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230 journalofMulticulturalcounselinganddevelopMent•october2007•vol.35

©2007americancounselingassociation.allrightsreserved.

latinaMothers’perceptionsofMentalhealthandMentalhealthpromotion

ElizabethM.VeraandWendyConner

latinamothers’perceptionsofmentalhealthandfactorsthatpromote/restorementalhealthwereexploredinthisqualitativestudy.participantsdiscussedthe importance of community, safety, and financial stability in addition toconventionalfactorsthatarerelatedtomentalhealth.implicationsforworkingwithurbanlatinasandtheirfamiliesarediscussed.

enesteestudiocualitativoseexploraron laspercepcionesde lasmadreslatinassobresaludMentalylosfactoresquelafomentan/restablecen.lasparticipantesdiscutieronacercadelaimportanciadelacomunidad,lase-guridadylaestabilidadfinancieraademásdeotrosfactoresconvencionalesrelacionadosconlasaludmental.sediscutenlasimplicacionesparaeltrabajoconlatinasresidentesennúcleosurbanosysusfamilias.

Theunderutilizationofmentalhealthservicesbypeopleofcolorhasbeenwelldocumented(Akutsu,Snowden,&Organista,1996;Padgett,Patrick, Burns, & Schlesinger, 1994; Pumariega, Glover, Holzer, &

Nguyen,1998).Althoughavailabilityofmentalhealthservicesundoubtedlyaffectsutilization,ratesofutilizationdifferamongethnicgroupsevenwhenaccesstoservicesissimilaracrossethnicgroups(Alvidrez,1999).Oneaspectofunderstandingthecausesofunderutilizationisexaminingtheculturalap-propriatenessofavailableservices.ThiscontentionissupportedbypoliciessuchastheMulticulturalCounselingCompetencies(Roysircar,Arredondo,Fuertes, Ponterotto, & Toporek, 2003) and the Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists(AmericanPsychologicalAssociation,2003),whichofferrecommendationsforadaptingservicestomeettheneedsofdiverseconstituents.

Understandingculturalbeliefsandvaluesofethnicgroupsisimportanttothedevelopmentoftreatmentapproachesthatareculturallycongruent.InthecaseofLatinoclients,muchhasbeenwrittenabouttheculturalcharacteristicsofthispopulation.Forexample,MarinandMarin(1991)characterizedLatinosas(a)grouporiented,(b)valuingharmoniousinterpersonalrelationships,(c)loyaltofamily,(d)deferenttoauthorityfiguresorreveredrelatives,and(e)valuingtraditionalgenderroles.Onthebasisofthisinformation,groupandfamily-basedmodalitiesofcounselingmightbeviewedasculturallyap-propriateforLatinoclients(Falicov,1996),primarilybecauseofthesystemicnatureofconceptualizationsthatmayappeal tomembersofcollectivistorinterdependentcultures(Triandis,1988).Althoughsuchtreatmentapproaches

Elizabeth M. Vera, School of Education, and Wendy Conner, Department of Counseling Psychology, both at Loyola University Chicago. Correspondence concerning this article should be addressed to Elizabeth M. Vera, School of Education, 820 N. Michigan Avenue, Loyola University Chicago, Chicago, IL 60611 (e-mail: [email protected]).e-mail: [email protected])[email protected]).

journalofMulticulturalcounselinganddevelopMent•october2007•vol.35 231

maybeeffectivewiththispopulation,Latinoclients’perceptionsofwhethercounselingisaculturallyappropriateoptionisdirectlyrelatedtotheirutiliza-tionrates.ThisissuemaybeparticularlyrelevanttotailoringmentalhealthservicestomeettheneedsofLatinawomen.Giventhatwomenoftenattendtotheemotionalneedsofthefamilies,understandingtheirperceptionsofmentalhealthandhelp-seekingbehaviorsare important tounderstandingtreatmentdecisionsofLatinofamilies.

