Experts say that many Latinx communities across the United States are in the midst of a mental health crisis during the coronavirus pandemic because of economic and public health disparities as well as cultural stigma around mental health issues.
Margarita Alegria, a professor at the Harvard Medical School and chief of the Disparities Research Unit at Massachusetts General Hospital, says the combination of stress over employment, lack of insurance and lack of information has created a perfect storm for Latinx communities.
"These disparities have been amplified by COVID-19 in Latinx communities. They really are suffering,” she says. “I think Latinos are being hit hard because of several things ... similar to blacks, they have very high rates of poverty. So they’re the ones who are in low-wage jobs that have laid off an enormous amount of people.”
And for those who haven’t been laid off, Alegria says they are working, which has created its own additional set of anxieties.
“They’re less likely to have opportunities to do this work at a distance,” she says. “Many are in construction, hospitality and leisure industries.”
The Centers for Disease Control and Prevention reports that workers without paid sick leave might be more likely to continue to work even when they are sick, which could increase their exposure to other workers who may have COVID-19. The report says that Hispanic workers have lower rates of access to paid leave than white non-Hispanic workers.
“You already have conditions that do not enable you access to health care. That does not enable you access to even vacation if you have to be out of work for two weeks, not to mention a month or two,” says Monica Villalta, director of inclusion at the National Alliance on Mental Illness (NAMI), where she is also the diversity officer. “And then you have the emotional response to feeling under attack by a virus that may be lurking anywhere.”
A recent Pew Research Center poll found that Hispanics (43 percent) are far more likely than whites (18 percent) to be concerned about getting COVID-19 and needing to be hospitalized.
According to the Henry K. Kaiser Family Foundation, 19 percent of non-elderly Hispanics do not have health insurance, compared with 11 percent for blacks and 8 percent for whites. And the CDC reports that, compared with whites, Hispanics are almost three times as likely to be uninsured.
“I’m very worried that in terms of psychological distress or mental health problems, they’ll have less access to insurance-based programs and that they’ll have to depend pretty much exclusively on ... community clinics,” says Alegria.
In addition to this, Alegria says many in the Latinx community have a lack of trust providing personal information to medical professionals out of fear of being reported to authorities.
“Many of the Latinos right now, with ... deportations, I think people are extremely worried about what information they are willing to give,” says Alegria, “and how that might impact whether they’re going to be traced.”
As a result, she says there’s underreporting of COVID-19 cases in the Latinx community. “We’re seeing ... that you get a lot of cases where race and ethnicity are not disclosed or race-ethnicity not reported. And therefore, I think it’s very hard to follow ... the cases of COVID-19 [among] Latinos.”
And for those Hispanic workers who are exposed to COVID-19, Alegria says there is additional stress due to lack of information and resources written in Spanish.
Last week the CDC reported that, in response to a COVID-19 outbreak at the Smithfield Foods pork plant in Sioux Falls, S.D., management handed out informational pamphlets about the virus in English, even though over 40 languages are spoken by workers there — including Swahili, French and Spanish.
There have also been issues with language barriers preventing proper medical and mental health care due to a lack of access to interpreters.
“There is not only a lack of resources available in Spanish but, worse, lack of culturally competent resources that are actually culturally relevant to members of the community,” says Villalta.
“Mental health is an issue that we in the Latinx community don’t often talk about proactively, and there is a lot of stigma,” she says. “And that stigma, along with the lack of understanding of what options for treatment and where you can get help in a holistic and a culturally relevant matter, is a big barrier.”
In response to this, NAMI has released a Spanish-language guide that features topics related specifically to mental health and COVID-19 and features a variety of topics including managing anxiety, finding online communities and accessing affordable services.
She says the goal is to make the content as relevant as possible to the families who need it the most. “If we’re going to make it relevant to members of the Latino community, we have to go beyond that. We have to talk about, ‘Wait, I still have to go to work. What can I do to mitigate my anxiety so I can protect myself physically and then protect my family?’”
She says the guide includes a section on what to do when you get home after working in the outside world, what to do with clothes that were worn. It also addresses how to deal with living in close quarters with other people, some of whom might not be relatives. And the guide also addresses domestic abuse resources while sheltering in place.
“We [also] include things you can do at home that are low cost or no cost, for example, mindfulness and breathing,” she says. “There’s no health without mental health.”
The CDC says the federal government must continue tracking and monitoring racial disparities in COVID-19 cases and complications. It also recommends providing better information to health care workers to understand cultural differences among patients and to better understand how they interact with the health care system.
Alegria says it’s also critical to work with community-based organizations that Latinx communities trust to disseminate resources and information.
NAMI has partnered with Hispanics in Philanthropy to reach an extensive network of agencies to help staff share the mental health guide.
“Our advocacy and the advocacy team of those serving Latinos are making efforts so that there is access and we increase the awareness ... the COVID-19 virus has showcased that we are really so interrelated and interconnected and that we cannot neglect the most vulnerable populations,” says Villalta. “We cannot neglect linguistic minorities, and we cannot neglect the well-being of the members of the Latino community.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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