Suicide among hispanics - Essay Example

?Hispanic Suicide Factors Introduction Suicide has a multitude of causes, one of which is cultural. There is ample evidence that cultural issues impact mental health – depending upon one’s culture, one is either more or less likely to get help for mental health issues. In some cultures, mental health issues are more stigmatized than in other cultures. In other cultures, there is a fear of seeking professional help. Other cultures rely more on clergy and friends than on mental health professionals. These factors might explain Hispanic suicide rates, but other factors are important to Hispanic communities as well. The sense of belonging is important for mental health, therefore it is seen that Hispanics who live in a community where there are a lot of other Hispanics have lower suicide rates than Hispanics who do not live in such a community. Also, for young Latinas, suicide attempts are more prevalent than whites because Hispanic families are more authoritarian and inflexible. This essay will examine these factors and more. Cultural Influences of Mental Health Culture has a mediating influence upon mental health. Within minority populations, there is the issue of the culture of the home being different than the culture of the dominant society that surrounds them (Greenfield & Suzuki, 1998). When the home culture is different from societal culture, issues may arise, according to Greenfield and Suzuki (1998). One of the issues is that the children of the home may be subjected to conflicting messages about values, behaviors and attitudes. Parents may have to choose with values that they need to instill in their children – the values of the society at large, or the values of the home. These conflicts are exacerbated by the fact that the choices that are to be made are often unconscious – the individuals are not necessarily aware that they are faced with these types of choices. This type of cognitive dissonance can be the root of mental health issues in the children and in the parents. According to the report by the Surgeon General (S. General, 2001), there are a myriad of ways that culture and society affect mental health. In this report, the Surgeon General states that culture shapes the mental health of minorities, as well as affects what kind of mental health services they use. The cultural barriers may also be a barrier to seeking mental health – that is because there often are cultural misunderstandings between doctor and patient, and there might also be bias on the part of the doctor because of the cultural differences. This is just one way that culture may present a barrier to seeking proper treatment for mental issues (S. General, 2001). Additionally, there are other reasons that culture impacts mental health issues (S. General, 2001). One way that culture impacts mental health is that it impacts how individual patients describe their symptoms to their clinicians. For instance, Asian patients might only describe somatic issues without divulging emotional symptoms. They only would divulge emotional issues if they are questioned further. This is because the symptoms which are divulged are only divulged in culturally acceptable ways - if it is not culturally acceptable to talk about mental issues, then a patient will not divulge this unless they are specifically asked about it. Moreover, culture affects how people attach meaning to a disease - the disease could be considered real or imagined, and there might be a great deal of stigma that surrounds it, depending on one’s culture. These cultural meanings have a bearing on whether or not people seek treatment, how they cope with their symptoms, how supportive their families and communities are, and whether they seek help (S. General, 2001). Cultural issues also have a bearing on other aspects of mental illness. For instance, cultural issues might have a causative effect on mental problems (S. General, 2001). The Surgeon General’s report, however, is careful to note that many mental illnesses, such as schizophrenia and bi-polar disorder, are not affected by culture, as these mental illnesses happen all around the world in roughly the same prevalence across cultures. What is affected by culture, however, is depression. The prevalence rates of depression vary across countries, which means that depression seems to be less heritable than are other mental illnesses. Therefore, depression is affected by social and cultural factors, such as exposure to poverty and violence, which are often linked to ethnicity and race, because many minorities are in a lower socioeconomic status than are others who are not a part of a minority race (S. General, 2001). The Surgeon General further states that culture and social factors have much to do with post-traumatic stress disorder, which might be a precursor to suicide, as is depression. This would possibly affect Hispanics, in that some of the Hispanics in America are immigrants from countries that are in turmoil, therefore Hispanics have a high rate of PTSD, according to the Surgeon General (S. General, 2001). Asians in America, especially those from Vietnam, Cambodia and Laos, also have an alarming rate of PTSD, as 70% of the immigrants from those countries have shown symptoms of PTSD. This is contrasted with just 4% of the United States population as a whole (S. General, 2001). Further, culture affects mental health, because culture affects how people cope with everyday problems. For instance, the Surgeon General (2001) found that Asians tend to keep problems inside, and avoid these problems, or, at least, not show the effects of problems on the outside. African Americans tend to take an active approach to the problems, as opposed to avoiding them. They are more inclined than are whites to handle everyday stressors on their own, and not seek professional help. African Americans also rely more on spirituality for their mental issues than do whites. Thai people are more likely to handle adverse situations covertly than are Americans (S. General, 2001). The Surgeon General (2001) further states that another way that culture affects mental health issues is in the area of treatment seeking. Racial