Mental Health

Mental health, as defined by the Surgeon General's Report, "refers to the successful performance of
mental function, resulting in productive activities, fulfilling relationships with other people, and the
ability to adapt to change and cope with adversity." On the other end of the spectrum is mental illness,
entailing health conditions characterized by alterations in thinking, mood, or behavior. Mental illness
encompasses many disorders, from major depressive disorder (MDD) to schizophrenia to
obsessive-compulsive disorder (OCD). Mental illness can take on many forms and not all individuals
present symptoms in the same way – some people experience early onset, while some disorders do not
emerge until later in life. Some people who experience mental illness have only mild symptoms and
benefit greatly from treatments, while other mental disorders are more severe and persistent, requiring
very involved interventions. There are also vast differences in the way people understand and approach
mental health, depending on culture, education, personality, accessibility, and many more factors.

Historically, people who were deemed neurodivergent have been isolated from society in the same
manner as criminals, either relegated to prisons or psychiatric wards. Mental health facilities in the past
often had extremely poor conditions, and effective treatments were scarce. As time has gone on, we
have come to better understand mental illness and developed interventions that are not only more
successful, but allow patients more agency regarding their own health. But has our attitude toward
those with mental illness changed all that much? We no longer subject patients to the same painful and
ethically questionable treatments as those used in the past, but how far have we come in reducing the
stigma surrounding mental health? How are those with mental illness depicted in the media and treated
by law enforcement? What kinds of protections exist in institutions, such as schools and workplaces, to
support those with mental illness and bolster mental health?

Research has shown that women find it easier to speak about mental health concerns, whereas men
often encounter barriers. Why might this be? Why has mental health research often failed to include
people in the LGBTQ+ community and communities of color? What efforts are being made to support
the mental health of these underserved populations? How does treatment accessibility differ across
socioeconomic status, race, gender, sexual orientation, and location? Should insurance plans and
pharmaceutical companies be regulated on the costs of psychotropic medications? While covering this
section, think about society’s general impression of mental health and how it has evolved over the
years. How does this attitude translate into concrete public health approaches? How does our general
population fare in terms of mental health? How can mental health be improved, and how will this
impact public health overall?

Resources:
● National Institute of Mental Health - [Link]
● National Alliance on Mental Illness - [Link]
● California Department of Health Care Services: Mental Health Services Division -
[Link]
● Anxiety and Depression Association of America - [Link]
● National Eating Disorders Association - [Link]
● American Institute of Stress - [Link]
● National Center on Sleep Disorders Research -
[Link]
research
 ● Children and Adults with Attention-Deficit/Hyperactivity Disorder - [Link]
● The Trevor Project: Mental Health -
[Link]
● National Queer and Trans Therapists of Color Network - [Link]
● Substance Abuse and Mental Health Services Administration - [Link]
● National Alliance on Mental Illness Statistics - [Link]
● University Health Services: Mental Health -
[Link]

Statistics:
● Approximately 1 in 5 adults in the U.S., or 46.6 million, experiences mental illness in a given
year (NAMI). 1 in 25 adults in the U.S. experience serious mental illness, and 17% of youth ages
6-17 experience a mental health disorder (NAMI).
● LGBTQ+ teens are 6 times more likely to experience symptoms of depression than non-LGBTQ+
identifying teens (Anxiety & Depression Association of America - 2018).
● 48% of transgender adults report that they have considered suicide in the last year, compared to 4
percent of the overall U.S. population (National Center for Transgender Equality - 2016).
● About 50% of people who experience a mental illness will also experience a substance use
disorder at some point in their lives and vice versa (National Institute on Drug Abuse - 2018).
● According to a 2015 report by the U.S. Department of Housing and Urban Development, a
minimum of 140,000, or 25% of people experiencing homelessness were seriously mentally ill,
and 250,000, or 45% had any mental illness. By comparison, a 2016 study found that 4.2% of
U.S. adults have been diagnosed with a serious mental illness.
● Eating disorders have the highest mortality rate of any mental illness, and every 62 minutes at
least one person dies as a direct result of an eating disorder (National Association of Anorexia
Nervosa and Associated Disorders).
● Serious mental illness costs America $193.2 billion in lost earnings per year (NIMH).
● Over one-third (37%) of students at least 14 years of age who have a mental health condition and
are served by special education drop out—the highest dropout rate of any disability group
(NAMI).
Understanding Mental Health as a Public Health Issue
[Link]/blog/mental-health-public-health

January 13, 2021

Poor mental health not only affects a person’s ability to live a fulfilling life and carry on with
their school, work, or familial responsibilities; it also can lead to physical and social problems
with serious impacts. By advocating for prevention and developing effective interventions,
public health professionals help individuals and communities combat mental health issues.

