Accessing mental health care remains a significant challenge for Hispanic and Latino communities, often hindered not only by practical obstacles but also by stigma surrounding mental health issues. In 2024, data from the U.S. Department of Health and Human Services Office of Minority Health indicated that Hispanic or Latino adults were 28% less likely than the overall U.S. adult population to receive mental health treatment. In 2023, fewer than half (47.4%) of Hispanic adults with mental illness received care, according to the Substance Abuse and Mental Health Services Administration.
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These statistics highlight the critical need to reduce stigma, foster trust, and enhance access to culturally sensitive behavioral health services. NYC Health + Hospitals plays a key role in these efforts, particularly as many of its patients are Hispanic. The facility's behavioral health teams focus on identifying individuals in need of support, irrespective of their ability to express that need.
Dr. Vladimir Gasca, Chief of Behavioral Health at NYC Health + Hospitals/Elmhurst, has been with the organization since 1999. Born in Colombia and raised in Venezuela, his personal migration experience resonates with the diverse Hispanic and Latino communities he serves, providing insight into issues such as acculturation and family separation. After studying substance abuse in California, he moved to New York City to complete his residency at the Mount Sinai School of Medicine.
Dr. Gasca identified cultural beliefs that may deter patients from seeking behavioral health care. For some, personal problems are viewed as family matters to avoid shame, and traditional gender roles may lead men to perceive emotional vulnerability as weakness while women prioritize family needs above their own emotional wellbeing. Additionally, patients may frame emotional suffering spiritually, favoring prayer over professional help. Practical barriers, including immigration status, financial stress, and work obligations, also contribute to hesitance in approaching healthcare systems.
Stigma manifests indirectly, with patients often presenting physical complaints, such as headaches or fatigue, when emotional distress is at the core. Younger generations currently show signs of changing attitudes, as many are more willing to discuss mental health issues and encourage their families to seek help. The COVID-19 pandemic has also spurred more candid conversations about mental health struggles.
To enhance access and reduce stigma, NYC Health + Hospitals integrates behavioral health into primary care and other medical settings. This approach allows patients to meet with mental health professionals in familiar environments. The organization also collaborates with community organizations and faith leaders to provide mental health education in comfortable settings.
Culturally responsive care, language access, and a diverse workforce serve to build trust among patients. The Platinum Rule—treating patients according to their preferences—plays a vital role in establishing rapport and understanding. The hospital’s diversity initiatives, like the MOSAIC program, aim to reflect the community it serves, easing patients' concerns about entering unfamiliar healthcare systems.
Dr. Gasca emphasized that seeking mental health care is not a betrayal of familial loyalty but a necessary step for personal well-being. Staff at NYC Health + Hospitals are encouraged to engage with patients sensitively and frame behavioral health services as support for life's challenges.
Dr. Gasca shared a composite case to illustrate the impact of overcoming stigma. A 58-year-old Ecuadorian man was brought to the emergency department for severe chest pain, feared to be cardiac-related. After ruling out heart issues, the medical team identified panic attacks as the root cause. Initially resistant, the patient eventually sought treatment after discussions framed it as a way to alleviate his physical symptoms and improve his strength for his family.
This case underscores the importance of understanding individual experiences and offering care that aligns with patients' values.