Fear Sadness Fear and Access to Mental Health Support

Mental health treatment is, in a certain regard, a widely accepted sector of the healthcare community. However, in spite of continued advances in this field, there remain many demographics which present a heightened and unmet need for mental health support. The review here, which assess two recent newspaper articles on the subject to mental health, reports on the need for an expansion and refinement of the responsibilities assumed by the mental health community.

Craft, C.H. (2012). U.S. mental health programs little help to Latinos, UC Davis study says. The Sacramento Bee.

A 2012 article by Cynthia H. Craft, published in The Sacramento Bee and entitled "U.S. mental health programs little help to Latinos, UC Davis study says," evaluates the relative experience of disenfranchisement from mental health treatment and counseling among Latinos living in the United States. The article evaluates the various cultural, economic and sociological reasons for this population's detachment from opportunities for psychological support. Here, it is clear that a number of obstacles persist which can prevent members of this demographic from ever seeking let alone received the support they need.

According to the article, the United States' mental health support system itself is ill-equipped to reach out to and effectively serve Latino clients. The article attributes this to a lack of sufficient resources for cultural and linguistic engagement and indicates that myriad steps must be taken to redress the absence of such resources. According to Craft, the UC Davis Center for Reducing Health Disparities released a study just this week revealing that an enormous gap existed between this population's mental health needs and the opportunities for treatment available to it. On this point, "according to Sergio Aguilar-Gaxiola, the study's lead author and director of the health disparities center, up to 75% of Latinos who do seek mental health services opt not to return for a second appointment. Cultural, social and language barriers are too high to surmount. The report, based on input from more than 550 Latinos, including some in Sacramento, found that the current workforce of psychologists and psychiatrists is ill-equipped to penetrate the disparities and bridge the cultural gulf." (Craft, p. 1)

This issue is only further compounded by the fact that many Latinos are unwilling to take the steps to find treatment when need presents itself. This can be attributed to a combination of cultural factors discouraging admission of mental health problems and to the contested legal status of many Latino immigrants in the United States. This latter reason may be a significant deterrent to many who might otherwise initiate contact with the mental health community.

Article Summary 2:

Ortega, J.R. (2012). Behavioral health expert talks future of mental, primary health care. Victoria Advocate.

A 2012 article by J.R. Ortega, published in the Victoria Advocate and entitled "Behavioral health expert talks future of mental, primary health care," draws the connection between primary healthcare and mental healthcare. The article indicates that the two dimensions of human health are inextricable and that, as a result, the degree to which we effectively treat mental health in the population will have a bearing on the medical health of the said population. Ortega's article centers specifically on the rising proportion of elderly Americans and the burden which this is increasingly placing on our public healthcare system.

Ortega asserts that the interconnectivity between primary and mental health will tend to intensify as one ages. As a result, the rising proportion of the elderly in our population denotes the need for a more encompassing and integrated identification of mental healthcare needs. According to Ortega, scholarly research has "placed focus on how both mental and primary health is directly linked. For example, depression leads to cortisol, which can later lead to a heart attack. David Way, associate director with Gulf Bend Center, agreed with Manderscheid, noting poor mental health can lead to health issues such as diabetes,

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This serves as the basic imperative for the idea asserted in Ortega's article, which calls for a high level of integration between primary and mental care. Ortega refers to this ambition as an agenda toward 'wellness,' a notion that expands western thinking on individual health to include mental, emotional and psychological conditions in assessing one's general health outlook.

Synthesis:

The two articles summarized here above merge to demonstrate that the ever-expanding role of mental healthcare in public life must be adapted to meet the needs of certain concentrated populations. These articles also denote that such determinants as fear can play a direct part in impeding our collective ability to meet these needs. The synthesis of these articles with lessons drawn from our course discussions and materials demonstrates that the mental health community must devise culturally attuned strategies aimed at countering this fear.

The Craft article is explicitly driven to this end. Indeed, what is particularly compelling about the article by Craft is that it underscores the role that culture can play in one's relationship to mental health treatment or the mental health community in general. Craft's focus on the experiences of Latin American immigrants helps to demonstrate the need for outreach but, beyond this, the need to tailor message effectively and to cater to the specific set of needs reflected in this specific demographic. Indeed, the article demonstrates the role that fear can play not just in intensifying the need for mental health counseling but also in shaping the way that this counseling is pursued.

In the Craft article, management of fear does play a direct part in the process of reaching out to a demographic in need. As, Moheno, a counselor for a community of migrant Latino farm-workers indicates, there are particular notes of caution in working with Hispanic clients, who tend to express cultural resistance when confronted with terms such as 'mental health.' Instead, Moheno reports that there is a need to choose one's words with care so as not to inflame the fear and apprehension of those who might otherwise benefit from direct counseling. Moheno indicates that "When I talk to them in forums, or out in the fields, I don't use words like "mental health," Moheno said Monday. 'I say, "Are you interested in having a better life, a life of tranquility?" I had to change my wording in order to reach people.'" (Craft, p. 1)

Craft points out that for many Latino immigrants, there is a cultural resistance to obtaining treatment for mental health maladies, with shame and embarrassment often playing a part in this resistance. Moheno confirms this point, indicating that these feelings are only exacerbated by interaction with a system that possesses neither the cultural nor the linguistic tools to effectively engage the Latino population. Craft reports that "stigma and shame over mental health issues are enough to stop some Latinos from seeking assistance, the study's authors said. And without someone to speak to in a shared language, reticence can become more acute." (Craft, p. 1)

This underscores the manner in which the fear both to admit that one suffers from mental health maladies and the fear of engaging the healthcare system head-on can function of true deterrents for those who might otherwise benefit substantially from treatment. This news item highlights the need for improvements in the linguistic versatility of the mental health system and in its efforts to engage Latino communities on their own terms. The call here for improvement in terms of outreach compliments the findings drawn from the Ortega article as well, which indicates that refinement of processes is also required for handling the ever-growing population of America's elderly citizens. Here, Ortega implies that there is a reigning fear that carries distinct political implications.

Namely, many elderly Americans who live in full recognition of their physical ailments and maladies may possess neither the wherewithal nor the willingness to concede to suffering related mental infirmities. According to the…