purpose of the studyIncreasingthefield’sknowledgeofhowwomenofcoloringeneral,andthosewhoaremothersinparticular,conceptualizementalhealthanditsmaintenancemaybeinformativetothedevelopmentofculturallyrelevantindividualandfamilymentalhealthpromotionandremediationefforts.Becausemothersareoftenthe“monitors”oftheirchildren’semotionalneeds,theirperceptionsofmentalhealthandrelatedinterventionswouldhaveimplicationsforworkingwithLatinasandtheirfamilies.Itisnotassumedthatbeingamother,perse,wouldaffectthementalhealthbeliefsandexperiencesofserviceprovisionsofLatinas.However,giventhepowerfulrolethatmanyLatinamothershavein protecting the mental health of their families, this population was thefocusof thepresent investigation.This studywasguidedbyan interest intheparticipants’beliefsaboutthefollowingissues:(a)Howismentalhealthunderstoodor conceptualizedbyurbanLatinamothers? (b)What factorsaffect mental health, both positively and negatively? and (c) What formalandinformalmethodsofhelpseekingareusedforthementalhealthneedsofLatinamothersandtheirfamilymembers?

relevant literatureIncomparisonwiththeamountofliteratureonLatinawomen,arelativelylargerbodyofresearchexistsonwomenofcoloringeneralandtheirdeci-sionstousementalhealthservices.Severalrecentstudieshaveexaminedthehelp-seekingattitudes,explanationsofpsychologicaldisorders,andcopingstrategiesofwomenofcolor(Alvidrez,1999;Brodsky,1996).Alvidrezfoundthat,forlow-incomewomenofcolor,thelikelihoodofmakinganappoint-ment to see a mental health professional was predicted by problem type,beliefsabouttheoriginofmentalhealthproblems,andhavingafriendorfamily member who had sought services. In her sample, stigma regardingpsychologicalproblemsandpreferenceforinformalmeansofhelpseekingwerenotfoundtoberelevantpredictorsofseeingamentalhealthprofes-sional.Alvidrez’sstudywasveryhelpfulinclarifyingsomeofthefactorsthatleadwomenofcolor toseektheassistanceofmentalhealthprofessionals,butitdidnotexploreawiderangeofprecipitatingeventsthatmightresult


inawomanseekingservicesinthefirstplace.Additionally,theroleoflargersystemic factors such as poverty or community in jeopardizing the mentalhealthofwomenwasnotexplored.

Brodsky(1996)examinedtheroleofpovertyandcommunity factors inthementalhealthandresiliencyoflow-incomeAfricanAmericanwomen.Resiliencyisdefinedastheabilitytopersevereinthefaceofobstacles(Mas-ten, 2001). Brodsky found that, for women who see the community as aburdenasopposedtoaresource,distancingfromthecommunitywasseenasacopingmechanismthatenhancedresiliencyandmentalhealth.Herfindingschallengedtheextantliteraturethatfoundcommunityinvolvementandbelongingtoberelatedtopositivementalhealthforwomenofcolor(McMillan&Chavis,1986).Yetthefindingscouldhavebeenafunctionofsocial class rather than the ethnicity of the participants. In other words,Brodsky’sparticipants’residenceinanimpoverishedneighborhood,nottheirethnicbackgrounds,wasmostlikelywhatinfluencedtheirperceptionsoftheneighborhoodasunsafe.ThemostdistinctiveaspectofBrodsky’sstudyis that it is one of the only investigations in which women of color wereinterviewedabouttherelevanceofcommunityandneighborhoodfactorsinrelationtomentalhealthandresiliency.

Otherthantheaforementionedstudies,therehasbeenrelativelylittlere-searchdoneonmothers’perceptionsofmentalhealth,barrierstotreatment,ormentalhealthpromotion.WefoundevenlessresearchonLatinamothers’perceptionsofmentalhealth.Onerecentstudy(Christie-Mizell,Steelman,&Stewart,2003)focusedonethnicdifferencesinperceptionsofmaternaldistressandneighborhooddisorderinanonclinicalsampleofmothers.ThatstudyfoundthatMexicanAmericanandAfricanAmericanmothersperceivedhigher levelsofneighborhooddisorder thandid theirWhitecounterpartsandthatperceivedneighborhooddisorderwassignificantlypredictiveofma-ternaldistress(afindingthatwasexacerbatedforAfricanAmericanmothersbynumberofchildren).

