Mental Health Issues in Hispanics: A New

1
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
• puente_at_uncw.edu
• www.uncw.edu/people/puente
• 1508 Military Cutoff Road 303
• www.clinicalneuropsychology.us
• New Hanover Health Department
• July 14, 2004

2
Demographics

• Growth
• 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

3
DemographicsHispanic Panorama

• United State Stats
• 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
• Primarily from California (also from the NE)
• Comparison (ND 282 decrease)
• From 1990 to 2000 57.9 increase
• New Hanover Stats ???
• Total Population 147,642 (22.7 increase)
• 1980 788 1990 747 2000 1,828

4
Additional Hispanic Statistics

• Percentage of Population
• - In US 12.5
• In NC 4.7
• - 36 are from Latin America
• - 30 are from Mexico
• Anticipated Growth
• In US Births will outpace immigration
• In NC 273 growth

5
Psychological Literature(from PsyInfo, 07.14..04)

• Psychology
• 464,5888
• Hispanics
• 7,462
• Hispanics and Mental Health
• 731

6
Sources of Mental Health Problems

• Language limitations
• Culture and Acculturation issues
• Family dysfunction
• Ineffective social support
• Low self esteem
• Limited education
• Financial limitations
• Religious affiliation
• Documentation

7
Language Problems

• 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

8
Culture and Acculturation

• Understanding the majority group culture and vice
  versa
• Maintaining culture of origin (e.g., southern
  Eng.)
• Being bi-cultural (its more than language)
• Some basic differences
• 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 ones problems to themselves or family
• Less material consumer focused
• More emotional
• More spiritual and religious

9
Family

• Defining Family
• Nuclear
• Extended
• Double
• Functional
• Divided Families
• Economics
• Geography
• Politics

10
Ineffective Social Support

• Medical
• Religious
• Educational
• Financial
• Social
• Marital

11
Low Self Esteem

• Productivity and Materialism
• Connectivity
• Self-Effacing Presentation
• Self-Fulfilling Prophecy

12
Education

• Typical Educational Background
• What it Means to be Educated- the difference
  between schooling and education

13
Financial Related Limitations

• The Limits and Hazards of Being Undocumented
• Type of Vocational Opportunities Corresponding
  Pay
• Banking Issues
• Saving for Retirement
• Drivers License (the TN solution)

14
Religion

• Predominantly Catholic, but not Exclusively
  (fundamental alternative)
• Importance of Religion and Related Social Support
• Church and Related Services in Spanish

15
Documentation

• Education
• Medical
• Legal
• Tax ID Numbers
• Social Security Numbers
• Drivers Licenses
• Aliases

16
Outcome of Problems

• Anxiety 13
• Substance abuse 8
• Depression 5
• Violence ?
• Ethnic identity issues
• Language at home Language for children
• Poverty and marginalization
• Higher Education as an example

17
Gender Issues

• Males vs Female
• Males 27
• Females 17
• Heterosexual issues
• Clashing of cultures
• Availability of partners
• Prostitution
• STDs
• Sexual Identity Issues
• Childhood Sexuality Abuse

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A Simple Model for Addressing Mental Health
Concerns

• Communication Narrative Approach
• Rapport and Trust
• Questioning
• Symptom Identification
• Empowerment
• Solution Focus
• Follow-up

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Personnel and Servicesin Southeastern NC

• Mental Health Public Sector
• Catholic Ministries- (?)
• SEMHC- (?)
• Titleson Clinic (first Wednesday)
• Mental Health Private Sector
• Psychologist- 1
• Health Public Sector
• New Hanover County- 1

20
Related Support

• Radio and Television
• 1 - AM Religious Station
• 1 - WHQR Sunday Night
• Newspaper
• 1
• Organizations
• Centro Latino/Amigos Internacional

21
Intra-Cultural Conflict

• Pertinent Groups
• Ola
• Titleson Clinic
• Centro Latino
• Hispanic Chamber of Commerce
• Hispanic Development Corporation (?)
• Others (?)
• Intra-Cultural Conflicts A Leadership Void

22
Cultural Matrix

• ISOLATED VS ACCULTURATED
• MAINSTREAM VS ASSIMILATED

23
From Isolation to Assimilation(from Hispanic
Business, December 2003)

• Isolation Acculturation Assimilation
• Income 20,500 36,100 37,000
• Size 3.9 3.6
  3.1
• Time in US1st gen. US born 4th Gen.
• Locale Inner City Suburbs ? Suburbs
• Values Hispanic Partial Hispanic Anglo
• Language Spanish Bilingual English

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The Future

• Clashing Curves and Cultures
• Financial Social Slavery
• Pay Now or Pay Later
• Social Welfare Programs
• Social Security Disability
• Penal System
• What is North Carolina and the Cape Fear Region
  Going to Do?