Featured on Refinery29. Author: Ludmila Leiva
When Mariana Jimenez* was 14 years old, she started hurting herself. Sometimes, she would intentionally burn herself with her curling iron. Other times, she’d take more of her prescription migraine medication than she was supposed to. “I would take a lot of pills — too many,’” Jimenez tells Refinery29. “It was a feeling of ‘I don’t care what happens.’”
Though Jimenez can't pinpoint exactly when she first started struggling with her mental health, she recalls that feelings of isolation, depression, and anxiety defined much of her youth. Throughout adolescence, Jimenez felt pressured by her intensely ambitious mother, whose high standards were seemingly impossible to meet. On top of this, her grandmother's deeply religious attitudes instilled in Jimenez an anxiety regarding her reputation, appearance, and behavior. Caught between these two women’s expectations, Jimenez felt she was never enough.
Then, during her freshman year of college, Jimenez was sexually assaulted. Following the incident, she descended into a deep depressive episode, during which she regularly missed classes, drank heavily, and began having panic attacks. Soon after, she attempted suicide.
Jimenez is one of many Latinas who attempt suicide each year. According to the Centers for Disease Control and Prevention’s 2017 youth risk behavior surveillance survey, 10.5% of Latina adolescents aged 10–24 years in the U.S. attempted suicide in the past year, compared to 7.3% of white female, 5.8% of Latino, and 4.6% white male teens.
The issue is so severe that it’s been referred to as an epidemic and, to make matters worse, depression and suicidal ideation are extremely taboo topics within the Latinx community. Unsurprisingly, this lack of dialogue and understanding only exacerbates issues surrounding mental health for young Latinas.
Regardless of race or ethnicity, mental health can be a tricky topic for any community to wrap its head around, but in the Latinx community the conversation is still shrouded in deeply-rooted stigma. And though the causes for the high rates of suicidal thoughts and attempts among Latina youth are countless, perhaps the starkest stems from these young women’s fraught relationships with their immigrant mothers. Such as in the case of Jimenez, the generational, cultural, and religious divides that often define mother-daughter dynamics in Latinx homes can cause deeply painful ruptures, which in turn can lead to high rates of suicidal tendencies among young Latinas.
Erika L. Sánchez first thought of killing herself when she was a young teenager, around the age of 13. Back then, she would cry daily and eventually began cutting herself to relieve the constant pain she experienced. Like Jimenez, Sánchez recalls that troubles with her mother made her feel isolated throughout much of her youth. “She was a pretty traditional Mexican lady and I was very much an Americanized teenager,” Sánchez says. “We butted heads a lot.”
Both Jimenez and Sánchez feel that many of the depressive and suicidal tendencies defining much of their youth were caused, in part, by fundamental misunderstandings they had with their mothers. “We had a really hard time understanding each other. She expected me to be docile and cook and clean and be very home-oriented and I wasn’t that way,” Sánchez explains. “I was very independent, very restless, and that wasn’t really appropriate for my mother.”
These generational misunderstandings, common between first-generation children and immigrant parents, are believed by experts to be part of the reason for many young Latinas’ mental health problems. Dr. Luis Zayas, the dean of the Steve Hicks School of Social Work at the University of Texas, Austin, has been studying Latina suicide trends as a clinician since 1980 and researching trends since the first youth risk behavior surveillance study was published in 1991. Dr. Zayas believes that ruptures between mothers and daughters are one of the primary causes of Latina suicidal tendencies.
“There are other things that influence it but it usually starts there,” Dr. Zayas explains. “Most of the issues that we found had to do with independence or personal autonomy where the girl wanted to do what teenage girls naturally wanted to do — go out with friends, dress differently, think the way the want to think, feel the way the want to feel — and not be governed by their parents.”
Dr. Zayas points out that these tensions are rooted in independence, particularly when parents are out of sync with their daughters and unable to adapt their parental approaches to a new culture and generation. “Many of the girls are either first or second generation who have grown up in U.S. culture while the immigrant parents are holding onto more traditional views of women,” Dr. Zayas adds. “About how [girls] should behave, what they should or shouldn’t do, the centrality of the family, taking care of the home, and protecting your virginity — or at least your reputation.”
