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In an environment of health disparities amplified by a pandemic and racial injustice, Providence is committed to improving diversity, equity and inclusion in our communities, workplaces, schools and more. The Culture of Health podcast will focus on what the future of healthcare and mental wellness look like in today's changing culture. In this podcast, we will discuss how we turn the conversation of culture and healthcare into lasting and meaningful action.
Let’s Talk Mental Health: The Latin X Communities
Mary Renouf
Hello everyone and welcome to the Let's talk mental Health Show where we discuss all aspects of mental health and Wellness and how it impacts our physical health. Will share stories and speak with behavioral health experts to normalize conversations around mental health and the need for occasional support. Our goal is to reduce stigma and provide listeners with tools and resources you need to lead physically and mentally healthy lives. I'm your host, Mary Renouf, and today we're speaking with Karen Rentis, a licensed clinical psychologist and director of Behavioral Health and Primary Care integration in the LA area.
And we're going to be discussing mental health in the Latin X communities. Remember everyone, most of our questions come from you, our listeners, via social media. We can be found on Twitter and Facebook, at Providence and on Instagram under. Providence health systems. Before we start, I want our listeners to know that the information provided during this program is for educational purposes only. You should always consult a healthcare provider if you have any questions regarding a medical condition or treatment. Well, let's get started by welcoming our expert today. Hello, Karen.
Karen Rentas
Hi, Mary.
Mary Renouf
Thank you for coming back and joining us. I really am super excited to have the conversation with you. I personally know you, but for those listening, who maybe it's the first time they've heard from you, can you tell them a? Little bit about hat you do with Providence?
Karen Rentas
Absolutely. So as you mentioned, my name is Karen. I'm a clinical psychologist and I'm a director of behavioral health integration with primary care. So that basically basically means that I support uh, our primary care settings in integrating or bringing behavioral health to to that setting. So when patients are dealing, for example, with depression or anxiety, we can quickly identify them by doing universal screenings and then connect them to treatment. According to their needs, some of those patients do get the treatments at this same primary care setting, and others are supported through more traditional models like, you know, connecting them to psychotherapy or or a psychiatrist. But in. Sense I make sure that in our primary care settings, we are identifying those patients with those needs so we can better serve them.
Mary Renouf
Well, I love the work you and your team do. So thank you for doing it. I know today we're discussing mental health in Latinx communities, and that's a very diverse and large. Population, right. There's a lot of different groups that are kind of I guess grouped in there, right? So talk to me a little bit about, are there any kind of overarching cultural stereotypes or roles that you see when you talk about mental health in this community?
Karen Rentas
Yeah, that's that's a very uh it's. It's kind of like a loaded question because I think that there's some. There's so many aspect to uh to consider. Uh. I'm gonna start with, you know, giving you a little bit of like a high level response when we look at who are the members of our Latino and and Hispanic population. We're looking at, let's say, for example, people that come from Latin America. So when we look at Latin America, we are looking at. At least 33 countries are plus territories, so I could start naming, you know, Brazil, Mexico, Colombia and China.
So there is, there is a lot of countries that you know go into that category. So I think it's it's it's quite a challenge to describe. Ultra stereotypes or roles that are relevant to this group because itself it's so diverse, right? Like we look. At. All these countries we we all have, you know, different historic backgrounds and I think it's, you know itself it's quite complex, but uh. With that being said, in my experience working with with Latinos or Hispanics, including, you know, coming from Puerto Rico, I have noticed their values one of them you know something like, you know, someone saying or feeling that I don't need to see a therapist because I'm not crazy or. Or I am not depressed because that that word is not part of my vocabulary or yes, I am struggling.
