Role of Culture in the Stigma of Depression and Treatment among Latinos - Research Paper Example

Role of culture in the stigma of depression and treatment among Latino population The research looks into the role of culture in stigmatizing depression among the Latino population. It also investigated how culture hampered the Latino population in seeking effective mental health intervention due to the negative perception on depression medication. Other factors were also considered in the development of depression such as acculturation among migrant Latinos and the cultural intolerance about homosexuality that contributed to the prevalence of depression among Latinos. Poverty in addition to culture was also identified as one of the factors identified to have caused depression of which the research recommends further research into the subject whether poverty aids culture in increasing prevalence of depression or each of these factors causes depression separately. Role of culture in the stigma of depression and treatment among Latino population Culture affects not only the way we live but also on how we are treated we get ill. Culture can either facilitate a speedy recovery from illness due to its favorable reception for treatment that could lead a healthy well-being or it could also be a hindrance especially when culture discourages a sick patient from actively seeking diagnosis and treatment. Linton defined culture as "a configuration of learned behaviors and results of behavior whose component elements are shared and transmitted by the members of a particular society" (1945 p. 32). This definition of learned behaviors shared and transmitted by the members of a particular society includes not only on how a particular group of people live but also transcends to attitudes and behaviors towards intervention in mental health particularly depression that could either help facilitate diagnosis and treatment or hamper and discourage it. Culture plays a significant part in the perception, attitude and treatment of depression among Latino population. The term “Latino” refers to individuals who has personal and family roots in the Latin American countries such as Mexico, Argentina, Cuba, Peru, El Salvador, Costa Rica (Organista and Munoz (1996). ”Latinos” as defined by the the U.S. Census Bureau (2002) are subgroups of the “Hispanic” ethnic group and are composed of “Mexicans (66.9%), Puerto Ricans (8.6%), Cubans (3.7%), Central and South Americans (14.3%), and other (6.5%)”. The case of depression among Latinos are more precarious compared to other ethnic groups. This can be attributed to cultural and accessibility factors. As a culture, Latinos still predominantly perceive mental problems including depression not as a psychological issue that could be attended by a health professional but rather as a spiritual and nonphysical problem and being such, resorts to superstition, to clergy or to spiritists for treatment (Garcia-Preto, 1996). As expected, many cases of depression are left untreated among the Latino population. Evidence also shows that there is a significant difference in the treatment access, appropriateness of diagnosis and intervention among Latino population in terms of receiving mental health services (Stacciarini, 2007). Factors identified to accessibility issue can be traced back to economic and cultural attitude. According to Rhoades, Latinos have low insurance rate with a staggering 36.2% among the population without any insurance coverage in the first half of 2004 (2005). This lack of insurance coverage in addition to, or contributed by, lack of economic opportunity to afford insurance and seek medical health service. Accessibility is also aggravated by cultural and familial attitude whereby depression is not taken as a psychological issue but rather as a spiritual or superstition issue that spiritists and/or clergymen are sought instead of mental health professionals in diagnosing and treating depression (Stacciarini, 2007). Mental illness such as depression became more common among minorities such as the Latino population in the US. Stacciarini and Mathews attributed this to the high poverty rate for Latinos (22.6%) and the overall lower level of academic achievement (2007). This lack of educational qualification that diminished the economic opportunities of Latinos made them more susceptible to mental health problems which includes depression. Most patients among Latino population can identify the psychosomatic symptom associated to depression as ‘‘a really bad headache,’’ ‘‘forgetfulness’’ and ‘‘feeling tired’’ (Wells et al, 2012). This includes feeling of “being myself’’, feeling unmotivated or being lazy, and the inability to do any simple tasks (Wells et al, 2012). Despite these acknowledgement about the psychosomatic symptom associated with depression, most patients among the Latino population never had depression treatment. Also, 18 of 24 patients never took any anti depression pills and half cited poor health as reason for not taking depression treatment. Only a meager 3 of 24 patients had taken medication pills among the Latino population. This indicates that despite the familiarity of the Latino population about the psychosomatic symptoms associated with depression, it does not necessarily translate to seeking intervention and treatment from mental health professionals. To support that depression is perceived among Latinos, Wells reported that only one in three patients received anti-depressants and half of this respondents (n=11) had a negative perception about medicating depression. The reasons given by the patients on their reluctance and/or negative perception about anti-depression pills ranges from non-familiarity of the medication, “not liking pills” worry about the side effects of medication (n=3), fear about the interaction of the medication with other prescribed medication (n=2) and the fear that they might get addicted to psychiatric medication (n=2). Almost all of the patients indicated the stigma of depression and along with it is the embarrassment in seeking a mental health professionals (Vega, et al, 2012). In another study conducted by Gonzalez et al. (2012), Latino population also had the perception that medication is inappropriate and ineffective in treating mental health problems. There were also other reasons cited why Latinos did not and/or were not able to seek mental health professional. These reasons include, “transportation problems, cost concerns, employment/ unemployment concerns, patient-provider dissatisfaction and issues, and immigrant documentation worries” (Wells, 2012). Cost also overwhelmingly permeated as the reason why patients failed to continuation their medication. Barrier to employment was also given as reason why patients cannot and/or did not continue to seek mental