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they said 62 million Hispanic and Latino people living in the United States—and by 2020, approx 7.7 million A study by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that Hispanic and Latino adults reported experiencing mental illness.
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Ruby Castilla, MD, Director of Clinical Development, Mood Disorders, Johnson & Johnson Pharmaceutical Companies
Consisting of people with roots in more than 20 Latin American countries, the Hispanic and Latino communities in the US are diverse demographically, ethnically, culturally, and economically. But they face many obstacles when it comes to getting the help they need, says Ruby Castilla, MD, director of clinical development, mood disorders at Johnson & Johnson Pharmaceutical Companies.
The reason for this access gap is a combination of factors that prevent people from making mental health a priority, says Dr. Castilla, who served as president of the American Hispanic Psychiatric Association from 2020 to 2022. For some, lack of insurance coverage is a problem. For immigrants, connecting with non-Spanish-speaking health care professionals is a challenge, and fear of seeking help if they are among the nearly 8 million undocumented is another factor.
Dr. Castilla added, “They may also be dealing with the horrors of the country they came here from.” Finally, he said, “‘I suffer;’ They have no chance. Can I get some support?’
Johnson & Johnson is on a mission to create such important opportunities to improve mental health for Spanish speakers in this country and around the world. In honor of Hispanic Heritage Month, Dr. Castilla shares additional insights about the unique mental health care issues faced by Hispanic and Latino people—and how Johnson & Johnson is proactively working to meet them.
1.
Supporting research on mental health care gaps
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Regardless of education or income level, stigma is a pervasive barrier to accessing mental health services across Hispanic and Latino populations, including US-born English speakers. A Research A paper co-authored by Dr. Castilla and sponsored by Janssen Scientific Affairs, published this summer, confirms this.
The study used artificial intelligence (AI) to analyze millions of digital conversations about depression across ethnic and racial groups, including Hispanics, non-Hispanic whites, blacks and Asian-Americans.
The result?
“We’ve learned that even if you have insurance, you’re more likely to be well educated and go to a doctor. If you’re Hispanic, you’re not going to go to a psychiatrist,” says Dr. Castilla. Indeed, the Hispanics in the study had higher rates of discussion of depression, indicating what she calls an “alienation mindset.”
“People who fell into other groups knew when they were depressed; “And because they see depression as a treatable disease, they try to get help,” she said. But Hispanics and Latinos in our study believe that depression is a part of life that you have to go through from childhood to adolescence.
The problem to be solved was clear to Dr. Castilla and her colleagues. “If there’s a big internal cultural barrier that’s not related to education, how can we overcome that?”
As researchers begin working on answers and developing culturally competent depression treatments for Hispanic and Latino populations, the study’s innovative AI approach is creating new ways to assess unmet healthcare needs.
“We’re creating awareness that this type of research can be done,” Dr. Castilla said. We are opening doors to more projects and opportunities with other teams in the company.
2.
Helping Spanish speakers find the resources they need
Given the high stigma associated with experiencing mental health issues in Hispanic and Latino communities, the wealth of medically validated, free information online can be a powerful tool to dispel misconceptions. ” of American Psychiatric Association (APA) It has great resources—but they’re in English,” says Dr. Castilla. “Our goal was to develop similar facilities for Spanish-speaking patients.”
And that goal will become a reality after launching this month. Mental healthAP website dedicated to Spanish-language information and resources on culturally competent and evidence-based mental health and substance use disorders. It mirrors the content of the APA’s English site, which focuses primarily on five main topics: depression, mental health stigma, suicide risk, substance abuse, and women’s health.
In weekly meetings organized by the APA, a group of Johnson & Johnson experts in Hispanic-focused psychiatry serve as a review board, reviewing translated articles that include text, videos, and transcripts.
“The difficult part of creating educational resources in a culture is that some terms and concepts are not directly translatable,” Dr. Castilla said. Sometimes when we’re reviewing a website that’s directly translated into Spanish, it doesn’t make sense. Being aware of those differences, while preserving the differences in empathy, is the main focus of the project.
You can’t imagine how difficult it is to find Spanish speaking mental health professionals. We need to create a new generation of physicians, clinicians, nurses and psychologists interested in the mental health of the Hispanic community.
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The process of maintaining meaning and relevance across cultures goes beyond comparing Spanish to English. “Sometimes at those meetings we have really good discussions about regional differences,” says Dr. Castilla. For example: ‘For Colombians, this is different than Brazil or Argentina or Puerto Rico.’ Or ‘we don’t say that in Mexico’ so we have to take those factors into account.
It is also important to consider how cultural differences affect the treatment pipeline.
“We recently reviewed the case of a woman who was a victim of domestic violence. She was afraid to meet the doctor because she was afraid that she and her family might be deported. “At La Salud, we’re trying to include resources that someone in those situations can turn to for help—especially in states with high Spanish-speaking populations like Florida, California, and Texas.
3.
Guiding students in the field of medicine
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Dr. Ruby Castilla with some of her colleagues at the 2022 American Psychiatric Association Annual Meeting. From left to right: Dr. Pamela Montano, Nancy Colimon, Whitney Cordoba, Ruby Castilla and Laura Jimenez.
They are Hispanic and Latino. Very low representation In the medical field. And when they attend medical school, studies show that they are less likely to graduate than their non-Hispanic white counterparts, especially when students come from low-income backgrounds before enrolling.
“Many drop out because they don’t have networks, and they don’t have role models,” says Dr. Castilla. “They need guidance.”
Enter Johnson & Johnson, which gave $100 million to invest and promote Health equity In health care. Helping to create a more diverse medical workforce is a critical part of this mission. Working with the National Hispanic Medical Association, the company is connecting five medical students a year with healthcare professionals for monthly one-on-one mentoring sessions to ensure they have the information and connections they need to thrive in their program and graduate.
If a medical student is a native Spanish speaker, they are paired with a mentor they can easily communicate with. “It’s hard to imagine how difficult it is to find Spanish-speaking mental health professionals,” says Dr. Castilla. Other challenges the counselors advise on include financial-aid concerns, housing and child care.
“We need to create a new generation of physicians, clinicians, nurses and psychologists interested in the mental health of the Hispanic community,” said Dr. Castilla. “They want someone who can show them that there is more than one path to navigate through medical school and the residency training program.”
4.
Reaching local communities
As an active member Hispanic Leadership and Achievement Organization (HOLA)The company’s Hispanic and Latino Employee Resource Group, Dr. Castilla currently leads the group’s Hispanic medical initiatives, 50% of which aim to raise awareness around mental health. These initiatives typically involve partnering with non-governmental organizations that support Hispanic and Latino populations. “We are lucky to have such a leader in Hola Joaquin Duato, He has done projects that have greatly impacted Hispanic communities,” says Dr. Castilla.
One example: a free Spanish-language series about mental health, created by HOLA in partnership with the Hispanic Psychiatric Association of America, a monthly organization based in Newark, New Jersey. House of Don PedroNot far from Johnson & Johnson. World headquarters In New Brunswick, the first half hour features a health care professional in Spanish, such as a psychiatrist talking about stress. The second half hour is an open space for attendees to ask questions, which Dr. Castilla says often includes concerns about family members.
“It was one of the most valuable programs we had,” she says.
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