and ethnic minorities are much less likely than whites to seek mental health treatment, and this is what largely accounts for the fact that these minorities are underrepresented in seeking mental health services. The minorities are less likely to see mental health professionals, and more likely to turn to alternatives such as clergy, family and friends, and traditional healers. This, too, varies across culture – American Indians and Alaskan Natives are more likely to turn to traditional healers, while African Americans are more likely to turn to clergy. Part of the reason why minorities do not seek mental help in the traditional mental health settings, states the Surgeon General (2001), is that these minorities are mistrustful of mental health treatment. For instance, African Americans who are suffering from major depression cite fears of hospitalization and of treatment when they state the reasons why they don’t seek treatment for mental issues. Half of African Americans, compared to 20 percent of whites, state that they are afraid of mental health treatments. This mistrust often stems from historical persecution, as well as struggles with racism and discrimination. Also, there have been documented abuses and mistreatment by medical and mental health professionals, so the mistrust stems from this as well. The Surgeon General (2001) cites a study that notes that 12 percent of African Americans and 15 percent of Latinos, compared to just 1 percent of whites, felt that their health provider or doctor treated them unfairly or with disrespect because of their race or ethnic background. Another study found that 43 percent of African Americans and 28 percent of Latinos felt this way, compared to 5 percent of whites (S. General, 2001). Related to the above concern is the concern regarding stigma. The Surgeon General (2001) states that stigma is the most formidable barrier to mental health treatment among minorities. Because of this stigma, people in different cultures may internalize their mental health symptoms, and not seek help because of embarrassment or shame. In the meantime, the stigma surrounding mental health issues also limits resources and opportunities, such as housing and employment, and also might lead to lower self-esteem and a greater feeling of isolation and hopelessness. This stigma may be greater in some cultures than in others – for instance, in Asian cultures, the stigma of mental illness is so extreme that it reflects poorly upon the entire family, which means that the marital and economic prospects of other family members are impacted by the stigmatization of the mentally ill family member (S. General, 2001). The Surgeon General (2001) further states that Asians and Hispanics saw patients with mental illnesses to be more dangerous than did whites, and that having contact with people with mental illnesses reduced stigma for whites, but did not reduce stigma for African Americans and American Indians (S. General, 2001). Finally, there is an issue with the stressors associated with migration, which affects many Hispanics living in America. Migration, according to the Surgeon General (2001) affects mental health, because there is extreme stress in adapting to a new culture. This is seen most severely in refugees who leave their country involuntarily. The psychological effects of immigration are seen most acutely in the first three years after arrival in the new country. The first year, however, is euphoric for many immigrants, followed by disenchantment and demoralization in the second year. The third year is marked by a gradual return to satisfaction and well-being. For Asian Americans and Latinos from war-torn countries, the stress of immigration is compounded by the PTSD that is suffered from being in these countries and experiencing the hardships and trauma of war (S. General, 2001). Hispanic Suicide Therefore, there are many cultural issues that have a bearing upon mental health. Many of these same cultural issues are seen in studies regarding Hispanic suicides. For instance, Wadsworth and Kubrin (2007) looked at the effects of immigration, assimilation, affluence and disadvantage on the rates of Hispanic suicide. That immigration and its effects must have an influence on the rates of Hispanic suicide is evident in the fact that, according to Wadsworth and Kubrin (2007), at least 50% of Hispanics who are living in the United States are immigrants. The processes of immigration have a profound effect upon social integration, and Hispanic mobility is similar to that of blacks and other minority groups. Therefore, there is the possibility that economic disadvantage and ethnic inequality might impact the rate of Hispanic suicide, much as it does for other minority races living in America (Wadsworth and Kubrin, 2007). Further, Wadsworth and Kubrin (2007) found that Hispanics have a much lower rate of suicide than do whites, so they wanted to discover what were the cultural and ethnically based protective factors that Hispanics have against suicide. Wadsworth and Kubrin (2007)’s conclusion regarding Hispanic suicide was that it was influenced by cultural, economic and demographic characteristics of metropolitan areas, and that the effects of the characteristics that were examined varied across native and immigrant populations. They compare the suicide rates of native-born and immigrant Hispanics, and found that immigrants had a higher rate of suicide, overall, but this difference was mediated by the size of the Hispanic immigrant community. In areas that had smaller immigrant populations, the Hispanic immigrants were at a higher risk for suicide than were native-born Hispanic counterparts. The opposite was true for areas that had larger immigrant populations – immigrants had lower risks of suicide than did the natives. This means, according to these researchers, that ethnic and cultural integration helped the Hispanics living in large immigrant populations to feel less alienated and isolated, and had more of a sense of community. In contrast, with Hispanics who were living in areas with smaller immigrant populations, these Hispanics were more forced to assimilate into the mainstream culture, and