health professional. In addition to attitude and economic reasons for not seeing mental health professionals and not taking medication, cultural preference to be attended by mental health professionals who also speak Spanish is cited. Non-English speaker Latino patients feels that they are not being listened to if they do not speak English and feels more comfortable to tell a Spanish speaking doctor that they do not feel good (Wells, 2012). One of the causes of depression in the United States among minority Latinos identified by Diaz et al are the discrimination and social injustice hurled against the sexual orientation of its minority. These sexual minorities are the non-heterosexual members of Latino population who could either be gay and bisexuals who had to suffer homophobia, poverty and discrimination (2001). The study reported that homophobia was a common experience among non-heterosexual Latinos experiencing it 91% of the time since childhood. They also suffer from guilt and embarrassment at 70% of the time that 64% of gay Latinos had to pretend to be heterosexual to escape embarrassment and that 29% of the population had to be removed themselves from their familial and social ties in order to live their homosexual lives. This is aggravated by racism experienced by non-heterosexual members of Latino population. Regression analysis showed that these combined experiences of homophobia, racism and economic difficulty were strong predictors of social isolation that could lead to depression (Diaz et al, 2001). In a study by Vazquez et al (2011), acculturation and substance abuse were also identified as one of the causes of depression. This supports the study of Diaz et al (2001) that “men who have sex with men” (Vazquez et al, 2011pg. 90) carries a negative stigma and are frowned and discriminated upon among Hispanics. Vazquez and Guarda (2011) however added one more cause of depression which is acculturation especially among migrants. The study cited that missing contact and social interaction with family and friends among newly arrived immigrants who has difficulty communicating in English felt “social isolation, boredom, and loneliness resulted that promoted alcohol consumption” (91) and eventually to depression. Conclusion The influence of culture that impacts the Latino population in diagnosing, treatment and intervention is significant. While related literature are mix with regard to the prevalence of depression among Latino population with some reporting it to be more prevalent among Latino population due to aggravating factors such as poverty, discrimination, social injustice, acculturation, some also reported that the population is equally vulnerable to depression just like any other ethnic groups as its prevalence is comparable to any other minority as reported by Staccianriani and Matthews (2007). While related literature about the prevalence of depression among Latinos are mix, what is certain is that depression is prevalent among Latinos regardless of its relative rampancy. Culturally, Latino population in general are still superstitious in their perception, attitude and behavior towards depression particularly in seeking treatment and intervention about mental health particularly depression. Most still relegates depression not as a psychological issue that needs mental health professional for treatment and intervention. They still perceive it to be caused by supernatural origin and being such, seeks clergymen and spiritist for treatment while avoiding professional treatment and medication for a variety of reason among which is the negative stigma associated with depression among Latino communities. Culture also plays a factor on the minority group among Latinos who do not have mainstream sexual orientation. Latino culture is not tolerant for gays and lesbians and study showed a higher incidence of depression among the homosexual population of Latinos. Some even have to leave their family and friends to live their homosexual life increasing their susceptibility to depression feeling lonely and isolated as cited by Diaz et al (2001) which is an issue of discrimination both from Latino community and society in general. It would be difficult to ascertain if culture is the only factor that discourages and/or prevents the Latino population from actively seeking the help of mental health professionals. Studies are mixed with regard to the cause of depression and their corresponding attitude and behavior towards treatment. It is however certain that culture plays a significant role in the cause of depression as well as the attitude of Latinos in seeking treatment. Many Latinos still relegate the cause of mental health problem including depression towards supernatural origin and this carries a stigma that prevent them from seeking professional treatment. Culture also plays a significant role in the misconceptions about treatment particularly their general dislike about depression medications. There were also other factors identified to have caused depression and its corresponding attitude towards diagnosis and treatment. Among the factors identified in addition to culture is poverty and lack of qualification that deprives man Latinos into poverty and drives them towards depression. Acculturation among migrant Latinos is also a major cause of depression. Poverty is also identified as one of the major hindrance in seeking treatment for depression. Among the reasons cited that fall into the poverty category are lack of insurance coverage, concern about cost, barrier to employment, etch. It is however unclear if culture and poverty overlaps, contributes and aggravates each other in causing depression among Latino population. This would make an interesting study in a future study to establish with scientific certainty that depression can and are caused by culture and poverty. References Díaz, R., Ayala, G., Bein, E., Henne, J., & Marin, B. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities. American Journal Of Public Health, 91(6), 927-932. Garcia-Preto, N. (1996). Puerto Rican families. In M. McGoldrick, J. Giordano, J. K. Pearce, & J. Giordano (Eds.), Ethnicity and family therapy (2nd ed., pp. 183–199). New York: Guilford González-Guarda, R., Peragallo, N., Vasquez, E., Urrutia, M., & Mitrani, V. (2009). Intimate partner violence, depression, and resource availability among a community sample of Hispanic women. Issues In Mental Health Nursing, 30(4), 227-236. doi:10.1080/01612840802701109 Linton, R. (1945). The Cultural Background of Personality. New York. Organista, K.,&Mu˜noz, R. (1996). 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Barriers to Depression Treatment Among Low-Income, Latino Emergency Department Patients. Community Mental Health Journal, 49(4), 412-418. doi:10.1007/s10597-012-9547-5 Read More