Facilitators and Barriers to Latinx Adolescents Discussion of Mental Health Needs with Caregivers and Use of Mental Health Services

Latinx youth are most likely to report declining mental health symptoms compared to youth from other ethnic-racial groups in the US. This includes higher rates of depressive symptoms and suicidality, while also being less likely to access mental health services. Among Latinx communities, mental health stigma may have a particularly profound impact due to elevated rates of harboring negative beliefs about mental illness and treatment. Limited or inaccurate information about mental illnesses, such as depression and anxiety– as well as the role of medication and therapy as treatments– also contribute to increased stigma and pose serious obstacles for accessing care. When individuals have a better understanding of the biological causes of mental health disorders, they tend to hold less stigmatizing views. As such, psychoeducation about the presentation of mental illnesses and available treatment options can increase mental health literacy, and, in turn, reduce stigma. Past studies have found that Latinx youth are often hesitant to discuss their mental health needs with their parents to avoid overwhelming them. This lack of communication, coupled with stigma and low mental health literacy profoundly impacts the mental health of Latinx youth.

In an effort to better understand some of the barriers Latinx youth from immigrant families experience to access mental health care, we conducted six focus groups (n = 56 individuals) with Latinx immigrant parents (n = 29) and their adolescents (n = 27) aged 14-18. Participants lived in Michigan, North Carolina and Texas. They were from varied South and Central American countries (e.g., Mexico, Venezuela, Dominican Republic, Bolivia, Costa Rica). Thematic analysis highlighted important barriers preventing youth from accessing mental health care.

Mental health stigma impacted both youth and parents, which prevented dialogue about mental health from taking place. The youth reported concerns of judgement or symptom minimization by parents as some of the reasons for not sharing their mental health needs in the home. Additionally, there were noted discrepancies between parental and adolescent understanding and conceptualization of mental illnesses and treatment. Adolescents were more likely to wait until symptoms were severe before asking for help, while parents indicated a desire for more information on mental health overall, including identifying symptoms, understanding available treatments, and ways to approach the topic with teenagers. Adolescents explained the role trust plays in facilitating self disclosure of mental health struggles and asking for support. They also indicated a desire for parents to not disclose the youth’s mental health information to members of the broader community due to fears of being labeled “crazy” by others. They also wished to feel accepted and loved by their families despite their struggles with mental health.

These findings highlight the need for interventions focusing on reducing mental health stigma, increasing mental health literacy, and supporting conversations about mental health between Latinx immigrant parents and their adolescents to increase youth’s access to mental health treatment. Practitioners can further support family discussions about mental health by providing tools to decrease stigma and improve mental health literacy, helping Latinx youth access the care they need.