As a young boy I remember asking my mother about a family friend who would mysteriously be missing from family functions for months at a time and never seemed to be herself. I asked my mother at the time “why is our friend not here?” She answered in Spanish “We don’t talk about those things… it’s our family secret”.
As a practicing neurologist who often treats patients with depression, I reflect back to that conversation as I later learned that this family friend had severe depression. My mother’s response about keeping the secret reminds me of the larger issue when it comes to the stigma of mental illness in Latinos.
Sadly, this big “secret” can have deadly and dangerous consequences. There has been a striking rise in the rate of suicide attempts by Latinas that has been known since the 1970’s, and confirmed recently by several survey studies conducted by the Center for Disease Control and Prevention (CDC).
Young Hispanic women have suicide attempt rates that are twice to 1-1/2 times higher than Black and White non-Latinas. In 1995, the rates were one out of every 5 Hispanic teen girls in contrast to one out of every 10 Black or White teens. According to 2012 CDC statistics, 13.5 percent of Latinas in grades 9 through 12 had reported attempting suicide in the last year, significantly more than than Black (8.8%) and White (7.9%) teen high school girls.
“This alarming rate in suicide attempts cuts across all Hispanic groups; no one group dominates whether you are Mexican, Puerto Rican, Cuban, Salvadoran, Honduran, Dominican or other,” says Dr. Luis H. Zayas, PhD, the Dean and Robert Lee Sutherland Chair in Mental Health and Social Policy at the University of Texas at Austin and author of the book Latinas Attempting Suicide: When Cultures, Families and Daughters Collide.
Dr. Zayas has conducted research on the topic since 1978, and he points out that there is no definitive answer on why young Latinas have reported higher rates of suicide attempts. He hypothesizes that apart from individual, developmental and social factors associated with suicidal behaviors, a clash of cultures at home versus outside the home may be a contributing factor.
For example, young U.S. Latinas with immigrant parents have to face their culture of origin at home, where they may be pressured to be more demure and adhere to traditional behavior. This can be in direct conflict with situations outside the home, such as in school, where girls are expected to be more independent. This can lead to tensions which can intensify mental health factors associated with a suicide attempt. Curiously, this is not seen in Latino boys.
There are several things that can be done to reverse this trend, especially family-oriented interventions, but the first thing we need to do is talk about it. Schools, homes, community centers, churches and doctors offices are all excellent locations to help initiate the discussion.
We need to help parents find a way to communicate, support and alter their own expectations for girls along the way. However, as Dr. Zayas puts it, “if we don’t respect the parents' culture and tell them what to do and not to do without taking into account their cultural beliefs - even causing them to feel dismissed - these interventions are doomed,” says Zayas.
Should you suspect that your child, friend, or perhaps yourself is having suicidal thoughts, there is help out there for you. If there is a suicide threat or attempt, go to your nearest emergency room. For suicidal thoughts, reach out to a health care professional that you feel comfortable with such as a pediatrician, family doctor, school nurse or counselor. If none of those are available, call the National Suicide Prevention Lifeline at 1-800-273-TALK, which is open 24 hours, seven days a week. More information can be found at the National Suicide Prevention Lifeline website.
It is only by frequent and repeated discussions about mental health issues that we can start turning the tide on these troubling statistics . It’s sad that we can’t talk about mental health in the way that we need to. Still, as Dr. Zayas has pointed out, we need to do something. “The attempts and damage doom young Latinas to lives in which they do not realize their greatest potential.”
With all due respect to my mother, it's time we all wake up and let go of the "family secret" and start talking.