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When he first started to have panic attacks in junior high, Javier Morales remembered telling his mom. Her reaction was a question, what should we do?
“I was like, ‘I don't know. I have no idea.’”
Instead of seeing a doctor or a therapist, he told himself “You really need to manage this better.” Trying to brush off mental health problems happens a lot with children of immigrants like him, Morales said. He’s now a therapist in Farmington, Utah, and has seen this in his practice.
Utah recently passed a law to make it easier for people to become mental health providers. However, the state’s Hispanic and Latino population has a high need for this kind of care and faces other, unique obstacles in accessing it.
“I don't really think the terms anxiety or depression are used very often,” he explained. “I think it's more like, I guess the word in Spanish would be like ‘nervios,’ which means, like, your nerves. It's just my nerves. That's what's making me feel this way.”
Morales has had clients who’ve had anxiety or panic attacks and gone to urgent care, not realizing what it was. Oftentimes, “that’s their first exposure to a doctor saying you should consider talking to a therapist.”
A 2021 national survey showed only 36% of Hispanic and Latino Americans received mental health treatment. Compare that to 52% of non-Hispanic whites. In Utah, Latina women are less likely to report poor mental health or get diagnosed. That’s from a 2022 Utah Women and Leadership Project report.
Mi casa es tu casa
One barrier to getting help is finding a place where people feel understood – not just in language, but also culturally.
Latino Behavioral Health Services, a nonprofit in Salt Lake City, isn’t your usual mental health clinic. The waiting area has a kitchen, couches and a big dining table. Bright maps of Spanish-speaking countries line the walls.
As Natanael Choi, who started here as a client himself, gave a tour he noted the “living room vibe.”
Sometimes people come in just to do homework. Support groups often meet to play games, eat dinner and do service projects. The room is intentionally warm and welcoming to ease visitors into care, he said.
“When someone comes in, it’s the ‘mi casa es tu casa.’”
To further break down barriers, the clinic emphasizes peer support. Choi, who is now the director of that program, said it helped him when he was getting treatment.
“It helps me to know that I'm not alone. I think the unique characteristic of a peer support is that they can share their own story.”
For Olimpia Canizal, another client turned clinic employee, meeting with a peer changed her life.
“Para mí era maravilloso porque yo sabía que alguien podía salir de donde estaba porque había luchado y tenía la experiencia para proveerme a mí como salir,” she said in Spanish, her first language.
Canizal said it was “marvelous” to connect with someone there who fought and overcame their mental health issues. Their experience showed her how she could too.
To her, and for Choi, access to a clinic that isn’t critical of who they are or the language they speak is key.
“I know that when I come in the door, like, I'm not going to be criticized for being queer or for being Latino or for speaking Spanish,” Choi said.
Generational trauma
Even those who speak English often like to see a care provider who is also Latino. That’s in part due to what Amanda Martinez, the clinic’s director of operations, calls “immigration trauma.”
“White people don't know what that's like,” she said. “And so it's really hard to communicate or connect with people who might not have any knowledge of what immigration trauma is.”
Morales, the Farmington therapist, has seen this often in his practice. And that trauma can be passed down to the next generation, as it happened with him.
Morales’ mom worked in a shampoo factory, and he said she didn’t feel respected as a manager because she spoke with an accent. His dad drove garbage trucks, and felt like he was spoken to in a “discriminatory or racist way.” So when the kids brought up an issue, they didn’t have the energy for much. The message from them “was more like, ‘Hey, I'm really tired. And I had a really rough day. And we're just surviving right now.’”
Beyond that, many children take on even more responsibility by translating for their parents, which can “put a lot of stress on kids,” he said.
Latino Behavioral Health wants to raise awareness so people will know where to turn for help. Martinez said they try “to find spaces where Latino communities are and be there with a table.” They have clinics around the state, and now go once a month to rural areas like Moab and Price where mental health stigmas are even greater.
Canizal has seen lives change due to peer support. That connection with someone in their community opens the door to healing.
“Tú ves como al cliente cómo se iluminan sus ojos y llega algo a su cara diciendo, ‘OK, tengo esperanza de estar bien.’”
“You see how the client’s eyes light up, and something comes over their face that says, ‘OK, I have hope that I can get better.’”