However,themajorityofextantresearchonLatinamothershasfocusedonmotherswhosechildrenhaveidentifiedpsychologicalorbehavioraldisordersoronthementalhealthproblemsofthemothersthemselves(Ainsenberg,2001;LaRoche,Turner,&Kalick,1995;Pavuluri,Luk,&McGee,1996;Raviv,Raviv,Propper,&Fink,2003).Ingeneral,thisresearchhasusedsurveyre-search that limits responses topredeterminedcategoriesofmentalhealthproblemsandresources.Thisisproblematicbecausewomenofcoloroftenhavealternativeconceptualizationsofmentalhealthproblemsandappropriateresponsestosuchproblems(Alvidrez,1999).Thepaucityofmorediscovery-orientedresearchunderscorestheneedforadditionalempiricalstudiesthataddressLatinamothers’generalperceptionsofmentalhealthbarriersandattitudestowardhelpseeking.Aqualitativeresearchapproachwasselectedforthisstudytogeneratesuchdiscovery-orienteddata.


Thisstudyusednarrativeinquiry(Guba&Lincoln,1985)asaqualitativemethodologytoinvestigateperceptionsofandattitudestowardmentalhealthinasampleofresilient,urbanLatinamothers.Innarrativeinquiry,first-personaccountsofexperienceformthenarrativetextofthisresearchapproach(Mer-riam,2002).Thegoalofnarrativeinquiryistomakesenseofexperiencebycommunicatingandconstructingmeaning(Chase,1995).Theinterpretationofnarrativedata involves the identificationof thematiccategories thataredescriptive(vs.interpretive)andareallowedtoemergefromthedatausinganopen-codingprocess(Miles&Huberman,1994;Strauss&Corbin,1990).Narrativeinquirydiffersfromotherapproachestoqualitativeresearch,suchasgroundedtheory,inthatitaimstodescribeexperienceasopposedtode-velopandprovisionallyverifytheorycontainedinthedata(Merriam,2002).GiventhelimitedresearchonLatinamothers’perceptionsofmentalhealth,itwouldbeprematuretoconstructtheory.Narrativeinquiryisappropriatewhendiscoveryofphenomenaisthegoalofthestudy.

Whereaspaststudies(Alvidrez,1999;Landrine&Klonoff,1994)havelargelyused quantitative approaches to understanding mental health conceptual-izationandpatternsofserviceutilizationinwomenofcolor(e.g.,symptomandresourcechecklists),existingsurveysoftenfailtoincorporateprotectivefactorsorprocessesthatmaypromotementalhealth,notjeopardizeit.Thedecisiontouseaqualitative,discovery-orientedapproachwasalsobasedontheanticipationofilluminatingprotectivefactorsorfactorsthatareimportanttomaintainingmentalhealth.

methodparticipants

Participantsinthisstudywere10Latinamotherswhoresidedinalow-incomeneighborhoodinalarge,midwestern,urbancommunity.Participantswerenominatedbytheirchildren’sschooladministrators,bycommunityleaders,andbyotherparentswhosechildrenattendedthelocalpublicelementaryschool.Thecriteriafornominationwerewomenwhowereperceivedassuc-cessfulinovercomingchallengesofraisinghealthychildren(i.e.,anexampleofresiliency)andlivinginalow-incomeenvironment.The10motherswhowereselectedforparticipation,then,werenotthoughttoberepresentativeofparentsingeneralorLatinamothersasagroup,butratherwerethoughttobepotentiallyeffectivespokespersonsforresilientLatinamothersinthecommunity. This participant selection procedure has been used in otherstudies(e.g.,Brodsky,1996).

