Mental Illness in Hispanics: A Review of the Literature

Although Hispanics are the largest minority in the United States, we have only fragmentary information and scarce guidelines on the frequency, recognition, and treatment of mental illness in this population. In reviewing the literature on this issue, the authors found that Hispanics are younger, poorer, and less educated than the average American; have an average unemployment rate; are heterogeneous in aspects such as race/genetics, health care access/utilization, acculturation, and legal status; differ in risk of some mental illnesses and in risky behaviors according to birthplace/acculturation; are at increasing risk of behaviors and health issues that complicate mental illness and its treatment, such as obesity, diabetes, and sedentary lifestyle; have less access to health and mental health care and receive less care and lower-quality care; tend to receive mental health care in primary care settings, often face linguistic barriers, and are more likely not to have mental disorders detected; seem less likely to suffer from depression and anxiety but tend to have more persistent mental illnesses; are more likely to somatize distress and to report psychotic symptoms in the absence of a formal thought disorder; do not appear to differ from Caucasians in drug metabolism and pharmacokinetics; seem to have lower medication adherence, which could be a function of socioeconomic and linguistic or educational factors; seem to respond well to adapted psychotherapeutic and psychosocial interventions and receive significant additional benefit from supplemental services such as case management, collaborative care, and quality improvement interventions.