Transcript Mental Health Issues in Hispanics

Mental Health Issues in Hispanics:
A New & Pressing Challenge
for North Carolina & the Cape Fear Region
Antonio E. Puente, Ph.D.
University of North Carolina at Wilmington
910.962.3812
[email protected]
www.uncw.edu/people/puente
1508 Military Cutoff Road #303
www.clinicalneuropsychology.us
New Hanover Health Department
July 14, 2004
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
Demographics:
Hispanic Panorama
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United State Stats
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Overall = 12.5% (vs 12.1% for AA)
Before 18 = 35%
18-65
= 60%
65 +
= 5%
Less Educated than counterparts
North Carolina Stats
• Overall = 4.7%
• Migration for Foreign Born = 50%
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Primarily from California (also from the NE)
Comparison (ND = 282% decrease)
• From 1990 to 2000 = 57.9% increase
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New Hanover Stats ???
• Total Population = 147,642 (22.7% increase)
• 1980 = 788; 1990 = 747; 2000 =1,828
Additional 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
(from PsyInfo, 07.14..04)
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Psychology
464,5888
Hispanics
• 7,462
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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 and losing culture
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 and
vice versa
Maintaining culture of origin (e.g., southern Eng.)
Being bi-cultural (it’s more than language)
Some basic differences
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Family above all (and extended family)
Friends and social groups are critical
Time to be enjoyed not conquered
Cooperation versus competition
Religion as source of support and socialization
Keep one’s problems to themselves or family
Less material & consumer focused
More emotional
More spiritual and religious
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 (the TN solution)
Religion
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Predominantly Catholic, but not
Exclusively (fundamental alternative)
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
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Ethnic identity issues
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13%
8%
5%
?%
• Language at home; Language for children
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Poverty and marginalization
• Higher Education as an example
Gender Issues
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Males vs Female
• Males
• Females
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Heterosexual issues
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27%
17%
Clashing of cultures
Availability of partners
Prostitution
STDs
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
Personnel and Services
in Southeastern NC
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Mental Health Public Sector
• Catholic Ministries(?)
• SEMHC(?)
• Titleson Clinic (first Wednesday)
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Mental Health Private Sector
• Psychologist-
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1
Health Public Sector
• New Hanover County-
1
Related Support
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Radio and Television
• 1 - AM Religious Station
• 1 - WHQR Sunday Night
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Newspaper
•1
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Organizations
• Centro Latino/Amigos Internacional
Intra-Cultural Conflict
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Pertinent Groups
• Ola
• Titleson Clinic
• Centro Latino
• Hispanic Chamber of Commerce
• Hispanic Development Corporation (?)
• Others (?)
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Intra-Cultural Conflicts & A
Leadership Void
Cultural Matrix
ISOLATED
VS ACCULTURATED
MAINSTREAM VS ASSIMILATED
From Isolation to Assimilation
(from Hispanic Business, December 2003)
Isolation
Income
$20,500
Size
3.9
Time in US1st gen.
Locale
Inner City
Values
Hispanic
Language Spanish
Acculturation Assimilation
$36,100
3.6
US born
Suburbs ?
Partial Hispanic
Bilingual
$37,000
3.1
4th Gen.
Suburbs
Anglo
English
The Future
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Clashing Curves and Cultures
Financial & Social “Slavery”
Pay Now or Pay Later
• Social Welfare Programs
• Social Security Disability
• Penal System
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What is North Carolina and the Cape
Fear Region Going to Do?