Transcript Mental Health Issues in Hispanics

Mental Health Issues in
Hispanics: A New Challenge for
North Carolina
Antonio E. Puente, Ph.D.
University of North Carolina at Wilmington
910.962.3812
[email protected]
www.uncw.edu/people/puente
1508 Military Cutoof Road #303
www.clinicalneuropsychology.us
New Hanover Regional Medical Center
Interdisciplinary Grand Rounds
January 16, 2003
Demographics
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Growth
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Fastest growing ethnic group in US
Will be or is the largest ethnic group in US
Approximately 15% of the population
Could represent the majority group in 2050
Probably undercounted
North Carolina
• One of the fastest growing states for Hispanic
• Southeastern NC particularly sensitive,
especially rural areas with agriculture and
livestock
Hispanic Statistics
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Percentage of Population
- In US = 12.5%
• In NC = 4.7%
- 36% are from Latin America
- 30% are from Mexico
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Anticipated Growth
• In US = Births will outpace immigration
• In NC = 273% growth
Psychological Literature
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Psychology
• 457,827
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Hispanics
• 6,384
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Hispanics and Mental Health
• 731
Sources of Mental Health Problems
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Language limitations
Culture and Acculturation issues
Family dysfunction
Ineffective social support
Low self esteem
Limited education
Financial limitations
Religious affiliation
Documentation
Language Problems
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English
Variations of Spanish
Spanish as a second language
Anxiety associated with learning
English
Children as translators for parents
Children choosing English over
Spanish as primary method of
communicating
Culture and Acculturation
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Understanding the majority group culture
Maintaining culture of origin
Being bi-cultural
Some basic differences
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Family above all (and extended family)
Time to be enjoyed not conquered
Cooperation versus competition
Religion as source of support and socializing
Keep one’s problems to themselves or family
Less material
More emotional
Family
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Defining Family
• Nuclear
• Extended
• Double
• Functional
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Divided Families
• Economics
• Geography
• Politics
Ineffective Social Support
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Medical
Religious
Educational
Financial
Social
Marital
Low Self Esteem
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Productivity and Materialism
Connectivity
Self-Effacing Presentation
Self-Fulfilling Prophecy
Education
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Typical Educational Background
What it Means to be “Educated”- the
difference between schooling and
education
Financial & Related Limitations
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The Limits and Hazards of Being
Undocumented
Type of Vocational Opportunities &
Corresponding Pay
Banking Issues
Saving for Retirement
Driver’s License
Religion
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Predominantly Catholic, but not
Exclusively (fundamental)
Importance of Religion and Related
Social Support
Church and Related Services in
Spanish
Documentation
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Education
Medical
Legal
• Tax ID Numbers
• Social Security Numbers
• Driver’s Licenses
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Aliases
Outcome of Problems
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Anxiety
Substance abuse
Depression
Violence
Ethnic identity issues
Poverty and marginalization
13%
8%
5%
?%
Gender Issues
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Males vs Female
• Males
• Females
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27%
17%
Heterosexual issues
• Clashing of cultures
• Availability of partners
• Prostitution
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Sexual Identity Issues
Childhood Sexuality & Abuse
A Simple Model for Addressing
Mental Health Concerns
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Communication & Narrative
Approach
Rapport and Trust
Questioning
Symptom Identification
Empowerment
Solution Focus
Follow-up
Suggestions for Health Issues
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Style/Rapport
Translation
Family
Documentation Status
Interpretation of Information
Follow-up
Personnel and Services
in Southeastern NC
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OAKS & SEMHC & Others
• SEMHC (1?)
• Titleson Clinic (first Wednesday)
• Catholic Ministries (1?)
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Private sector personnel
• Psychologist- 1
• Psychiatrist1
• Social Worker- 1 (?)
Related Support
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Radio and Television
• 1 Program?
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Newspaper
• 1?
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Organizations
• Centro Latino/Amigos Internacional
Cultural Matrix
ISOLATED
VS ACCULTURATED
MAINSTREAM VS ASSIMILATED
From Isolation to Assimilation
Isolation
Assimilation
Income
$20,500
Size
3.9
3.1
Time in US1st gen.
Locale
Inner City
Values
Hispanic
Language Spanish
Acculturation
$36,100
3.6
$37,000
US born
Suburbs ?
Partial Hispanic
Bilingual
4th Gen.
Suburbs
Anglo
English
The Future
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Clashing Curves and Cultures
Financial & Social “Slavery”
Pay Now or Pay Later
What is North Carolina and New
Hanover Going to Do?