Mothersrangedinagefrom30to43years.Sixwerefirst-generationMexicanimmigrantswhohadlivedintheUnitedStatesformorethan10years(rang-ingfrom10to18years).Oftheremainingfourparticipants,threewereborninthecontinentalUnitedStatesandwereofArgentinian,PuertoRican,and


multiracialethnicbackgrounds.OnemotherwasbornontheislandofPuertoRico.Allmothershadworkedoutsidetheirhomesinpositionsthatrangedfrompaidemploymentassecretariestovolunteerworkasteacher’saidesorcrosswalkguards.Nospecificdataweregatheredontheincomesearnedbytheparticipantsbecauseitwasdeterminedthroughconsultationwithleadersinthecommunitythatsuchaquestionwouldbeviewedasculturally inap-propriate.Sevenofthemothersweremarriedtothefathersofatleastoneoftheirchildren,andthreewereinnonmarital,cohabitatingrelationships.Thenumberofparticipants’childrenrangedfromonetothree.Theagesofthechildrenrangedfrom18monthsto12years.

Themotherswereinvitedtoparticipateinthestudybytheprimaryinvesti-gator(firstauthor)atatimethatwasconvenientforthemintheirchildren’sschoolsetting.Motherswhowereemployedbyorvolunteeredattheschoolreceivedpermissionfromtheprincipaltoparticipateintheinterviewsduringtheirworkdays.Informedconsentwasobtainedpriortothebeginningoftheinterviews,andtheparticipantswereassuredthattheinformationgatheredwasanonymousand thatpseudonymswouldbeused in thedescriptionofthefindings.Aftertheinterviewswerecompleted,giftcertificatestoalocalgrocerystorewereofferedtoparticipantsastokensofgratitude.Noincentivewasofferedtomotherswhentheywereinvitedtoparticipate.

procedure

Individualinterviewswereconductedforthisstudybyabilingual,doctoral-levelpsychologist(firstauthor) inEnglish,orSpanish,orboth languages,dependingonthepreferencesoftheparticipants.Interviewslastedapproxi-mately30minutesandwereguidedbythefollowingopen-endedquestions,derivedfromareviewofpreviousliterature:(a)“Howdoyouunderstandthetermmental health?”withafollow-upprobe,“Forexample,whatwouldbesomeofthecharacteristicsofpeoplewhohavegoodmentalhealth?”(b)“Whatarethekindsofthingsthathelppeopletostaymentallyhealthy?”(c)“Whatarethekindsofthingsthatcandamageorthreatenmentalhealth?”(d)“Whatwouldbeacceptablewaystoaddressamentalhealthprobleminyourcom-munity?”(e)“Whatisavailabletopeopleinthecommunityrightnowthathelpspromoteandmaintainmentalhealth?”and(f)“Whatarethingsthatarenotavailablerightnowbutwouldbebeneficialinpromotingandmain-tainingmentalhealthforpeopleinthecommunity?”

dataanalysis

Individualinterviewsweretranscribedfromaudiotapes,andthetranscriptswereinitiallyreviewedbytheparticipantsforaccuracy.Secondaryinterviewswerescheduledwiththeparticipantsafterthenarrativedatahadbeenana-lyzedandcategorizedbythecoders.Atthetimeofthefollow-upinterviews,


participantswereabletocommentontheextenttowhichthecategorizationoftheirindividualresponsesappearedappropriateandtoelaborateontheirinitialresponses.Thisprocesswasusedtoenhancethecredibilityandvalidityofthedataobtained.Additionally,inanefforttominimizepersonalbias,theinterviewerkeptfieldnotes,whichwerelatercomparedagainsttheresultsofthefinalanalysis.

Twoindependentcodersidentifiedemergentdescriptivethemesfromthetranscribedinterviewsinthisstudy.OneofthecoderswasaWhite,femalegraduatestudentwhohadpreviousclinicalandresearchexperienceworkingwithLatinos,and theotherwasaLatinaprofessor.The themeswere thencomparedandintegratedintoaninitiallistofcodingcategories.Onceafinallistofthemeswasconstructed,twoadditionalcoderstestedthereliabilityofthecodingscheme.ThesesecondarycoderswereWhite,femalegraduatestu-dents.Eachcoderhadbeentrainedinqualitativeresearchanddataanalysisinthecourseoftheirstudies,andneitherwasinvolvedintheplanningofthisstudy.Thedecisiontousetheseadditionalcoderswaspartofastrategytoincreasetherelativeobjectivityofthedataanalysisandtopreventresearcherbiasfrominfluencingtheresults.Thesecondarycoderscategorizedsamplesofthedataintotheexistingschemawitha90%successrate.Discrepanciesincategorizationwerediscusseduntilconsensuswasachieved.Narrativesampleswerethenselectedfromtheinterviewstoillustratethemes.Illustrativesampleresponseswereattributedtoparticipantsusingonlypseudonymsandbriefdemographicdescriptors.

resultsWhatdefinesMentalhealth?