But I have learned that things like this are not to be disclosed outside of my family or community of faith. So at times when we have. You know those beliefs? That could delay our motivation and energy and desire to to get the care that we need. And of course, if you delay care to take care of your of of your emotional well-being, that could lead to increased symptoms. So again, like I feel like none of these values. Are specifically unique to our Latino population. But from my experience these are some of them, so it's it's it's. It's an interesting concept. Again the group itself, it's very complex and it would be unfair to look at cultural stereotypes that would be applicable across the board.
Mary Renouf
I think that's so true with any culture. I think, you know I'm indigenous and people will ask me questions about Cherokee tribes or they'll ask me and I'm like, I don't know. Not how I was raised. Couldn't I think Tell you know you just mentioned delay of care and I think it's really interesting because, you know, we know that when you look at the Latin community specifically, it's that that community seeks out mental health care really like, way less than other populations. I think I read it's 33% of the Latin community. When the national average is is at least 10% higher than. That why, why? Do you think that is do you Think it's stereotype. Do you think it's barriers to entry? What is causing that kind of lack of seeking here? Because we do know that the longer it takes for you to get care, the harder it may be for you to actually find success, right?
Karen Rentas
Yeah, I think I think that's you know. I'm glad that you had that statistic. Uh, it's hard to uh, determine what you know. What's the main driver for that delay in care? I think that there there are many factors. One of them. Firstly, you know giving our cultures, is it OK to to reach out for help? When it comes to seeking, you know, professional help, what's what's the value that that person has in in, in regard? Just to you know, let's say you're having a conversation with a primary care physician about their mood or one step further connecting with with with a behavioral health provider. So that's that's one aspect another layer to consider.
It's it's coverage insurance coverage. Is it a matter of not having the resources to to connect with uh, with, with, with the treatment provider? And even if those resources are available, do we know how to get to them? So I think that, you know, access to to resources and knowing those where those resources reside, it's it's a big component and of course the, you know some of the stigma. Where uh, as I mentioned earlier, could it be that you know within my value within my culture, you know I I reach out to my elders for example or to my leaders in my community of faith.
So I think it's it's a combination of different. Doctors, another one it's, uh, being able to connect with with the with the therapist or or psychiatrist. Whoever is gonna like, provide that specific treatment, support feeling that you know you are connected with someone that really understands your background and feeling that. OK, when I connect with with this professional, I don't have to repeat myself. I don't have to kind of like. I share a lot about my own culture because this person is gonna immediately get a sense of what's what's the, what's the background that I'm I'm bringing into the table. So I think it's it's a combination of of different factors.
Mary Renouf
I think we do hear a lot about the looks like me. Sounds like me understands me, right? I think that's really hard. So Karen, how how? Do we as a society, as a country, as a system, how do? We support these people and their need.
Karen Rentas
That's a very good question. I think that one of the initiatives within Providence and I think it's also a trend for for you know, across the country, it's being able to provide A level of care for behavioral health within the primary care settings. This is what we call integrated. Care or behavioral health integration with primary care where uh when when patients of you know with diverse backgrounds are connected to to their primary care. We are making sure that we are asking the questions to see how they're doing with their mental health. Uh, and being able to provide A level of care at that pretty much uh, brief setting to be able to to support them.
We also have many initiatives in within our communities, communities that you know serve on the serve. Patients where they might not have access to primary care. For example, we have community programs where. Uh people are getting education on or around how to take care of themselves. Uh, places that they go and not being financially strained by, you know, the finances should. Not be the. The driver for them to to reaching out for help or not.
But I think that there is a long way to go within Providence, specifically with the with the Latino population, we're making sure that. We we have caregivers, there are Spanish speaking. So when those patients do come to connect with us, we have caregivers that could connect with them and simply connect with them from, you know, from a language perspective. So we can better serve them and they feel welcome and they feel that. You know, we are understand where they're coming from. We we also have we're putting a lot of effort in you know something as simple as translating documents and materials for patients in, in Spanish quite recently we are now.
