Ismael Cordová-Clough has never been one to hide his emotions. Born to Mexican immigrants in suburban Chicago, Cordová-Clough is quick to speak up when something bothers or upsets him—a habit that often annoyed his family growing up.
“My parents always identified me as overly sensitive, and they considered that a very strong weakness,” said Cordová-Clough, 26, a community outreach coordinator at a federally qualified health center. “(They) always said my life could be a lot worse, so I had no reason to complain or feel the emotions that I felt.”
At 12 years old, Cordová-Clough was outed as gay by a member of his family’s church. The revelation further alienated him from his parents and siblings, leading him to resort to self-harm as a coping mechanism. Four years later, he tried to take his own life and spent 18 months at a state-run psychiatric hospital.
“That (experience) really turned a page for me,” said Cordová-Clough, who went on to earn a college degree and start a career in the medical industry. “I realized that God made me survive for a reason. And so I had to find my path and identity.”
It took a suicide attempt for Cordová-Clough to receive comprehensive psychiatric care and other behavioral health services. His experience as a teen highlights the ongoing challenge of mental health care accessibility in the U.S., especially for Latinos and communities of color.
Officials have recently taken steps to address the gap in care. On July 25, the White House proposed new rules to pressure insurers into bolstering behavioral health coverage, on the same day that Sens. Alex Padilla (D-CA) and Bob Menendez (D-NJ) introduced legislation to strengthen education around mental health.
Cordová-Clough believes these and other policy changes are needed to connect more Latinos to mental health services.
“To this day, many of the clients and patients I see struggle with access to quality and affordable behavioral health,” he said. “It breaks my heart.”
Ending the Stigma
Just 36.1 percent of Latinos with mental illness received treatment in 2021, compared with 52.4 percent of white adults and 39.4 percent of Black adults, according to the latest National Survey on Drug Use and Health from the Department of Health and Human Services.
Federal data also points to worsening mental health among Latinos in recent years. Latinos reported exceptionally high levels of anxiety and depression throughout the COVID-19 pandemic, government surveys show, and their suicide rate climbed nearly seven percent between 2018 and 2021.
Such data underscores the need to address persistent barriers between Latinos and behavioral health services.
“We’re talking about a community that sees mental health as taboo,” said Bethsy Morales of the Hispanic Federation, a national nonprofit empowering Latinos through partnerships and community initiatives. She cited the ongoing shortage of Latino behavioral health providers as a major deterrent to seeking care.
Eliminating the stigma around mental health will require increasing Latino representation in psychiatric care and making services more culturally and linguistically responsive, says Morales. Her organization is trying to accomplish this through CREAR Futuros, a program that offers mentorship opportunities to Latino college students and helps them start careers in the medical field.
The bill introduced by Sens. Padilla and Menendez in late July, the Mental Health for Latinos Act, aims to encourage Latino participation in behavioral health services through education and outreach campaigns at the federal and community levels. Lawmakers hope the measure can be incorporated into a broader mental health package passed by the House of Representatives in 2021, NBC News reported last month.
“The Mental Health for Latinos Act will improve mental health outcomes by strategically reducing stigma and encouraging people to reach out for help,” said Sen. Padilla in a statement.
Some leaders say combating the stigma will require challenging longstanding norms ingrained in Latino communities.
“Many of us often grow up in a machismo culture, thinking that we’re not allowed to cry and we’re supposed to work through burnout,” said Juan Rosas, a California-based pastor and a program associate at the Hispanic Access Foundation, another Latino advocacy group. “We need to learn how to… break Hispanic stereotypes on what it means to be a young man or young woman in society.”
Experts also blame high costs and coverage gaps for limiting access to mental health services. Federal law requires insurance companies to offer equal coverage for physical and behavioral care, but private health plans have been criticized for refusing to pay for certain treatments and excluding providers from their networks.
Insurers’ unequal coverage of behavioral health services reflects enduring societal attitudes about the value and legitimacy of mental health, one medical professional told Latino Rebels.
“We are very harsh on people” when it comes to mental illness, said Dr. Jane Delgado, a clinical psychologist who heads the National Alliance for Hispanic Health. “Unless we see something physically wrong with them, whatever empathy we have disappears.”
The Biden administration is looking to boost mental health parity standards through the series of rules unveiled last month. The proposed regulations, which must still undergo a public comment period, would require insurers to analyze their plans to ensure equal access to mental and physical health benefits.
“I don’t know what the difference is between breaking your arm and having a mental breakdown is—it’s health,” President Joe Biden said during an event at the White House announcing the new rules.
Delgado calls the proposed changes “a step in the right direction” but notes that they won’t help the nearly 18 percent of Latinos in the U.S. without health insurance. Many lack coverage through no fault of their own, Delgado explains, either because their employer doesn’t offer health benefits or their state hasn’t expanded Medicaid under the Affordable Care Act.
“At a fundamental level, people need to have access to insurance,” she said. “If you don’t have that, you’re not going to see anyone” specializing in behavioral health.
Cordová-Clough stresses that cost shouldn’t be a barrier to behavioral health services or any other type of care. He urges young people to talk about their mental health struggles, noting that his stint at the psychiatric hospital a decade ago probably saved his life.
“Even though it feels in the moment like the world is crumbling all around you, you will get past it,” he said. “There is always a path to happiness.”
Illan Martin Ireland is a summer correspondent at Futuro Media and a graduate of the Columbia University Graduate School of Journalism.