Mental Health as a Public Health Issue

Public health aims to promote healthy lifestyles, as well as to detect, prevent, and respond to
diseases. The prevalence of mental health issues that affect individuals’ physical and social
well-being makes dealing with mental health integral to achieving public health goals.

To begin with, mental health has a huge impact on how people relate to others, make
decisions, and handle stress. People’s ability to live fulfilling lives often depends on their
mental health. This makes protecting and restoring mental health of immediate concern to
public health professionals.

Mental Health and Social Relationships

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Poor mental health influences people’s relationships with their children, spouses, relatives,
friends, and co-workers. Often, poor mental health leads to problems such as social isolation,
which disrupts a person’s communication and interactions with others. This can have
particularly harmful effects on children and adolescents whose development depends on
forming bonds with their family members and peers. In adulthood, this social isolation can
lead to family breakdown, divorce, or even childhood neglect.

Mental health problems frequently put financial and emotional strain on families. For
example, a family trying to address a child’s mental illness may exhaust untold funds in
search of treatment. Individual family members may also struggle to cope with their own
symptoms that require support, such as depression or sleeping problems.

Children who have family members experiencing mental health problems may blame
themselves. This can result in loneliness and feelings of being different. It may also lead to
future behavioral or social problems. Additionally, as families address their loved ones’
mental health problems, they may socially isolate out of fear of judgment from others, further
disrupting their emotional well-being.

Mental Health and Substance Misuse

A clear relationship exists between mental health issues and substance misuse. Each can lead
to the other. In fact, one in four people with a serious mental illness also has a substance use
disorder, according to the National Institute on Drug Abuse. Data from the Substance Abuse
and Mental Health Services Administration (SAMHSA) shows that people with mental health
issues are also at greater risk of using nonprescription opioids.

People with mental illness consume substances that harm their health at higher rates than
people without mental health issues, according to the 2018 National Survey on Drug Use and
Health. Consider the following statistics: 37 percent of individuals with severe mental health
issues smoke cigarettes, while only 16 percent of people without mental health issues smoke;
nearly a third of adults with severe mental health issues are binge drinkers, compared to a
quarter of people without mental health issues who report binge drinking.

Additionally, the National Institute on Drug Abuse reports an increased risk for the
development of substance use disorders among children and adolescents with mental
disorders. The research shows that children develop mental health issues such as depression
and anxiety before they develop substance use disorders, suggesting mental health issues
lead to problems with alcohol and drugs.

Mental Health and School

Evidence suggests that poor mental health affects people’s educational success. Many
students experiencing mental health issues struggle to form positive relationships with their
teachers. They may also find it difficult to concentrate, feel motivated, or follow school rules.

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This often results in disciplinary measures that can interrupt their learning process.

According to the Child Mind Institute, the suspension/expulsion rate for students with
emotional disturbances, for example, is 64 percent. Additionally, every year nearly 28,000
students with mental health issues and other health issues drop out of school. These
individuals who drop out are 63 times more likely to end up in jail than college graduates.
People with no high school diploma also live 9.2 years less than high school graduates.

Public health professionals know that education levels play an important role in many
aspects of a person’s wellness and quality of life. In fact, greater levels of health correlate with
higher levels of education. The Centers for Disease Control and Prevention (CDC) reports
that the mortality rates of people with some college are half of those of people who never
attend college. Rates of diabetes and asthma are also lower for people who attain higher
levels of education.

Mental Health and Work

Mental health issues can also lead to struggles at work. Mental health issues often reduce
concentration, which can compromise a person’s productivity. The National Alliance on
Mental Illness reports that difficulty focusing often accompanies depression. Reduced
productivity can limit one’s ability to earn promotions, excel, and build successful
relationships with supervisors and co-workers, which ultimately affects job satisfaction.
Mental health issues can also lead to increased absenteeism at work. This can result in job
loss or reduced hours, which affects a person’s ability to earn a living.

