SAMHSA Data, Reports, and Issue Briefs

National Latino Behavioral Health Association

SAMHSA Programs and Initiatives

  • Hable. Ellos escuchan es la campaña nacional patrocinada por SAMHSA para la prevención del consumo de alcohol entre menores de edad ayuda a los padres y a los cuidadores para que puedan empezar la conversación con sus hijos acerca de los peligros del alcohol.Talk. They Hear You is SAMHSA’s underage drinking prevention campaign that helps parents and caregivers start talking to their children early about the dangers of alcohol.
  • La Semana Nacional de Prevención es un evento anual de salud apoyado por SAMHSA, que busca concientizar al público y generar acción respecto al abuso de sustancias y a los problemas de salud mental. El lema y enfoque de la Semana Nacional de Prevención 2020 es: Nuestras vidas. Nuestra salud. Nuestro futuro. Este año queremos destacar la importancia del rol que cada uno de nosotros desempeña en el mantenimiento de un estilo de vida saludable y un futuro próspero.National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance use and mental health issues. National Prevention Week 2020 is about Our Lives. Our Health. Our Future. SAMHSA will be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future.

Materials are available in English and Spanish.

SAMHSA Behavioral Health Resources

  • Depresión en madres: Más que tristeza (Depression in Mothers: More than the Blues). Muchas madres luchan diariamente con la depresión y muchas de ellas ni siquiera saben que están deprimidas. Este kit de herramientas está diseñado para los proveedores comunitarios, incluyendo los que trabajan en programas de visitas al hogar; los trabajadores del programa WIC; y el personal de Head Start Temprano, Head Start y otros programas de cuidado de niños. (This toolkit equips providers with information about depression, and offers strategies in working with mothers who may be depressed. The toolkit includes resources, referrals and handouts for depression, and screening tools for more serious depression).
  • El alcohol y la depresión: El camino de Jorge hacia una vida mejor (Alcohol and Depression: Jorge’s Journey to a Better Life). Equipa a los lectores con información acerca del alcohol y la depresión en un formato de fotonovela culturalmente competente. Reduce el estigma relacionado con los trastornos concurrentes y enfatiza la importancia de buscar ayuda tanto para el trastorno mental como para el abuso de sustancias. (This Spanish- language fotonovela employs believable characters and dialogue to tell a story that educates readers about co-occurring substance use and mental disorders and their treatment).
  • Prevención de la Sobredosis de Opioides Manual de Instrucción (Opioid Overdose Prevention Toolkit). Equipa a los proveedores de atención médica, las comunidades y los gobiernos locales con materiales para desarrollar prácticas y políticas para ayudar a prevenir las sobredosis y las muertes relacionadas con los opioides. Aborda diferentes asuntos de interés para los proveedores de atención médica, personal de primeros auxilios, los proveedores de tratamientos y los que están recuperándose de sobredosis de opioides. (This toolkit offers strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths. Access reports for community members, prescribers, patients and families, and those recovering from opioid overdose).

Publicaciones de SAMHSA disponibles en español (Additional SAMHSA Spanish-language publications)

Visit behavioral health equity resources for select SAMHSA in-language resources and quality practice and workforce development for select SAMHSA OBHE webinars and blog posts.

Federal Initiatives and Resources

External Resources

SAMHSA’s 2018 National Survey on Drug Use and Health (NSDUH) estimates that 1.1 million Hispanic/Latino youth used illicit drugs in the past year, including 208,000 who misused opioids in the past year. The rates of substance use among this population places them at a greater risk for engaging in unsafe sexual practices linked to Human Immunodeficiency viruses (HIV), Hepatitis C virus (HCV) and sexually transmitted infections (STI). The 2018 NSDUH indicates that 92 percent of Hispanic/Latinos youth with a substance use disorder did not receive treatment in a specialty facility. NSDUH reports that an estimated 17 percent of Hispanics/Latinos adults suffer from mental illness, and 15 percent of Hispanic/Latino youth experienced a major depressive episode. The co-occurrence of a substance use disorder and mental illness increases the vulnerability for poor health outcomes among this population.  Hispanic Heritage Month, September 15 – October 15, is an important opportunity to raise awareness about these trends and more importantly, identify culturally and linguistically appropriate prevention and treatment strategies to reduce mental and substance use disorders in the Hispanic/Latino population.