To win, we're to win depression screening for all of our patients that come through our primary care settings and we we we aim to identify patients that who prefer to to speak in Spanish and we we aim to connect with them and provide those screening tools in, in their own language. So I think it's again, there is a long way to go, but I think that we are on the right path. There is great momentum, great interest in in increasing our our efforts to to support Latino patients, the Latino population.
Mary Renouf
I love you know that Providence has kind of put a stake in the ground and and really made this something to focus on. But and and you know Providence is a large system, right? But we know we can't do it all on our own. And one of the things I know that your area works on is kind of these key partnerships in the community. Is there any partnership or anything that comes to mind that you think is really moving the needle when it comes to Latin? Mental health services.
Karen Rentas
Absolutely. We have, uh, one particular partnership with the with the Community organization. And where we are connecting senior patients who are English speaking or Spanish speaking who are dealing with depression and we are connecting them with peers. What what this organization calls peer support specialists and their peer support. Specialist are people that also have gone through. Symptoms of depression or anxiety, and they have identified peers who are able to support Spanish speaking patients because they they speak Spanish.
So this particular program doesn't have any financial implications. For for our patients. But we are seeing that because of these peers that are in the communities connecting with our patients in the Community, our patients are likely to follow, you know, treatment recommendations that are getting from from our healthcare providers for us. So those peers are, uh, the extended arms of of our providers within the community. So they're also doing their their fair part in supporting Wellness of our patients in the community. So that's an example of how that, you know, peer-to-peer support. It's proving to be a a great partnership to to connect with our patients within their come.
Mary Renouf
How fun is that? I love it. I feel like that could be a whole separate show. So we. Don't have to bring it back.
Karen Rentas
Definitely.
Mary Renouf
Again, well this. Is a great conversation. I do know we're almost out of time for our first half, so we're going to take a quick break and when we come back, we'll continue the. Conversation on mental health in the late next community.
We are back and we are talking with Karen Rentas about mental health and the impact on the Latin X communities. And Karen, we talked a little bit earlier about some of the potential stereotypes or or negative things around, you know, culture as it relates to mental health bills, talk about some of the positive because I know you know with Latin X communities tend to have kind of a strong sense of of. Ethnic identity, family identity and which can really lead to resilience. Connection. Kind of a a sense. Of a network. Talk to me about some of the positive aspects.
Karen Rentas
Definitely. I I really like this question, Mary. And I think that you know that. I think that when when it comes to we looking we when we're looking at certain core concepts of what you know what entails emotional well-being there are a couple of them that are supported and maintained by our Latino cultures.
Let's say for example. What we call behavioral activation and and you know that linkage with depression. Uh, basically, we as professionals, we believe that someone that starts feeling depressed or sad, they increasingly disengage from their routines. They withdraw from their environment and over time that withdrawal increases our depressed mood. We lose our opportunities to be positively reinforced through pleasant activities, social activities, and even experience that sense of accomplishing good things in our lives.
So that's that's an explanation of behavior activation. How is that related to depression when it comes to our cultures, there is there is a connection and belonging there are there are those. Those are two very strong values within our communities. So those are like protective factors that keep. Lost, active and not isolated. Behavioral activation. It's a concept that, as you are active and not isolated and connected with other people and engaging in in new activities that keeps that keeps your well-being and that protects you from being in a in a depression. You know, vicious cycle.
And that's something that, you know, many of our Latino cultures provide us. They provide that sense of, you know, being active and taking care of, of ourselves by being engaged in in different activities. And the other concept, it's what we call altruism. This concept refers to our beliefs and practices of the importance of caring for others without necessarily expecting something in exchange. And I'm pretty sure that you're aware that in.
Many of our Latino cultures, we learn to take care of others. That's that's a core value that you need to take care of your aunt or your or or your cousins or your neighbors. You. You need to look for them because those are those are that's your support network. And and and. One interesting aspect is that research does show that people generally feel better when they help others, because when we help others, we experience that feeling of we are helping others for the greater good of our families, our communities. Country and even the world. So I think that those that that concept of you know helping you know our our community brings that sense of accomplishment connection and it's it's good for our well-being and that's proven by research.