Participantsdescribedavarietyofcharacteristicsofmentallyhealthypeople,suchasstabilityandhappiness.Onerepeatingthemeinall10interviewswastheinterpersonalnatureofmentalhealth.Harmoniousrelationshipswithinthefamily,providingsupporttoothers,andfosteringinterdependencewereassociated with positive mental health. Every participant talked about theconnectionbetweenparentalandchildmentalhealth.Parentswereviewedasrolemodelswho“taught”theirchildrenhowtobehealthypeople.Toquoteoneofourparticipants,“happyparentsmakehappychildren.”

Interpersonalcomponentsofmentalhealthwerenotdiscussedtotheexclu-sionofindividualfactors.Hopeandoptimismwereidentifiedascomponentsofpositivementalhealth.Daria,a30-year-oldmotheroftwo,stated,

Igivemykidsahardtime.Itellthemthatifyouhaveabadattitude,youaregoingtohaveabadday.Everythingisinyourmind.Ifyouexpect[tohave]agoodday,lookforwardtogoingtoschool,thenyouwillhaveagoodday.Itisuptoyou.Nooneelsedeterminesthis.


WhatproMotesMentalhealth?

Environmentalinfluencesonmentalhealthconstitutedanothercategoryoffactorsthatpromotedmentalhealth.Havingaccesstotangible,economic,andsocialresourceswasseenbyeightparticipantsascriticalinfluencesonthementalhealthoffamiliesinthecommunity.Participantsrecountedsto-riesoffamilieswholosttheirhomesbecauseoffiresorwhowereforcedtomoveinwithotherfamiliesbecauseofunexpectedjobloss.Althoughtheseeventswereassociatedwiththreateningmentalhealth,thesocialresourcesprovided by neighbors were cited as “protective.” Cristina, a 43-year-oldmotherofthree,stated,

Lotsoffamiliesstrugglehere,andiftheyrecover,itisbecausesomeonewasthereforthem.Mostofthetime,itisotherfamiliesthatstepintobethere.Butwhenfamiliesreachouttoneighborswho[have]stumbled,amazingthingscanhappen.

Notonlywerealackoffinancialresourcesaconcernforparticipants,butalsotheavailabilityofcommunity-sponsoredresourceswereconcideredanimportantprotectivefactorforhalfoftheparticipants.Theavailabilityofre-sourcessuchassaferecreationalareaswasseenasafactorpromotingmentalhealthforfamilies.Jacinia,a34-year-oldmotheroftwo,stated,

Whatpromotesmentalhealth?Tome,it’sdaycarecenters,aclose-byjob,parkdistrictprograms. (Interviewer: How do these help promote mental health?) When you canprovideforyourkidsanddon’tfeelguiltyaboutnotbeingwiththemorwonderiftheyaresafe,youhavepeaceofmind.Knowingyourkidsaresafeishavingmentalhealth.

Onasimilarnote,neighborhoodfactorssuchasaffordablehousingwerelinkedtomaintainingmentalhealth.Carolina,a30-year-oldmotheroftwo,toldastoryaboutafamilythathadbecomehomelessbecauseofgentrificationintheneighborhood,whichhadpromptedlocallandlordstoraiserents.Sheconcludedthat“ifyouloseyourhome,everythingisupforgrabs.Yougotoashelter,youmoveinwithanotherfamily,buteverythingchanges.Thisiswhyparentshavetocometogethertofightgentrificationandotherthreats.”