Job loss can result in the loss of health insurance, and the loss of health insurance reduces
people’s access to health care, which can result in untreated health conditions and the
inability to receive preventive care. A diminished ability to earn a living can also lead to
poverty, which affects people’s ability to find housing and receive a quality education, among
other things.

Mental Health and Physical Wellness

Mental health issues influence the onset, development, and effects of physical illnesses.
Often, high-risk behaviors such as substance misuse and physical inactivity correlate with
poor mental health. Research also indicates that mental illness could reduce life expectancy
by 20 years, according to a 2019 study published in The Lancet Psychiatry. The study found
people with depression have a 40 percent higher chance of developing cardiac disease,
hypertension, stroke, and diabetes than the general population. In addition, the study found
that mental illness can reduce life expectancy by up to 20 years. Such statistics highlight that
public health and mental health are two sides of the same coin.

Mental Health and Marginalized Communities

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Marginalized communities consistently experience worse mental health than other
communities for preventable reasons. Racial, gender, and sexual minorities, as well as people
from low socioeconomic backgrounds, often find themselves particularly hard hit by mental
health issues.

Case in point, Black individuals make up about 12 percent of the US population, but as a
result of historical social, economic, and political inequalities, they comprise around 40
percent of those who are homeless, 50 percent of those who are incarcerated, and 45 percent
of the children in foster care. Homelessness, prison, and experience in the foster care system
all increase a person’s probability of having a mental health condition. As such, Black
individuals are often at greater risk for mental illness than others. Consider the following
additional mental health disparities among marginalized communities reported by the
American Psychiatric Association:

Up to 75 percent of youth in the juvenile justice system, who are disproportionately

from racial and ethnic minorities, have mental health disorders.
Minority youth who have behavioral problems are more likely to be referred to the
juvenile justice system than to healthcare providers, compared to non-minority youth.
LGBTQ individuals experience depression, anxiety, and substance misuse at a rate 2.5
times higher than heterosexual individuals.
Healthcare providers are less likely to offer African-American patients evidence-based
medication therapy or psychotherapy than other populations.

Factors contributing to mental health disparities among marginalized communities include

limitations to health care access and negative perceptions about mental health treatment.

Poor Access to Mental Health Care Services

Marginalized communities face many barriers to receiving needed mental health care. For
one, individuals from these communities are overrepresented in jobs that do not provide
health insurance. Without health insurance, few can afford any type of mental health care
service.

Historically, people from marginalized backgrounds with insurance have encountered

discrimination when receiving care or disparate treatment. For instance, Black individuals
are offered medication and therapy for their mental health issues at lower rates than the
general population, according to the American Psychiatric Association.

A lack of cultural competency among mental health care providers can diminish the quality
of care marginalized individuals receive as well. According to Mental Health America, the
fact that less than 2 percent of American Psychological Association members are Black makes
it especially difficult for Black individuals to receive culturally competent care. Organizations
that influence treatment approaches need more reflective representation within their ranks
to expand marginalized communities’ access to mental health care.

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Therapeutic relationships depend on understanding and comfort. A lack of diverse
representation in the mental health field can limit both and makes it harder for mental health
professionals to understand their patients’ identities and address them openly.

Finally, language barriers and implicit bias can interfere with access to mental health
services, resulting in individuals giving up on treatment or not recovering completely.
Additionally, many marginalized people have fewer mental health professionals in their
communities, which can pose challenges to accessing care as well.

Cultural Stigmas and Negative Perceptions About Mental Illness

Cultural stigmas and negative perceptions about mental illness can discourage individuals
from getting help. Attitudes about mental health issues vary among different communities.
Both religious ideas and cultural perceptions can shape how people feel about getting mental
health care.

Sometimes these ideas and perceptions stigmatize mental illness, which can prevent people
from seeking treatment for themselves or loved ones. In some cases, communities may
discourage men from showing any signs of weakness. This can result in reticence among men
to seek needed mental health treatments.

Understanding different cultural perceptions about mental health is key to developing

culturally sensitive programs and services accessible to members of all communities.

