‘Taboo’ & ‘crazy:’ researchers examine mental health stigma

EL PASO, Texas (July 13, 2023) — Hispanic adults with mental health conditions were 17 percent less likely to receive treatment than their non-Hispanic white counterparts. But what causes this discrepancy and how can we fix it?

That’s a question recently asked by Jason Mallonee, DSW, assistant professor in the Department of Social Work at The University of Texas at El Paso.

“There is a higher likelihood of unresolved mental health conditions in this community and we want to try to understand that,” Mallonee explained. “What stops someone from seeking help or engaging in services and then, what can help someone?”

To answer his question, Mallonee and a team of graduate research assistants went straight to the source, studying the mental health perspectives of Hispanics living along the US-Mexico border in El Paso, Texas. These findings, published in the journal Frontier in Public Healthuncovering the pervasive stigma around mental health in Hispanic cultures and how social workers can help more members of the public seek treatment.

To conduct the study, 25 participants were recruited from an El Paso food pantry called the Kelly Center for Hunger Relief.

“What I’ve found in my research is that people who have difficulty meeting their basic needs also have a higher likelihood of developing an unresolved mental health condition,” explains Mallonee.

Participants were recruited by agency staff and assigned to smaller groups. Rose Escalante Lopez, who graduated with a master’s degree in social work at UTEP this spring, had focused one-on-one discussions in Spanish and English. Mallonee, who currently serves as president of the Kelly Center for Hunger Relief Board of Directors, does not participate in recruiting or focus groups to minimize conflicts of interest.

Small group discussions ranged from an hour to an hour and a half each and Escalante Lopez asked lots of questions to understand perceptions of mental health and potential barriers to seeking help.

Her response was shocking and shocked Escalante Lopez how taboo mental health is in society. Statements from participants include:

• “In the Latino community, everyone refuses to see a psychologist because they’re not crazy…”
• “When they hear of mental illness, they already think they have a bad brain.”
• “Something very taboo, something that isn’t needed if you are a man. You are a man and you don’t need help so they can control your mind.”
• “Embarrassed, scared, rejected, or people will say or bad-mouth me…”

“Listening to some of the participants’ experiences with mental health or the experiences of relatives, it was surprising to hear how they were taught to suppress their emotions,” said Escalante Lopez. “While there is better mental health acceptance today in the wake of the COVID-19 pandemic, the stigma around it continues to be a barrier to seeking services.”

Each discussion is recorded and then analyzed to identify overarching themes. In addition to identifying a need for mental health to normalize, the researchers paid attention to dissatisfaction with and distrust of current mental health services.

“Someone reported a two-year waiting list to see a psychologist,” says Mallonee. “Others have commented on how providers change so quickly that you have a new therapist every few months, so you will go through your story again and again.”

Mallonee added, “They tell us how they always get this ‘Mental Health Resource List’ with a number for help, but when they call, no one answers or returns calls. Those are all things that would make one stop looking for help.

Armed with this perspective, Mallonee recently started an evidence-based mental health program in El Paso called ‘Pensamientos y Platicas’ or ‘Thoughts and Conversations’.

This four-week program is facilitated by UTEP social work students and is intended to normalize the conversation around mental health and help those with mental health conditions cope and make plans to manage their condition and seek treatment when needed.

Mallonee was thrilled to see the impact of the program.

He says, “We took the recommendations from the focus groups and built this program from scratch while incorporating best practices.”

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About the University of Texas at El Paso

The University of Texas at El Paso is America’s leading Hispanic-serving University. Located on the westernmost tip of Texas, where three states and two countries meet along the Rio Grande, 84% of our 24,000 students are Hispanic, and half are the first in their families to go to college. UTEP offers 169 undergraduate, masters, and doctoral programs at America’s only open-access, top-level research university.