According to the CDC, illicit drug use, including opioid misuse, often leads to adverse health consequences such as increased risk of HIV, hepatitis B and C, sexually transmitted disease and endocarditis. Alarmingly, in 2016, 26 percent of the new HIV diagnoses in the US were from the Hispanic/Latino population. Many of these consequences are associated with Hispanics/Latinos being unable to access bilingual treatment programs, fear of speaking to government agencies, and lack of health care coverage. Understanding the barriers that prevent Hispanics/Latinos from participating in treatment is key to decreasing the misuse of substances and related comorbid conditions.

A culturally and linguistically competent workforce is central to improving the behavioral health outcomes for Hispanic/Latino populations. SAMHSA’s National Network to Eliminate Disparities in Behavioral Health (NNED) provides training and resources for community-based organizations like the Puerto Rican Organization for Community Education and Economic Development, Inc. (PROCEED) to expand their capacity to provide counseling and treatment services for Hispanic/Latino populations.  PROCEED’s participation in NNEDLearn 2019 increased their ability to engage Hispanic/Latino youth.  As SAMHSA takes steps to ensure that culturally and linguistically appropriate  prevention and treatment services for individuals with mental and substance use disorders  are available, Hispanic Heritage month is a reminder that we all have a role in preventing alcohol and other drug misuse for vulnerable populations and ensuring the availability of recovery support services.

Strategies to Address the Opioid Epidemic in Black and Hispanic/Latino Communities

Hispanics/Latinos Face Growing Mental Health Care Crisis

HIV, Hepatitis C and Substance Abuse Prevention Among the Latino Community/VIH, La Hepatitis C y el Abuso de Sustancias en las Comunidad Latina 


Hispanic Americans are one of the fastest growing segments of the United States population. The U.S. Bureau of the Census estimates that there are 60 million people of Hispanic origin (as of July 1, 2018) living in the United States, comprising 18.3% of the total population.1  With the Hispanic population expected to increase to over 30% of the population by 2050,2 it is imperative that we address any substance abuse and addiction treatment disparities currently experienced by these individuals.

Substance Abuse Among Hispanic Americans

The rates of substance abuse among Hispanic Americans generally mirror those of the general U.S. population, although there are some slight differences. Findings from the 2018 National Survey on Drug Use and Health include:3

  • 7.1% of Hispanic Americans have a substance use disorder, compared to a rate of 7.4% among the total population.
  • 3% of Hispanic Americans have an illicit drug use disorder (the same rate as that among the total population).
  • Hispanic Americans report lower rates of lifetime illicit drug use (37.7%) than European (54.5%) and African Americans (45.9%)
  • Rates of past month and past year drug use among Hispanics are comparable to those of other ethnic groups.
  • Rates of alcohol dependence (5.3%) and binge drinking (24.6%) among Hispanics are similar to those of European Americans and slightly higher than those of African Americans.

Differences Across Hispanic Communities

Although Hispanic Americans are often studied as a single population, there are important differences in the rates of substance abuse among different Hispanic subgroups.  A report from the National Institute on Drug Abuse describes differences among the U.S. Hispanic population that include:4

  • Puerto Ricans have the highest rate of recent illicit drug use (6.9%) and South Americans have the lowest (2.1%).
  • Puerto Ricans have the highest rate of recent marijuana use (5.6%) while Cubans and South Americans have the lowest (2.1%).
  • Other Hispanics (individuals originating from a Spanish speaking country other than Puerto Rico, Mexico, Cuba, Central America, and South America) have the highest rate of recent cocaine use (1.7%) while Cubans have the lowest (0.5%).

According to a recent study published in the journal Alcohol and Alcoholism, Puerto Rican men and women tend to be the heaviest drinkers of all Hispanic Americans.5 The study authors propose that the reason Puerto Ricans are almost 3 times more likely to develop alcohol use disorders than non-Hispanic white Americans is because of cultural differences that include:

  • Drinking starts at an earlier age in traditional Puerto Rican culture.
  • There is less stigma concerning alcohol in Puerto Rico compared to the contiguous U.S.

The study also notes that Cuban men drink the least of Hispanic men and Mexican women drink the least of Hispanic women. Beer is the preferred beverage across all Hispanic subgroups in the U.S., followed by wine.5

The Discrepancy in Treatment Options and Outcomes Among Hispanics

Substance abuse is a concerning public health problem in the United States. Unfortunately, Hispanic Americans experience greater consequences of their abuse of substances compared to than their non-Hispanic counterparts.  Although the rates of substance abuse among Hispanic Americans do not differ from those of the overall U.S. population, there is a gap between Hispanics and the rest of the population when it comes to substance abuse treatment. Studies show that despite being more likely to need substance abuse treatment, Hispanic Americans have less access to substance abuse treatment and must wait longer to access such services when compared to non-Hispanics.6-7  The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 91% of Hispanic Americans with a substance use disorder are unable to receive the treatment that they need at a specialty facility (such as substance abuse rehabilitation centers).3 And those who do receive treatment do not fare as well as the rest of the population, as studies show that Hispanic Americans have poorer outcomes in substance abuse treatment programs.8   Some of the disparities in treatment that occur within the Hispanic community can be resolved through increased availability of culturally sensitive treatment programs.  Some key features that need to be incorporated into treatment programs tailored for Hispanics include the offering of bilingual or exclusively Spanish speaking activities and acknowledgment of Hispanic cultural values such as family structures, gender roles, personal relationships, respect, spirituality, and religion.9