The Role of Public Health Professionals in Promoting Mental Health

Public health professionals play a key role in tackling the factors that adversely influence
mental health. Addressing a community’s well-being requires a comprehensive approach. To
promote mental health, public health professionals find ways to prevent mental disorders,
improve access to mental health services, support recovery, and lower the rate of death,
disease, and disability among those with mental illnesses. They also work to increase
awareness of mental health issues and reduce stigmas, so people can get the treatment they
need. Finally, they strive to eliminate health disparities and provide equitable access to
health services.

Prevention and Intervention

Public health professionals develop programs that address the factors that contribute to poor
mental health or focus on intervention methods known to foster good mental health.
Identifying risk factors for mental illness, such as trauma and chronic health conditions,
plays an important role in implementing prevention programs. Identifying risk factors also
allows for early intervention. Examples of prevention and intervention strategies that can
promote mental health include early childhood programs, programs for older adults, and
violence prevention initiatives.

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Early Childhood Programs

Early childhood intervention programs for at-risk children offer stable, emotionally
supportive environments, learning opportunities, and interactions that stimulate
development. These efforts help positively shape the architecture of children’s brains and can
improve their chances of experiencing sound mental health throughout their lives.

The Infant and Early Childhood Mental Health Consultation (IECMHC) program, for
example, helps families and adults who work with young children strengthen their ability to
cultivate healthy environments that support a child’s social and emotional development. The
program aims to respond before intervention is required.

IECMHC brings mental health consultants to childcare centers, homes, and preschools where
they may engage in the following:

Consult with preschool staff, sharing strategies and insights regarding how to handle
the mental health needs of families with infants and young children.
Provide childcare staff with referral information for mental health services appropriate
for young children.
Consult with administrators regarding policies that support mental health and provide
information about the effects of policies, such as expulsion, that affect mental health.

Programs for Older Adults

Programs that support older populations who face isolation may offer social activities,
interactions with the community, and assistance dealing with other social and emotional
issues. Such programs offer vital support to older adults, 20 percent of whom experience
some kind of mental health issue, according to the CDC.

A recent study published by the Scandinavian Journal of Public Health found the most
effective mental health intervention programs for older adults tend to have certain
characteristics in common:

They take into account the individual needs and preferences of the older adults so as to
develop motivation. Participant motivation is key to improving mental health in this
population.
They continuously adjust to the changing physical, cognitive, social, and mental
functioning levels of the older adults they serve.
They prioritize group-based intervention strategies that offer a social component.

The National Council on Aging lists several programs that can improve older adults’ mental
well-being:

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 Healthy IDEAS (Identifying Depression Empowering Activities for Seniors) aims to
detect and mitigate depression symptoms in seniors who have chronic conditions or
limited abilities to function. The program screens and assesses older adults and
provides education and referrals for mental health professionals as appropriate.
Brief Intervention and Treatment for Elders (BRITE) provides substance abuse
intervention for seniors. The program offers substance abuse screening, identifies
nondependent use of substances and prescription medication issues, and offers
intervention strategies that prevent those issues from requiring extensive substance
abuse treatment.

Violence Prevention Initiatives

The American Public Health Association reports that violence significantly harms children’s
development and affected communities’ health. In addition to causing physical harm,
violence and associated trauma negatively impact behavioral and mental health. In fact,
trauma has been linked to substance misuse and self-injury, as well as depression, anxiety,
and post-traumatic stress disorder (PTSD), according to the Substance Abuse and Mental
Health Services Administration.

Programs that challenge social norms, reduce risk factors for violence, and cultivate
resilience help improve a community’s health. For instance, in some communities, attitudes
about a woman’s sexual purity and family honor have led to violent acts. Violence prevention
initiatives can take on such ideas and make it harder to justify violent behavior on the basis
of a social norm.

