Abstract
BackgroundBarriers to mental health care access among Latinx children contribute to mental health disparities. It is unclear whether traditional spiritual guides in Latinx communities may function more as gateway providers or in some instances as deterrents to mental health treatment. This study assesses whether family involvement in Espiritismo and/or Santeria, two forefront non-Christian spiritual traditions among Latinx families, is associated with mental health care utilization among Puerto Rican children in two contexts.MethodsData are from Waves 1–3 (2000–2004) of the Boricua Youth Study, a population-based longitudinal cohort study of Puerto Rican children from San Juan and Caguas, Puerto Rico (PR), and the South Bronx, New York (SBx), 5 to 17 years of age (N = 2491).ResultsAt baseline, 5.02% (n = 58) of the families reported involvement with Espiritismo and/or Santeria in the SBx and 3.64% (n = 52) in PR. Logistic regression models predicting mental health service use found, after adjusting for multiple risk and protective factors, that families involved with Espiritismo and/or Santeria were 2.41 times more likely (p = 0.0034) to use mental health services over the course of 3 years than children with no family involvement in these practices in the SBx. The same association was not found in PR.ConclusionsThe findings among PR families in the SBx lend support to the gateway provider model in which spiritual guides open doors to mental health treatment. Forming community connections between mental health providers and traditional spiritual groups may be a culturally considerate, fruitful approach to reducing barriers to mental health treatment among Latinx families.
Highlights
Barriers to mental health care access among Latinx children contribute to mental health disparities
The main question that the present study is designed to answer is if Puerto Rican families involved in Espiritismo and/or Santeria are more likely to utilize mental health services, revealing a pattern compatible with spiritual guides acting as gateway providers in the community
We aim to identify characteristics among these families involved in Espiritismo and/or Santeria that may impact the use of child mental health services
Summary
Barriers to mental health care access among Latinx children contribute to mental health disparities It is unclear whether traditional spiritual guides in Latinx communities may function more as gateway providers or in some instances as deterrents to mental health treatment. Among Latinx subgroups in the United States, Puerto Rican adults have been identified as having higher rates of mental health service utilization, and higher rates of mental disorders relative to other Latinx subgroups [7,8,9]. The hurricane season in 2017 led to a sustained economic depression in Puerto Rico, with increased migration to the mainland United States; and the COVID-19 pandemic has led to ongoing devastation in Latinx communities It is, important to understand successful pathways to mental health treatment among Puerto Ricans and reduce barriers to accessing treatment. Collaborations between biomedical providers and spiritual leaders have demonstrated positive results in mental health treatment [19]
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