Sources

  1. United States Bureau of the Census. (2019). Quick Facts: Hispanic, percent.
  2. Ennis, S. R., Rios-Vargas, M., & Albert, N. G. (2011). The Hispanic population: 2010 (2010 Census Briefs C2010BR-04). Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau.
  3. Substance Abuse and Mental Health Services Administration. (2019). 2018 National Survey on Drug Use and Health Detailed Tables.
  4. National Institute on Drug Abuse. (2003). Drug Use Among Racial/Ethnic Minorities.
  5. Ríos-Bedoya, C.F., & Freile-Salinas, D. (2014). Incidence of Alcohol Use Disorders Among Hispanic Subgroups in the USAAlcohol and Alcoholism, 49(5), 549–556.
  6. Wells, K., Klap, R., Koike, A., & Sherbourne, C. (2001). Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health careThe American Journal of Psychiatry, 158(12), 2027-2032.
  7. Substance Abuse and Mental Health Services Administration. (2012). The NSDUH Report: Need for and Receipt of Substance Use Treatment among Hispanics.
  8. Chartier, K.G., Carmody, T., Akhtar, M., Stebbins, M.B., Walters, S.T., & Warden, D. (2016). Hispanic Subgroups, Acculturation, and Substance Abuse Treatment OutcomesJournal of Substance Abuse Treatment, 59, 74-82.
  9. Alvarez, J., Jason, L.A., Olson, B.D., Ferrari, J.R., & Davis, M.I. (2007). Substance abuse prevalence and treatment among Latinos and LatinasJournal of Ethnicity in Substance Abuse, 6(2), 115-141.

The Hispanic/Latinx community in the U.S. is very diverse, including people from many different nations and regions of the world.

While the differences are many, there are some shared cultural factors that connect people across nationalities. There is a connection to Spain as both the colonial power and the mother land. A large portion of this culture speaks the Spanish language. There is also a shared connection of religious affiliations, strong family bonds, connections to extended networks and a resilient approach to life and work.

It is indisputable that individuals of Mexican, Puerto Rican, Cuban, Central American and other descent have been part of the American cultural tapestry for centuries, and their presence and resilience enrich our communities and workplaces.

Identity And Culture

Identity and culture for members of the Latinx/Hispanic community is as complex and rich as the story and trajectory of this population. In other words, there is no one Latinx/Hispanic culture.

In the context of health and mental health, it is important to understand these differences and even how community members self-identify. For example, Latinx, vs. Latino/a and/or Hispanic. Those who identify as Latinx may consider themselves of Latin American ancestry (Central America, South America or the Caribbean). Those who identify as Hispanic may be proudly referring to ancestors from Spain or other Spanish-speaking countries.

Since cultural identity is a construct shared by groups, recent immigrants may identify by their country of origin instead of as “Hispanic” or “Latinx.” Since the Spanish language is typically gendered, the term Latinx is used to eliminate a binary choice (male vs. female) that is limiting and excluding to trans individuals and others who identity as fluid or non-binary.

Barriers To Mental Health Care

Latinx and Hispanic communities show similar vulnerability to mental illness as the white population, however, they face disparities in both access to and the quality of treatment. This inequality puts these communities at a higher risk for more severe and persistent forms of mental health conditions, because without treatment, mental health conditions often worsen.

Approximately 33% of Hispanic or Latinx adults with mental illness receive treatment each year compared to the U.S. average of 43%. This is due to many unique barriers to care.

Language Barriers
Language barriers can make communicating with providers difficult, or even impossible, particularly when a person is seeking counseling for sensitive or uniquely personal issues. These topics can be difficult for anyone to put into words, but it is especially difficult for those who may not speak the same language as a potential provider.

Less Health Insurance Coverage
According to the Kaiser Family Foundation, in 2018, 19% of Hispanic people had no form of health insurance. In addition to facing an already limited pool of providers due to language barriers, people identifying as Latinx/Hispanic have even fewer options when they are uninsured.

