People from different cultures express symptoms of depression in various ways. In addition to changes in their mood, Hispanics tend to experience depression as bodily aches and pains (like stomachaches, backaches or headaches) that persist despite medical treatment. Depression is often described by Hispanics as feeling nervous or tired. Other symptoms of depression include changes in sleeping or eating patterns, restlessness or irritability, and difficulty concentrating or remembering.
Use of Mental Health Services
Among Hispanic Americans with a mental disorder, fewer than 1 in 11 contact mental health specialists, while fewer than 1 in 5 contact general health care providers. Among Hispanic immigrants with mental disorders, fewer than 1 in 20 use services from mental health specialists, while fewer than 1 in 10 use services from general health care providers.
One national study found that only 24% of Hispanics with depression and anxiety received appropriate care, compared to 34% of whites. Another study found that Latinos who visited a general medical doctor were less than half as likely as whites to receive either a diagnosis of depression or antidepressant medicine.
Precise estimates of the use of complementary therapies by Hispanic Americans do not exist. One study found that only 4% of its Mexican American sample consulted a curandero, herbalista, or other folk medicine practitioner within the past year, while percentages from other studies have ranged from 7 to 44%. The use of folk remedies is more common than consultation with a folk healer, and these remedies are generally used to complement mainstream care.
Availability of Mental Health Services
In 1990, about 40% of Hispanics either did not speak English at all or did not speak it well. While the percentage of Spanish-speaking mental health professionals is not known, only about 1% of licensed psychologists who are also members of the American Psychological Association identify themselves as Hispanic. Moreover, there are only 29 Hispanic mental health professionals for every 100,000 Hispanics in the United States, compared to 173 non-Hispanic white providers per 100,000.
Another big problem is access to professional help. Nationally, 37 percent of Hispanics are uninsured, compared to 16% for all Americans. This high number is driven mostly by Hispanics' lack of employer-based coverage - only 43% compared to 73% for non-Hispanic whites. Medicaid and other public coverage reaches 18% of Hispanics.
Need for Mental Health Care
Generally speaking, the rate of mental disorders among Hispanic Americans living in the community is similar to that of non-Hispanic white Americans. However,
- Adult Mexican immigrants have lower rates of mental disorders than Mexican Americans born in the United States, and adult Puerto Ricans living on the island tend to have lower rates of depressions than Puerto Ricans living on the mainland.
Studies have found that Latino youth experience proportionately more anxiety-related and delinquency problem behaviors, depression, and drug use than do non-Hispanic white youth.
Regarding older Hispanic Americans, one study found over 26% of its sample were depressed, but depression was related to physical health; only 5.5% of those without physical health problems said they were depressed.
Culture-bound syndromes seen in Hispanic Americans include susto (fright), nervios (nerves), mal de ojo (evil eye), and ataque de nervios. Symptoms of an ataque may include screaming uncontrollably, crying, trembling, verbal or physical aggression, dissociative experiences, seizure-like or fainting episodes, and suicidal gestures.
- In 1997, Latinos had a suicide rate of about 6% compared to 13% for non-Hispanic whites. However, in a national survey of high school students, Hispanic adolescents reported more suicidal ideation and attempts proportionally than non-Hispanic whites and blacks.