Mary Renouf
I love it. I we actually have a question that I think resonates with what you're saying and it it comes from Grace via Instagram. And she says my family is very close and we share everything. But I feel like I need to talk to a professional about my anxiety and depression. The family doesn't understand why I want to talk to a stranger rather than them helping me. How can I get them to understand my needs without hurting their feel?
Karen Rentas
Ohh, that's that's a. That's a interesting question. I think that tapping into what's important within your family, I'm pretty sure that you know from what you share that you know every, every, everyone shares everything. You know that at the end. They they care for you. So I think that, you know communicating that that this is my way and this is your way of taking care of me. It's by allowing me to have this conversation with, with, with someone that could give me a different insight or perhaps confirm what you would have said.
Any way, if I if I wanted to get the support from within my my own family. But it's it's an interesting question because you know, everyone has their own family dynamics within our cultures. But I think it's it's, you know, being able to identify what's what's the driver and what's what's the rationale behind not you know behind. That desire to manage certain things within the within the circle and being able to kind of like tap into that and kind of like use the same argument but kind of kind of like keep a shift and and reconnect with with that professional that you think that might be able to help you.
Mary Renouf
Well, Speaking of professionals, I can help you. We had another question come from Selena via Twitter, and she said, I'm Latina and my therapist isn't. I feel like his lack of understanding about my culture preventing us from connecting is that a valid reason to find a different therapist? First of all, I think any reason is. Valid right? But. Would you, would you encourage somebody to continue? Trying to find somebody that they feel like they connect with.
Karen Rentas
I'm gonna say yes, but there's always a but right. I would encourage to have a conversation with the therapist about specifically that I always say that regardless of what you decide at the end, but if there is something that it's. Not working when you're reconnected with the behavior health provider that you feel that it's not working within that relationship, giving yourself the opportunity to bring that to the therapist.
As a therapist, I could share that whenever someone comes to me and tells me. You know what this is not working. You know, you are not a good fit for me. That gives me the opportunity to have that conversation. And if there is something that I could do from my end to to better help and better assist a patient, I've definitely. Going to to try to do that. But also it it it will give you the opportunity to clarify what's important, what's missing and and give yourself a chance to kind of like where is this coming from?
So yes, if at the end if it's not working, go for it. I I'm a true believer that. You know, we all are accountable for taking care of ourselves. So if that, uh therapist or that provider is not a good fit for you. Go for another one. Just give yourself the chance to have that conversation with that provider so it could be a learning experience on both ends.
Mary Renouf
Spoken like somebody who tries to help people get healthy. I love it. Well, you know, I do think it's important, though to talk about kind of this Latin X community and the caregivers because we do know that there's kind of a national. I don't want to use word crisis. But I think if you're talking about bipac as a whole, we would probably say there's a crisis and a lack of. By park caregivers in the behavioral health space. So what do you think we can do to help promote getting more members of the community, both to seek care but then to get more people to go into the to the space of actually becoming mental health providers?
Karen Rentas
I mean, at a organization level, I think that we could, uh, I mean, it would be wonderful to partner with. You know, education is it, schools, high schools and just kind of like being able to establish. The culture. That this is this is a very rewarding field and being able to have those partnerships with communities where we are, we are like.
Inserting those values that you know come into to mental health, it's it's a very rewarding field. So from a from a organization level, I think that we could we could be more intentional in creating partnerships. So this field it's it's an option to to many students that are that are. In that process of deciding what, what, what they want to do with with their professional lives.
From a perspective of coming to treatment, I mean I think that across the board stigma, when it comes to behavioral health, it's it's present. I think that again like we, we are responsible of taking care of ourselves. So at the very least, you know, having a conversation with the primary care physician. That's what's going on. I think that primary care physicians do possess a unique set of skill. Bills that uh, it could be it could be, it could be super beneficial to have that first conversation with with a primary care provider that could then guide you in terms of where to go or perhaps, you know many, many, many primary care practices do have behavioral specialists embedded in their in their spaces.