this often accompanied a disintegration of the cultural and ethnic belief system and social networks, which led to higher rates of suicide (Wadsworth and Kubrin, 2007). Further, they found that Hispanics had lower suicide rates when they were less culturally similar to whites, and, as they became more culturally similar to whites, the suicide rates went up. The researchers theorized that assimilating into the mainstream culture caused suicide rates to increase because this assimilation negated the cultural specific protective factors against suicide. This means that these Hispanics who were more integrated into the mainstream culture lost many of the shared beliefs, rituals and social networks that were shared by their ancestors, while weakening their sense of group solidarity. This increases the feelings of alienation and isolation (Wadsworth & Kubrin, 2007). This is compounded by the fact that the United States has more of an ethos of individualism and competition than do traditional Hispanic societies, and this, too, would lead to more of a feeling of disconnection from the community at large (Wadsworth & Kubrin, 2007). Perhaps not surprisingly, Wadsworth & Kubrin (2007) further found that economic advantage leads to lower suicide rates among Hispanics. In other words, the better off, economically, a Hispanic person is, both in comparison to other Hispanics and in comparison to whites, the less likely that person is to take his or her own life. Also, the more educated a Hispanic is, the less suicide. Therefore, Wadsworth and Kubrin (2007) theorize that Hispanic suicide can be lessened by giving disadvantaged Hispanics hope for a better future, as the researchers found that, in communities where there middle and upper class Hispanics, there is less suicide than in communities where there are not such examples. Therefore, the presence of middle and upper class Hispanics in a community leads to less suicide rates, not only because they provide a good example of what to aspire to, but also because these more middle and upper class Hispanics support churches, schools and neighborhood associations, and these are all institutions which are protective against suicide. Smith et al. (1986) looked at suicide among Hispanics who live in the Southwest part of the United States. They found that the 5 year suicide rate for whites in the southwestern states was higher than for all whites nationally, and that the suicide rates for white non-Hispanics was twice the rate than for white Hispanics. However, they state that a possible bias in the study was that undocumented Hispanics were not represented in the statistics, which might account for some of the differential enumeration of Hispanics and Anglos in the current population survey data that the researchers that were used. Zayas et al. (2005) looked at why so many Latina teens attempt suicide. They noted that adolescent Latinas have a higher reported suicide attempt rate than the non-Hispanic counterparts. They stated that Hispanic familism is strong, in that the family was central in institutional structures of Latin American societies and that the family has an important governing role in the life and behavior of the individual. The family is where the Latinas get their self-identity and social world. There is a deference to the family and the needs of the family, which means that there is more interdependence in Latina families. Cultural traditions demand that Latinas be passive, demure, and “hyperresponsible for family obligations, unity, and harmony” (Zayas et al., 2005). They also found that migration, discrepant levels of acculturation, acculturative stress and other Hispanic sociocultural factors, and these are all important elements that would help understand Latina suicide attempts. This combines with socioeconomic disadvantage, the gender role socialization, and adolescent-parent conflict to raise the rates of suicide attempts. Other factors might be the fact that the Latinas often are living in a restrictive family environment with authoritarian parenting, which means that the parents are not able to be flexible in dealing with crucial development periods. Conclusion In looking at Hispanic suicides, it is clear that there are a variety of factors that would lead to higher rates. These have to do with culture issues. It also has to do with issues regarding acculturation and assimilation. It seems that there is an issue with integration into the dominant society – if Hispanics are around other Hispanics, which means that the Hispanics are able to keep their same traditions and beliefs that are traditional in their society, without feeling alienated and isolated, then this is a protective factor against suicide. What leads to more mental health issues also has to do with culture – some cultures are less likely to seek mental health because of stigmas and cultural beliefs, while other cultures are afraid to seek this health. Hispanic family issues also seems to lead to higher rates of suicide, as the authoritarian and inflexible nature of many Hispanic families leads to more suicide attempts because the family is not able to deal with developmental issues. These are only a few factors, and there are undoubtedly many more. References Greenfield, Patricia M., and Lalita K. Suzuki. "Culture and human development: Implications for parenting, education, pediatrics, and mental health." Handbook of child psychology 4 (1998): 1059-1109. General, S. (2001). Mental health: Culture, race, and ethnicity. Supplement to mental health: a report of the Surgeon General. Washington (DC): Government Printing Office. Smith, J. C., Mercy, J. A., & Rosenberg, M. L. (1986). Suicide and homicide among Hispanics in the southwest. Public Health Reports, 101(3), 265. Wadsworth, T., & Kubrin, C. E. (2007). Hispanic Suicide in US Metropolitan Areas: Examining the Effects of Immigration, Assimilation, Affluence, and Disadvantage1. American Journal of Sociology, 112(6), 1848-1885. Zayas, L. H., Lester, R. J., Cabassa, L. J., & Fortuna, L. R. (2005). Why do so many Latina teens attempt suicide? A conceptual model for research.American Journal of Orthopsychiatry, 75(2), 275-287. Read More