UsingcommunityresourcesonaregularbasiswasviewedasanavenuetopromotingmentalhealthforLatinawomeninthecommunityinparticular.Linda,a30-year-oldmotheroftwo,stated,

EspeciallyforLatinas,wedon’tneedtosithomealoneinthehouse.Ifyoucan’tgetajob,whileyourkidsareinschool,youneedtostayactive,involvedwithpeople,caringforyourkids,yes,butalsogoingtochurch,exercising,volunteering,whateveryoucangetyourselfinto.

Community-sponsored programs for families and youth were mentionedbyhalftheparticipantsasresourcesthatcanprotectmentalhealth.Yetoneparticipant, Linda, a 30-year-old mother of two, expressed a concern that


there were misperceptions of some of the existing programs that affectedhowmuchtheywereusedbythecommunitymembers:

Alotofparentsseetherec[reation]centersandaren’tsureiftheyarereallygoodfortheirkids.Theythink,“Whatifthisiswherethegangbangershangout?”evenifitisnottrue.Itisreallyimportantforparentstoknowthatitissafeforyourkidshere.

Mistrustduetoperceivedcommunitydangerswasmentionedasan issuethatpreventedsomemembersofthecommunityfromtakingadvantageofavailableprograms,althoughsuchproblemshavethepotentialtoenhancefamilymentalhealth.Theseresponsesreflectedanawarenessofformalmentalhealthservicesinthecommunitybutunderscoredtheimportanceofsuchresourcesbeingtrustworthyandsafe.

WhatthreatensMentalhealth?

Manyconventionalthreatstomentalhealthwereidentifiedinresponsetothisquestion.Allparticipants listeddivorce,drugs,conflict,neglect, illness,andabuseaslifeeventsthatarehighlydisruptivetoone’smentalhealth.Halfoftheparticipantsgaveequalemphasistolackofresourcesandnegativecommunityinfluences.Forexample,alackofopportunitiesto“staybusy”withone’sfamilywasmentionedasathreattomentalhealth.Additionally,gangsandrelatedviolenceinthecommunitywerelistedasfactorsthreateningmentalhealthinfamilies.Cristina,a43-year-oldmotherofthree,stated,

Someofthethingsinthestreetthatfamiliesareexposedto...thatkindofnegativityisahardthingtoovercome.Youtakethelittleonestotheparkandsometimesyougetnervous’causeofwhoelseisthere.Maybesomethingisabouttogodown,youdon’tknow.Buthavingtoworryaboutwhatyoudon’texpect,thatisaproblem.

In addition to safety, direct family influences were seen as affecting thementalhealthofchildren.Sevenparticipantsdiscussedconcernsaboutthecommunity’s number of teenage parents viewed as being ill-equipped toprovide for their children’s emotional needs. For parents in general, notspendingtimewithone’sfamilywasidentifiedascontributingtoaclimatethatthreatensmentalhealth.Insomecases,thereasonsforthiswereeconomic.Threeparticipantsdiscussedsituationsinwhichparentsworkedtwoorthreejobsandwereneverphysicallypresentwhentheirchildrenwerehome.Allparticipantsdescribedthestressorsofbeingsingleparentsthatcompromiseone’s ability to be emotionally present in the family. Linda, a 30-year-oldmotheroftwo,stated,

Lotsofparentsinthiscommunityareliterallynottherefortheirkids.Thekidsgohometoanemptyhouseeveryday.Othersstartoutbeingtherebutcan’thandleallthepres-sureofbeingalonewiththekidsandfallthroughthecracks.Youarehanginginthere,holdingajob,payingrent,andonedayitgetstobetoomuchanditallfallsapart.


Whetherabsencewasdefinedasphysicaloremotional,beingunavailabletoone’sfamilymemberswasviewedasanimportantthreattomentalhealth.

WhatareacceptaBleWaystorestoreMentalhealth?

Manyinformalandformalmechanismsforaddressingmentalhealthprob-lemswerediscussedbytheparticipants.Theimportanceofconsultingwithtrustedindividuals,suchasfamily,friends,clergy,orpeersinthecommunity,wasdiscussedbyeightparticipants.Fiveoftheseparticipantsdescribedsuchindividualsas“mentors,”orpeoplewhohavedifferentperspectivesonsitu-ationswhoseadvicewouldbevaluableandwelcomed.

