La Familia Central Valley featured in Modesto Bee:
With more teens contemplating suicide, Latino advocates and educators are speaking out
Almost a third of young adults in California contemplate suicide, a recent study from UCLA found. That’s more than double the rate from five years ago, and suicide remains a leading cause of death for young people.
For San Joaquin Valley families, the issue is compounded by regional challenges that include a housing crisis, limited psychiatric hospital beds and scarce mental health resources. And for Latino families, factor in documented racial and ethnic health disparities.
It’s a daunting challenge, but some Latino mental health advocates and educators are working to buck these trends. They want to address the daily psychological struggles that Latino students are facing before they consider or attempt suicide.
On a Monday morning in south Modesto, community health educator Mireya Santibanez gathered in a church with a group of mothers to decorate candy skulls, or calaveras, and make paper marigolds, or cempasúchil, for an upcoming Day of the Dead celebration. They joked, drank coffee and munched on pan dulce, but the casual cadence of the conversation belied a more serious purpose.
“Here,” in this church, said one mother in Spanish, “I feel free, comfortable,” to talk about her marriage, her children and above all, her family’s struggle with mental health. She asked to be identified only as Rosa, her mother’s name, to protect her privacy.
An afternoon six years ago, Rosa was hit by a car while walking with her three children. She was injured and recovered, slowly, but her son had deeper scars. He was just 6 years old at the time, and in the days, weeks and years following the collision, he changed.
“We would all be sitting together at a lunch place and he would hide under the table,” she said. He became withdrawn, locking himself in his room and refusing to play with other children.
She knew he needed help, but she struggled to find a therapist. The Golden Valley Health Centers branch she could walk to — the only place that was accessible since she didn’t have a car — had no appointments available for months, she said.
Like Rosa’s family, Santibanez’s clients are predominantly Latino, and many — especially the parents — prefer to speak Spanish. As a trained community health advocate, a promotora, through Sierra Vista Child and Family Services, she makes 30 to 40 referrals a month to various mental health providers. That demand for services continues despite the statewide shortage of mental health providers and, according to the American Psychiatric Association, a nationwide decrease in Spanish-language speaking facilities.
COMMON DIAGNOSES
In schools, the most common diagnoses for children are depression, anxiety and adjustment disorder, said Juan Perez, the clinical director with La Familia Central Valley, which provides licensed therapists in nine school districts across Stanislaus and Merced counties. More than half of its clients identify as Latino.
Adjustment disorder is just what it sounds: a reaction to a stressful event in life. The COVID-19 pandemic set off many of those reactions for students. “I had one family where the father died because of COVID, and they’re going through grief and loss but also an adjustment because the father was the primary wage earner,” Perez said.
A disproportionate number of Latinos in California died from COVID. Even for those children whose families did not experience death, the fear of contracting the illness or having someone die created “a lot of anxiety,” Perez said.
Adjustment disorder also can stem from a family move. In rural school districts like Hughson, Delhi and Livingston, many students migrate depending on the season and the crop their parents are picking. Other families are moving to Stanislaus and Merced counties to escape the Bay Area’s soaring housing prices.
“We know that to thrive, kids need safety and stability, and if they don’t have that stability, it can be challenging,” Perez said. A different school environment, a different city, a different culture — it can all cause emotional distress.
For example, Rosa moved her family to Modesto about six years ago, just after the car accident. Their landlord in Hayward evicted them, and they couldn’t find affordable housing nearby. Modesto, though, had more affordable housing and was closer to her husband’s work and her sister.
“My husband basically threatened me — either it was Modesto or Mexico,” she said. They stayed in the U.S., but the move to the Central Valley destabilized her son, who still was emotionally reeling from the collision.
“I think the move made the problem worse, traumatizing him a lot more,” she reflected.
When she finally found a therapist through Golden Valley Health Clinics, his mood started to improve. The therapist explained that her son’s reclusive behavior was an attempt to protect himself and his family, a defense mechanism borne out of the car accident and the move to Modesto.
STIGMA AND FEW SERVICES
Perez said he worries that some families fail to seek adequate mental health care because of stigma, a belief that their child would get labeled “crazy.”
“You’ll hear things in Spanish like, no quiero que sean adictos, (meaning) I don’t want them to be addicted” to drugs, said Perez. In reality, La Familia recommends talk therapy before psychiatric medication interventions, but those misunderstandings persist.
In other instances, undocumented children and families may be wary of soliciting help because they fear it might affect their immigration status. Until recently, for example, immigrants could be denied a green card or citizenship if they received certain public benefits.
Anahi Cortez and Sadith Velasquez rotate as part-time therapists in the Hughson and Livingston Unified school districts through a partnership with La Familia. Despite the stigma, there’s constant demand at each school where they work.
Velasquez sees six or seven students a day at Hughson High School, and even more at the junior high. “Students right now are dealing with a lot of suicidal ideation, self-harm, so a lot of preventative care needs to be done in Hughson,” she said.
For a child who attempts suicide or who needs other urgent psychiatric care, there are few resources. Stanislaus County hospitals have no inpatient psychiatric beds for pediatric patients. Instead, the county has contracts with hospitals in Sacramento, Fresno and Bakersfield, said Kevin Panyanouvong, chief operations officer with Stanislaus County Behavioral Health and Recovery Services (BHRS). Adult patients are often sent to other cities as well, because the county has only 95 psychiatric beds for them.
MORE DEMAND AND MORE DOLLARS
But Cortez sees a silver lining. She noted that the pandemic “brought light to mental health” because parents spent more time observing their children’s behavior at home.
That trend is particularly true for Latinos. In the past three years, Latinos of all ages
called BHRS for mental health services more than any other demographic.
BHRS data include calls for referrals, appointments and crisis interventions for Medi-Cal beneficiaries and the uninsured. Given that Latinos represent nearly half of the county population and a similar percentage of Medi-Cal enrollments, BHRS data seem to represent the county writ large.
In 2020, BHRS saw a drop across the board in demand for mental health services. But it saw the smallest drop in callers who identified as Latino. (A significant number of callers did not disclose their race or ethnicity).
Velasquez and Cortez will see additional support soon at their schools, too. La Familia recently received a $1 million federal grant to hire two more therapists and a community health worker that will support the predominantly Latino students in Hughson and Delhi.
Velasquez is thrilled, “the community so desperately needs that.”
Call or text 988 to reach the 988 Suicide & Crisis Lifeline 24/7. Or use Lifeline Chat. Services are free and condential. U.S. veterans or service members who are in crisis can call 988 and press “1” for the Veterans Crisis Line, text 838255 or chat online.The 988 Suicide & Crisis Lifeline in the U.S. also has a Spanish-language phone line at 888-628-9454.
BY ADAM ECHELMAN
UPDATED OCTOBER 25, 2022 4:50 PM