‘Taboo’ & ‘crazy:’ researchers examine mental health stigmas on the border

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

That was a question recently posed by Jason Mallonee, D.S.W., an assistant professor in the Department of Social Work at The University of Texas at El Paso. 

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

To answer his questions, Mallonee and a team of graduate research assistants went straight to the source, studying the mental health perspectives of Hispanics living along the U.S.-Mexico border in El Paso, Texas. The findings, published in the journal Frontiers in Public Health, reveal the pervasive stigmas surrounding mental health in the Hispanic culture and how social workers may help more community members 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 have found in my research is that people who have a difficult time meeting their basic needs also have a higher likelihood of unresolved mental health conditions,” Mallonee explained. 

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

Small group discussions ranged from an hour to an hour-and-a-half long each and Escalante Lopez posed multiple questions to understand mental health perceptions and potential barriers to seeking help.

The responses were striking and it surprised Escalante Lopez just how taboo mental health is in the community. Statements from participants included:

• “In the Latino community, everyone refuses to see a psychologist because they are not crazy…”
• “When they hear mental illness, they already think they have a bad brain.”
• “Something very taboo, something that is not needed if you are a man. You are a man and you do not need help so they can control your mind.”
• “Shame, fear, rejection, or that people will say or speak ill of me…”

“Listening to some of the participants’ experiences with mental health or a relative’s experience, it was surprising to hear how they were taught to suppress emotions,” Escalante Lopez said. “Even though today there is a better acceptance of mental health after the COVID-19 pandemic, the stigma around it continues to be a barrier to seek services.”

Each discussion was recorded and then analyzed to identify overarching themes. In addition to identifying the need for mental health to be normalized, the researchers noticed dissatisfaction and distrust of current mental health services.

“Someone reported a two-year waitlist to get in to see a psychologist,” Mallonee said. “Another commented on how providers turn over so quickly that you have a new therapist every few months, so then you’re going through your story again and again.”

Mallonee added, “They told us how they always get these ‘Mental Health Resource Lists’ with numbers to call for help, but when they call, no one answers or returns the calls. Those are all things that are going to turn someone off from seeking help.”

Armed with these perspectives, Mallonee has just kicked off an evidence-based mental health program in El Paso called ‘Pensamientos y Platicas’ or ‘Thoughts and Talks.’

The four-week program is facilitated by UTEP social work students and is intended to normalize conversations around mental health and help those with mental health conditions cope and create a plan to manage their condition and seek treatment when needed.

Mallonee is excited to see the program’s impact. 

He said, “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 at the westernmost tip of Texas, where three states and two countries converge 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 bachelor’s, master’s, and doctoral degree programs at the only open-access, top-tier research university in America.