Whether addressing intimate partner violence or firearm violence, evidence-based programs

can have an impact on this public health issue. The CDC offers recommendations for effective
approaches to prevent every type of violence. Some proven strategies for addressing intimate
partner violence include:

Bystander empowerment programs and education

Social-emotional learning programs for children and adolescents
Healthy relationship programs for couples

In addition to specialized approaches to the different types of violence, the CDC focuses on
strategies that apply to addressing all types of violence:

Starting prevention efforts early and continuing them through life

Identifying the populations at greatest risk for experiencing and perpetrating different
types of violence
Building prevention programs that consider the risk and protective factors most likely
to influence several types of violence so as to make the broadest impact

Policy Advocacy

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Public health professionals can fight for policies that foster mental health and allow people
living with mental illness to thrive. A public health advocate might work to reduce
homelessness and incarceration rates — circumstances that exacerbate mental illness and
disproportionately affect people with mental illness. Public health advocates work to change
systems that perpetuate mental health problems and the undignified treatment of people
with mental illnesses.

A group of mental health organizations including Mental Health America and the National
Council for Behavioral Health recently sent a letter to Congress advocating for policies that
address mental health during the COVID-19 pandemic. Specifically, the letter exhorted
Congress to:

Ensure that nonprofits receiving Medicaid reimbursements are still eligible for the
emergency Small Business Loan Program because they are experiencing significant
losses due to COVID-19, which can affect their ability to provide mental health services.
Expand flexible reimbursement policies regarding telehealth in Medicare to include
audio only telephone services so millions of Medicare patients vulnerable to COVID-19
and in need of mental health care can get the help they need.
Allocate more funds for mental health and addiction care.

Mental Health Research

To identify comprehensive prevention strategies and intervention methods, public health
professionals need evidence. When professionals conduct research through a public health
lens, they uncover the evidence they need to develop the most effective approaches to
prevention and treatment. Research also identifies causes of mental health problems,
informing public health professionals’ work in policy advocacy, prevention, and treatment.
Research illuminates the public health professional’s understanding of mental health at the
individual and community level. Whether studying suicide using an epidemiological
approach or examining social media’s effects on self-image, research offers public health
professionals important insights.

Earn a Master of Public Health and Tackle Mental Health Disparities

Mental health issues put people at a disadvantage. Not only do mental health issues
compromise people’s well-being, they levy social and physical consequences as well. To help
individuals and communities foster their individual strengths, gain access to care, and
address disparities related to poor mental health, public health professionals need empathy,
as well as expertise in the best intervention and prevention strategies. Explore how Tulane
University’s Online Master of Public Health program equips graduates to tackle mental
health disparities and build healthier communities.

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Colleges Tap Outside Companies to Address Student
Mental-Health Crisis
[Link]/articles/colleges-tap-outside-companies-to-address-student-mental-health-crisis-11666356507

October 21, 2022

College students are increasingly seeking help when they are overwhelmed by academic
assignments, drifting toward depression or in the throes of suicidal thoughts, school officials
say.

Schools buckling under the heavy demand for mental-health services now are finding help of
their own, via virtual-counseling companies.

Hundreds of institutions, from Diablo Valley College in California to Dartmouth College in

New Hampshire, are joining with companies including TimelyMD, Uwill and Talkspace to
ease the burden on their campus-based counseling centers and give students more options
for which counselors to see, when and how. In addition to live therapy sessions and text
messaging, some services also have 24/7 crisis hotlines that connect students to clinicians in
a matter of minutes.

This fall the University of Kentucky signed a $1 million annual contract with teletherapy
company Talkspace Inc. to give students free round-the-clock access to counselors via text
and up to two live video or phone sessions a month.

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Over the prior six years, the school of 32,000 students had expanded its counseling center
staff by more than 50% and stayed open two extra hours each day. Still, its wait list for
services could regularly balloon to 80 students, with wait times up to three weeks for an
intake appointment, and another few weeks to begin therapy.

Kentucky’s campus is now blanketed with signs advertising Talkspace as a convenient option
for students seeking therapy, or who just need some reassurance ahead of a coming exam
period or want to learn calming techniques.

“Mental health issues can’t be addressed on a 9-to-5 basis and only in person,” said Sandra
Doran, president of Bay Path University in Longmeadow, Mass. She likened the need to
address college students’ mental health to the importance of children eating breakfast before
school: Without it, she said, “You’re not equipped to learn.”