Thegeneralissueoftrustworthinesswasmentionedinalloftheconversa-tions.Giventhattheproblemsdiscussedbytheparticipantswereofamorepersonalnature(i.e.,familyproblems),participantsstressedtheimportanceoffindingsomeonewhocouldprotecttheirprivacy.Thethemeoftrustwor-thinessextendedtotheparticipants’opennesstoformalsourcesofsupportas well. In terms of formal strategies to address mental health problems,participantslistedcounselors,socialworkers,andpsychologistsasbeinggoodresources,especiallyiftheywere“knownquantities.”Schoolcounselorsandpsychologistsaffiliatedwiththeparticipants’children’sschoolswereseenaspotentialresources.Allparticipantsseemedknowledgeableabouttheclinicsinthecommunitythatofferedmentalhealthservicesandmentionedseveralbyname.The formal sourcesof supportwere identifiedaspreferredoverinformalresourcesonlywhentheproblemwasofalargeenoughmagnitudeandinformalresourceswereinsufficient.

WhatresourcesareavailaBleandWhatareneeded?

Noneoftheparticipantsreportedconcernsabouttheoverallqualityoftheresourcescurrentlyavailable to thecommunity,buthalf reported that thequantityandavailabilityofsuchresourcescouldbegreatlyexpanded.Theexistingcommunityresourcesappearedtobeunderutilizedbyfamilieseitherbecauseofsafetyconcernsorbecauseparentslackedtheinitiativetolocatesuchresources.Claudia,a35-year-oldmotherofone,stated,

Thereareopportunitiesforfamiliestogethelpwhentheyneeditandtostayinvolvedinthingsthataregoodforthem,butyouhavetolookforthosethings.Theyarenoteverywhereordeliveredonaplatetoyou.Youhavetocheckthingsoutandgetit.

Thisstatementillustratestheparticipants’sentimentsthatitwasuptopar-entsnotonlytobeawareofwhatisavailablebutalsotobeactiveinpursuingandevaluatingthequalityofresourcesfortheirfamilies.

Inadditiontocommunityprograms, fourparticipantsexpressedadesireformentalhealthprofessionalstobeactivemembersofthecommunity.Theimportanceofmentalhealthprofessionalsknowingthestrengthsandneeds


ofthecommunity,asopposedtointerveningonlywhenproblemsarise,wasdiscussed.Cristina,a43-year-oldmotherofthree,stated,

Ifcounselorscouldbeapartofthecommunity,partofanefforttopreventproblemsfromthebeginning,walkingintheshoesofthecommunity, itwouldbebetterthanwaitingtostepinuntilitistoolatetodomuch.Weneedpartnerstowalkwithus.

discussionTheresultsofthisinvestigationareconsistentwithseveralotherstudiesthathavefoundmentalhealthtobeperceivedasinfluencedbyindividual,family,andenvironmentalfactors,specificallybywomenofcolorandLatinasinpar-ticular(Christie-Mizelletal.,2003;Jenkins&Cofresi,1998).However,thesedatasuggestthatseveraltypesofindividual,family,andcommunityresourcesareviewedasassetsthatpromotementalhealthforLatinasandtheirfamilies.Participants in the studywere family andcommunity focused inhow theyconceptualizedmentalhealthandwhichpreventativeresourcestheyviewedasrelatedtothemaintenanceofmentalhealth.Therewereseveraloccasionswhenindividualpsychologicalresources(e.g.,positiveattitude)weremen-tionedasimportantdeterminantsofmentalhealth,butthethemesidentifiedfromthedatareflectadistinctfocusonfamilyandcommunityinfluences.Thismaybecause,asmothers,theseLatinaparticipantsweremoreorientedtoaspectsoffamilyandparentingthanwouldbewomenwithoutchildren.Participants’ ethnic heritages may also shape their worldviews to be morecollective, regardlessofwhether theywereparents (Marin&Marin,1991;McNeilletal.,2001).Thelow-incomestatusoftheneighborhoodcombinedwiththecollectiveorientationoftheparticipantsmayhaveexacerbatedtheimportanceofcommunity,aswasfoundinBrodsky’s(1996)study.