So, uh being able to connect you with with a provider at that same setting? Uh. So I think that there there is a long way to go. Uh, but I am. I am confident that you know the more. We normalize mental health. We are going to see a, a, a good positive results in both ends. Having more professionals serving our patients, but also having more people willing to to to have those conversations. With with the professionals, I think it's it's it's a it takes a village. But I think that we're getting there.
Mary Renouf
Think we have a long way to go, just in general, when we talk about mental health as a whole, but especially in the Latin next communities. And I see this because I want to ask you a little bit about kind of. Younger members of the Latin X community because, you know, I think you and I've talked before, that Latino girls have the highest suicide attempt rate right in the entire country of any, any nationality.
And and I I do feel like there's a lot of, you know, conversation happening. I do feel like there's a lot of work. Being done but. How do you see mental health impacting kind of the younger? Members of Latin next. Community is, is, is something that signals maybe improving do how do we how do we talk about this? I feel like it's such a big opportunity for young people.
Karen Rentas
I I I do believe that many schools in in our country are taking the lead in in bringing those conversations to the students we have, you know, many programs where we are from a prevention side, we are educating our Latino students. But also we have, you know, school counselors that are embedded in the schools already doing the the work in, in helping with helping our our students. I think that the there is is a good momentum.
I I think that you know from from 2020 and and COVID there is a. Such beautiful uh, increased awareness of uh mental health and I think that's, you know, in years to come we're gonna we're going to see people you know reaching out for help but also more resources available to the to the community with with specifically. With Latina students. You know it's it's it's an interesting because we know that females are more likely to seek out for treatment. And with that statistic that you share it's it's interesting. So we have more suicide attempts within within. Uh within Latina teens, but also we know that uh females in general, they tend to be more open to follow treatment. So that gives me hope. I'm just hoping that they're gonna be able to connect with with treatment. Quickly. So those symptoms are not getting are not they don't increase and they become a major problem.
Mary Renouf
I feel like I could talk to you all day and I feel like this topic needs a lot longer. We're almost at a time, so I'm going to ask you head of a an open-ended broad one. Is there anything else around mental health in the let next communities we didn't touch on that that you would want to? Kind of as a last party word share with the. Audience.
Karen Rentas
I think that, uh, one value that is not necessarily uh specifically to to mental health. But I think that one one thing that is for us that you know me included, we tend to see the physician or the doctor as someone with a lot of power, right. So you you get to see your. Your primary care physician or pediatrician. At times you can like, feel afraid of bringing certain issues that you're dealing with because that kind of like power dynamic.
And of course, adding the layer of, you know dealing if you're dealing with with the mental health issue, being able to work through those beliefs that you know that provider is there to serve you, that my primary care physician is there to serve. To me right, and being able to have those honest conversations, giving your your yourself the chance to have those conversations without kind of like. Overcoming those feelings that OK, this is someone that you know has so much power that I I could be afraid of, you know, sharing my what I'm really feeling. Just giving yourself the opportunity to have those conversations with, with your, with your provider.
Mary Renouf
That was really good advice. Thank you, Karen, for joining us today and let's talk mental health. We look forward to continuing the important conversation on mental health and Wellness with more experts from Providence in our future. Episodes make sure to listen to all of our shows on Dash radio under future of Health Radio or your favorite podcast platform.
Follow us on social media. We can be found on Twitter and Facebook at Providence and on Instagram under Providence Health. System to learn more about our missions, programs and services, visit providence.org and for a free mental health resource hub, visit workwell.org/wellnessresources. That's work the number two bewell.org/wellnessresources thanks for listening. And remember, you're not alone. Providence cares.