Health & Fitness

Latino youths see big rise in psychiatric hospitalizations

Nubia Flores Miranda, 18, works part-time at Family Paths, a counseling and mental health organization in Oakland, Calif., on Friday, January 29, 2016. Miranda said she became interested in a career in mental health after she started experiencing depression and anxiety her freshman year at Life Academy of Health and Bioscience.
Nubia Flores Miranda, 18, works part-time at Family Paths, a counseling and mental health organization in Oakland, Calif., on Friday, January 29, 2016. Miranda said she became interested in a career in mental health after she started experiencing depression and anxiety her freshman year at Life Academy of Health and Bioscience. Kaiser Health News

Psychiatric hospitalizations of Latino children and young adults in California are rising dramatically and at a much faster pace than among their peers, according to state data.

While mental health hospitalizations of young people of all ethnicities have climbed in recent years, Latino rates stand out. Among those 21 and younger, rates shot up 86 percent, to 17,813, between 2007 and 2014, according to the Office of Statewide Health Planning and Development. That’s compared with a 21 percent increase among whites and 35 percent among African Americans.

Policymakers and Latino community leaders offer varying and sometimes contradictory explanations. Some say the numbers reflect a lack of culturally and linguistically appropriate mental health services for Latinos and a pervasive stigma that prevents many from seeking help before a crisis hits.

“Often, they wait until they are falling apart,” said Dr. Sergio Aguilar-Gaxiola, a professor at the University of California, Davis, Medical School and director of the university’s Center for Reducing Health Disparities.

Others blame stress from the recent recession, family disintegration and an influx of traumatized children fleeing poverty and violence in Central America.

Still others suggest the trend might actually be positive, reflecting an increasing willingness among Latino parents to seek treatment for themselves and their children.

Among Latino adults, psychiatric hospitalizations rose 38 percent during the same period. Similar hospitalizations of black adults increased 21 percent, while hospitalizations of white adults remained flat.

Margarita Rocha, the executive director of the nonprofit Centro la Familia in Fresno, said mental health issues are starting to be discussed more publicly in the Latino community.

“That’s helping people to come forward,” she said.

Kids’ psychiatric hospitalizations overall rose nearly 45 percent between 2007 and 2014, regardless of ethnicity, a pattern experts attribute to factors such as a shortage of intensive outpatient and in-home services, schools’ struggles to pay for mental health services through special education and a decline in group home placements.

The rise among Latino youths is remarkable in part because hospitalization rates for that population historically have been low. And population increases do not nearly account for the growth.

Latino children remain much less likely to receive mental health treatment through Medi-Cal, the state and federal coverage program for poor and disabled residents. Between 2010 and 2014, less than 4 percent of Latino children received specialty mental health services through the traditional Medi-Cal program. That’s compared with 7 percent of eligible black and white children, according to state data. The numbers don’t include those enrolled in managed care.

Access to care can be even harder for recent immigrants. Spanish-speaking children who have been referred for a special education assessment, which can help them become eligible for mental health services, sometimes wait years before someone tests them, said Leslie Preston, the behavioral health director of La Clínica de La Raza, in East Oakland.

“The families don’t know the system,” she added. “They don’t know their rights.”

Other clinicians point to relatively low health insurance coverage among Latinos, particularly those without legal status, and a cultural resistance to acknowledging mental illness.

Dr. Alok Banga, medical director at Sierra Vista Hospital in Sacramento, said some immigrant parents he encounters don’t believe in mental illness and have not grasped the urgency of their children’s depression and past suicide attempts. Many are working two or three jobs, he said. Some are undocumented immigrants afraid of coming to the hospital or having any interaction with Child Protective Services.

But the biggest problem, from his perspective, is the shortage of child psychiatrists and outpatient services for the population.

“The default course for treatment falls on institutions: hospitals, jails and prisons,” he said.

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