can educate others.
More than half of California’s elementary children are of Latino origin, according to the California Department of Education. Aguilar-Gaxiola said that many start developing mental health problems at a young age, adding that about 50 percent of severe mental illness are identified by age 15.
But instead of providing troubled children with counseling options, Aguilar-Gaxiola said they often get disciplined at school as the 'problem kids,' or even as bullies, instead. He said if schools used available curricula to teach educators how to identify things like depression and anxiety, they'd have a better chance of flagging it in their students.
"I think there is a unique opportunity in the school settings to have early interventions and screenings for kids that may be manifesting some behavioral problems. Depression screening, for example. It can be the teacher that is trained on how to deliver this information. Or it can be the school nurse. Some should be familiar with this information. "
Aguilar-Gaxiola said and a clinical psychologist recently met with the principal and teachers of a school in Sacramento to give them a tutorial about mental health disorders in adolescents.
"It was a an eye opener for us in terms of the questions we got from the teachers," he said. "They didn't know that mental illnesses could manifest through certain kinds of behaviors."
Another barrier to care is stigma. Aguilar-Gaxiola told me most of the Latino participants in the UC Davis study associated mental illness with being ‘crazy,’ like Lali Moheno's family had done. He also found that prayer was the number one thing that participants said they turned to when they had problems like depression. Aguilar-Caxiola said while it's fine to turn to family or religion for help with mental illness, sometimes therapy or other mental health support is also needed.
"Often when someone suffers from depression, unfortunately some family members -- and I have seen it in churches also -- they say it's because of the weak character that they have, or they haven't prayed hard enough. Sending the message that they would change if they would only put there will to work. Well it doesn't work like that."
Aguilar-Gaxiola said telling people with depression to toughen up, or to use their will, could actually make their depression worse. He said educating priests and family members that, in addition to prayer, they could also look at psychiatric and psychotherapy options, could help change the dialogue about mental health both in the church and in the home.
"We need to reach out much more to religious leaders. Not only priests, but rabbis and pastors, and work with them to learn how to identify and deal with mental illness."