Lack of Cultural Competence 
Cultural differences may lead doctors to misdiagnose those from the Latinx/Hispanic community. For instance, they may describe their symptoms of depression as “nervios” (nervousness), tiredness or as a physical ailment. These symptoms are consistent with depression, but doctors who are not trained in of how culture influences a person’s interpretation of their symptoms may assume it’s a different issue.

Legal Status
For immigrants who arrive without documentation, the fear of deportation can prevent them from seeking help. Even though millions of children of undocumented immigrants are eligible for health insurance under the Affordable Care Act, many families may be afraid to register due to fear of separation.

Stigma 
Latinx/Hispanic individuals may not seek treatment because they don’t recognize the signs and symptoms of mental health conditions or know where to find help.

Many in the Latinx community are familiar with the phrase el dicho “la ropa sucia se lava en casa” (similar to “don’t air your dirty laundry in public”). Many people in the Latinx/Hispanic community tend to be very private and often do not want to talk in public about challenges at home. This can lead to a lack of information within the community about mental health as talking about it can be viewed as taboo.

This lack of information also increases the stigma associated with mental health issues. Many do not seek treatment for fear of being labeled as “locos”(crazy) or as having a mental illness because this may cause shame. Additionally, sometimes faith communities can be a source of distress if they are not well informed and do not know how to support families dealing with mental health conditions.

How To Seek Culturally Competent Care

Cultural competence is a doctor’s ability to recognize and understand the role culture plays in treatment in order to meet a person’s needs. When a person is struggling with their mental health, it is essential to receive quality and culturally competent care in order to improve outcomes.

A provider who understands one’s culture and needs will know culturally specific information. For example, someone might describe what you are feeling with commonly used phrases such as “Me duele el corazón.”While this literally means “my heart hurts,” it is an expression of emotional distress, not a sign of chest pain. A culturally sensitive doctor would be aware of this interpretation and would not assume you were talking about actual chest pain.

While we recommend going directly to a mental health professional, a primary care doctor can be a great place to start and may be able to start the assessment or give a referral to a mental health professional.

When meeting with a provider, ask questions to get a sense of their level of cultural sensitivity. Providers expect and welcome questions from their patients since this helps them better understand what is important in their treatment. Here are some questions to ask:

  • Have you treated other Latinx/Hispanic people?
  • Have you received training in cultural competence or on Latinx/Hispanic mental health?
  • ​How do you see our cultural backgrounds influencing our communication and my treatment?

Whether you seek help from a primary care doctor or a mental health professional, you should finish your sessions with health professionals feeling heard and respected. You may want to ask yourself:

  • Did my provider communicate effectively with me?
  • ​Is my provider willing to integrate my beliefs, practices, identity and cultural background into my treatment plan?
  • Did I feel like I was treated with respect and dignity?
  • Do I feel like my provider understands and relates well with me?

The relationship and communication between a person and their mental health provider is a key aspect of treatment. It’s very important for a person to feel that their identity is understood by their provider in order to receive the best possible support and care.

More Information

  • If finances are preventing you from finding help, contact a local health or mental health clinic or your local government to see what services you qualify for. You can find contact information online at findtreatment.samhsa.gov or by calling the National Treatment Referral Helpline at 800-662-HELP (4357).
  • If you or your loved one does not speak English, or speak it limitedly, you have the right to receive language-access services at institutions that receive funding from the federal government as well as the right to request a trained interpreter and to receive forms or information in Spanish.
  • If you do not have legal documentation, seek out clinics and resources that care for all members of the community. Latinx-based organizations often provide services regardless of legal status.

Resources

NAMI’s Compartiendo Esperanza
A 90-minute program to increase mental health awareness in Latino communities by sharing the presenters’ journeys to recovery and exploring signs and symptoms of mental health conditions. The program also highlights how and where to find help.

Compartiendo Esperanza: No Hay Salud Sin Salud Mental
Through stories and quotes, this booklet provides mental health information in a sensitive manner. Recovery is possible, and this booklet tells you where to find more information, seek help and be supportive. You can preview the booklet for free or buy hard copies through the NAMI Bookstore.

Psychology Today
A directory of Latinx/Hispanic therapists.

Therapy for Latinx
A database of therapists who either identify as Latinx or has worked closely with the and understands the unique needs of the Latinx community. The website is also offered in Spanish. 

Mental Health America’s Resources for Latinx/Hispanic Communities
General mental health Spanish speaking resources, including a list of Spanish language materials and Spanish-language screening tools.

American Society of Hispanic Psychiatry 
Promotes the research, education, advocacy, and support for those in the Hispanic community. Offers a “Find a Physician” feature on their website.


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