The University of Kentucky signed a $1 million annual contract with Talkspace to give
students a convenient therapy option.
Forty-one percent of college students screened positive for depression in winter 2021, up
from 17% in 2013, according to the Healthy Minds Study, which surveys tens of thousands of
students annually. Positive screenings for anxiety rose to 34% from 17% in that time. Many of
America’s young adults are at a crisis point, public health experts say, exacerbated by the
pandemic’s startling and prolonged isolation.

Before the pandemic, Bay Path offered in-person counseling on weekdays. But only 26% of
the roughly 3,000 students take classes on campus; the rest attend entirely online.

The school is now one of more than 100 that contracted with Uwill Inc., which focuses
specifically on teletherapy for college students. Ms. Doran said even campus-based students
opt for the more convenient and discreet virtual option—and give the program high marks,
according to feedback surveys.

Colleges are trying a range of ways to reach more students on campus. They are offering
shorter appointments, encouraging group therapy, creating peer-support programs, referring
students to outside clinicians and sending students to workshops on stress relief and

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mindfulness before starting counseling.

Teletherapy is proving a particularly useful tool in the arsenal of support services. Dartmouth
College liked that Uwill could provide unlimited therapy sessions to students, as its campus
counseling center focused on shorter treatment timelines. For Swarthmore College in
Pennsylvania, Talkspace was appealing because its psychiatric service could provide
medication management during school breaks.

At the end of each virtual-counseling visit, Timely Telehealth LLC, known as TimelyMD, asks
students what they would have done without access to that service: gone to a campus-based
clinic, gone to urgent care, or done nothing. More than 60% of students say they would have
done nothing, said CEO Luke Hejl.

Colleges are offering shorter appointments, encouraging group therapy, referring students to
outside clinicians and sending students to workshops on stress relief before starting
counseling.
TimelyMD, founded in 2017, exploded at the start of the pandemic, as schools hurried to give
students access to counselors when campuses shut down. Licensing rules meant therapists
based on campus couldn’t necessarily serve students living across state lines.

The company now has 230 school clients, which together enroll 1.5 million students,
including a number of California community colleges, James Madison University, University
of Chicago and University of San Diego.

Roughly 45% of their mental-health appointments are outside regular business hours, and
Mr. Hejl said he sees his company augmenting, not replacing, in-person services.

The share of students who screen positive for depression, anxiety, eating disorders and other
concerns but haven’t gotten any treatment is especially large among students of color,
according to research by Sarah Lipson, an assistant professor at Boston University’s School of
Public Health and principal investigator of the Healthy Minds Network, which runs the
Healthy Minds Study. The highest rate of recent treatment for Asian, Black and Latino
students who screened positive was at or below the lowest rate for white students, she found.

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Teletherapy—particularly access to a more diverse set of counselors than might be available
on campus—could prove helpful in closing that gap, she said.

School-based clinicians tend to be a less diverse group than the students they serve,
according to surveys of center directors. The ability for students using teletherapy platform
Uwill to input preferences—such as gender, ethnicity and native language—to match with a
therapist was a major selling point for Western Michigan University.

“They can see a counselor on their own terms, in a way they’re most comfortable,” said
Reetha Raveendran, the school’s associate vice president for student affairs and dean of
students.

Western Michigan is paying $174,000 a year to give students access to at least three 30-
minute live sessions, as well as a 24/7 crisis hotline.

Elisha Ewing, a third-year engineering student at Western Michigan who as a member of the
student government was involved in discussions about the Uwill partnership, said Covid-19
“opened up the doors to a whole new demographic of students to have access to therapy.”

“If Covid taught us anything, it’s that things that we didn’t think could happen in the virtual
world could be even better,” she said.

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Moving past mental health stigma in the Latino
community
[Link]/News/Meriden/Meriden-News/Moving-past-the-mental-health-stigma-in-the-Latino-
[Link]

A stigma attached to mental health services prevents some Latinos from seeking help because
they fear talking openly about problems or worry that seeking help may cause people to view
them differently.

Professionals and organizations, like the American Mental Health Counselors Association,
stress the importance of viewing mental health just like physical health. Visiting a mental
health professional is no different than going to a doctor for a physical ailment.

The stigma attached to mental health treatment affects many ethnic minority groups,
including Latinos, who may fear being seen as crazy or psychotic, according to the National
Alliance on Mental Illness. A lack of information also contributes to a continued stigma about
mental health, noted NAMI.