Thesenarratives support thepastworkof feminist theorists(Mattis,2002)documenting thatworldviewsofwomen ingeneralarerelational innature.TheimplicationsforpsychologistsandcounselorsworkingwithurbanLatinamothersandtheirfamilies,especiallythosewhoresideinlow-income,urbancommunities,aremultiple.First,adoptingasystemic,relationalfocusinthedeliveryofmentalhealthservicesissupportedbythesedataandpastliterature(Falicov,1996;i.e.,familyandgroup-basedinterventions).Second,attendingtothelargersocialcontextintheprovisionofservices(e.g.,communityresources,familyincomeneeds,publicspacesinwhichfamiliescanspendtimetogether)asitaffectsmentalhealthandwell-beingissupportedbythesedataandotherstudies(Rosado&Elias,1993).Third,afocusonpreventiveinterventionsandconnectingfamilieswithcommunityresourcesmaybeanimportantsupplementtomoretraditionalservicedelivery(i.e.,therapy;Vera&Speight,2003).Inad-dition,informalsupportserviceswithincommunityinstitutions(e.g.,supportgroups)mayalsobeviewedfavorablybyLatinamothers,afindingsupportedbypreviousliterature(Rhodes,Contreras,&Mangelsdorf,1994).


Fourth,theabilitytoformongoing,collaborativerelationshipswithinthecommunitymaybeakeytodecreasingtheunderutilizationofservicesbyLatinamothersandtheirfamilies.Participantsinthisstudyempha-sizedtheimportanceoftrustworthinessandfamiliarityintheutilizationof formal community services. Although many service providers maywork in agencies or schools that are located within the communities,theextenttowhichtheyareviewedasinsidersversusoutsidersmaybeanimportantissueinfluencingdecisionstoseekservices.Itmaybethattheissueoftrustisexacerbatedbyacculturationinthatmoreaccultur-atedparticipantswouldhavepreferredtheuseofservicesbyunknownprofessionals,asismoretypicaloftraditionaltherapeuticservices.ThisinterpretationmaybesupportedbyfindingsfromanotherstudyofLa-tinamothers,whichfoundthatprivatepsychologistswerepreferredtoschool-basedpsychologistsinseekingtreatmentfortheirchildren(Ravivetal.,2003).However,Ravivetal.suggestedthattheirfindingsreflectedtheir participants’ strong distrust in public systems. Thus, trust was aconsistentthemeinbothsetsoffindings.Outreachintothecommunitythroughinvolvementinlocalschools,placesofworship,orcommunityorganizationsmayenhancethetrustworthinessandcredibilityofserviceproviders with populations that historically have underutilized formalservices. These recommendations are supported by existing literature(Vera&Speight,2003).

Theimplicationsofthisstudymustbetemperedinthattheparticipantswerespokespersonsofauniquecommunity.Philosophically,qualitativedataarenotintendedtobegeneralizable.However,whendiscussingrecommendationstomentalhealthpractitioners,itisimportanttoconsidertheopinionsoftheparticipantsaspartofanemergingpictureofperspectivesonmentalhealthfromhistoricallyunderservedconstituents.Inthisinstance,theperspectiveswerethoseofurbanLatinamothersresidinginalow-incomeneighborhood.Theirperspectivesmaydivergefromthoseofotherurbanwomenorotherwomenofcolor.Itisimportanttokeeptheseconsiderationsinmindwhenevaluatingthevalidityofthedata.

Thesedatacontributetothedialogueofhowtomakecounselingservicesmoreculturallyrelevant.Futureresearchshouldfocusonclarifyingtheinteractionofethnicityandsocioeconomicstatusastheyaffectmothers’perceptions of mental health and service provision. Also, it would bevaluable tosystematically study the impactofavarietyofcommunity-based services (e.g., prevention programs, family recreation) on theoverall mental health and functioning of low-income Latino familiesandotherfamiliesofcolor.Inthequestofprofessionalsinthefieldforanswers to these questions, larger problems of the underutilization ofpsychologicalservicesbypeopleofcolorandracialdisparitiesinmentalhealthproblemsmightbebetterunderstood.


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