Hispanics and Latinos make up 18.5% of the population, according to the U.S. Census
Bureau. Of those, over 16%, approximately 10 million people, have had a mental health
illness within the last year. According to the National Alliance on Mental Illness, more than
half of Hispanic young adults ages 18-25 that have serious mental health issues have not
received treatment.

“The Latino culture is generally a happy culture,” said Zorayda Cocchi, wellness consultant
and mental health activist in Wallingford. “So when someone is upset for any other reason
other than a tragic event, it’s something not many people in the community know how to deal
with.

“Many people grow up in these environments and then aren’t sure how to express their
feelings,” Cocchi added.

The saying “la ropa sucia se lava en casa” is something most families go by. It’s similar to
“Don’t air your dirty laundry in public” and means that problems at home should stay in the
house and shouldn’t be shared with strangers, explained the NAMI website.

Generational trauma
“The idea of “machismo” is a sense of masculine pride. It oftentimes is a barrier that keeps
people from recognizing that it’s OK to seek help. Specifically when it comes to talking about
depression and suicide,” according to the website Mental Health Match.

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Liz Schacht, a counselor at Yale University and former social worker for the Department of
Children and Families, said she has helped Hispanic men who felt they couldn’t express their
feelings.

“Some men feel pressure and it can impact their life with their children,” Schacht said.
“Having to take care of their family can add stress and cause them to ignore getting help.”

During her six years as a social worker for DCF, Schacht had cases where children would hold
back on their emotions because it’s what they were taught from a young age.

“Parents are the children’s first teacher and if they are suppressing their problems then
children will learn to do the same,” Schacht said.

Schacht says it’s also common for immigrants who have recently moved to experience
trauma.

“I moved here from Peru when I was in my twenties,” Schacht said. “It can cause trauma
because for most people you’re moving to another country with no family, guidance, or help.”

Schacht also noticed that some Latino parents don’t seek help because they think it would be
selfish to take care of themselves.

“I tell parents that taking care of their mental health is important because it can help them be
there for their children,” she said.

What not to say

■ Saying nothing is better than saying the wrong thing.

■ Cocchi suggests that taking the word “just” out of the beginning of the sentence can be
impactful. “When people add the word ‘just’ it makes it seem as though their problem is easy
to fix,” Cocchi said. “Saying things like ‘oh just be happy’ or ‘just try this’ can make the person
feel as though they aren’t trying hard enough.”

■ Another important factor to be conscious of is religion. Bringing up religion can make an

individual feel as though they aren’t trying hard enough. “When people tell you to just pray
harder and God will heal you — it minimizes the effort that the person is doing,” Cocchi said.
“Most likely that person has prayed so much and now they probably think they aren’t praying
enough or don’t believe enough.”

Schacht added that churches should become knowledgeable on this topic so they can stop the
stigma. “Instead of further enforcing the stigma, churches have the power to help people in
the community who need help,” Schacht said.

■ Active listening is a powerful tool, says Cocchi. The tool allows people to hear their peers
out without the possibility of saying something hurtful.

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Community help
It’s important for people to get help without language barriers. Sometimes not being able to
communicate prevents individuals from seeking help.

“It’s important for people to be able to get the right help,” Cocchi said. “When they reach out
to someone who speaks their language it can create trust and confidence.”

In addition, Schacht said people who have access to resources have a higher chance of
moving past the stigma to receive help.

Cocchi, also a yoga instructor, has her own website called Zorayda Yoga & Wellness. She’s
seen the way yoga has helped people get in touch with their emotions. Sessions are held
online.

“As someone who has influence over my students, I find it important to make sure they’re
doing well mentally. I can see a difference in these people’s lives.” Cocchi said.

Rushford, a mental health service provider, has a location in Meriden at 883 Paddock Ave.
One service offered is a Latino Intensive Outpatient Program.

According to Rushford’s website, the program offers group therapy in Spanish. The
treatment focuses on gaining the skills and confidence needed to cope with mental illness
and/or substance use issues. The program offers clinical treatment five days a week from 9
a.m. to noon, with three groups per day.

For more information visit [Link]

treatment/latino-intensive-outpatient-program or call 877-577-3233.

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