In Dr. Zayas’ studies, young Latinas who attempted suicide had restrictive and controlling parents, particularly mothers. One of the main problems, Dr. Zayas says, is many parents’ inability to reconcile their own world views with their daughters’. “Parents are trying to impose traditional cultural values of family and socialization of women when that’s not these girls’ experience,” Dr. Zayas says. “They might want her to behave how they did in a small city in Mexico or the Dominican Republic versus being in the U.S. in an entirely different culture. She may then feel left out or like she’s straddling the two cultures, and that’s where it hurts.”
Lending An Ear
One night during her freshman year of college, Jimenez experienced a particularly bad panic attack and was seriously considering a suicide attempt. She willed herself to go to a hospital close to her college campus, but was not met with the support she had hoped for. After checking in at the front desk, she was asked to wait. “I had a sense of urgency and was so tense and upset, I couldn’t just sit in this room with all these other people,” Jimenez says. Eventually, she just got up and left.
Though Jimenez was able to find the initial courage to seek out help, she was quickly overcome by anxieties about the consequences of admitting her struggles. “I was scared to tell the counselors I was thinking about suicide because I thought they’d make me drop out of class or keep me somewhere for a long period of time,” Jimenez says. “The other thought in the back of my head is how am I going to explain [this] to my family?”
Jimenez comes from a culturally traditional Guatemalan family and witnessed firsthand the cultural barriers that prevented candid discussion of mental health in her household. “We don’t really have these conversations,” Jimenez explains. “A lot of Latinx people construct stereotypes about therapy — that it’s something for ‘crazy people.’”
According to the National Alliance on Mental Illness, only 20% of Latinxs with mental health symptoms talk to a doctor about their concerns, and only 10% end up contacting a mental health specialist. This inaccessibility is further magnified by a shortage of mental health professionals equipped to support culturally-specific challenges.
Though mental health struggles impact all Latinxs, challenges for Latinas can be especially unique. Misogyny, machísmo, rape culture, hyperfemininity, and generational trauma — combined with a culture that speaks of mental health only in whispers and behind closed doors — have historically made Latinas especially vulnerable to suicidal ideation. And, until Latinas are able to have candid conversations about their mental health, it’s unlikely these trends will improve.
Sánchez, however, was able to get some support from her family. After a bout of suicidal thoughts landed her in a psychiatric hospital when she was 15, her family was supportive and did not shame her — even as others in her community did. Still, Sánchez feels things could have turned out differently if she had been equipped with better tools.
“It was really difficult when I was younger because I didn’t have the knowledge of what was happening to me,” Sánchez says. “I didn’t have the vocabulary, I didn’t have culturally competent care and I think that’s unfortunate. A lot of Latinas struggle with their mental health and have nowhere to turn.”
Talking About It
Sánchez now talks openly about mental health in Latinx communities, and the topic of mental health among Latinas, specifically, has become a central theme in her literary work, including her novel, the New York Times bestseller and a National Book Awards finalist, "I Am Not Your Perfect Mexican Daughter."
Looking back, Sánchez says she has been able to see many of her experiences more clearly in hindsight, and uses her literary work as a means of raising awareness about mental health and eroding stigma in the Latinx community.
“I write a lot about depression, I think it’s one way for me to cope and process grief and sadness,” Sánchez says. “Literature is a way for people to learn empathy and I hope that through my work others can understand what it’s like to live with a mental illness and perhaps feel more compassion for people.”
On top of prestigious accolades, Sánchez has received feedback from Latina readers who have felt represented by her work. “I get a lot of messages from young women telling me how much the book means to them, that they were sobbing while they read it,” Sánchez says, noting that, beyond representation, she hopes the book encourages those experiencing mental illness to get support. “There is no shame in asking for help,” Sánchez adds.
Indeed, the key to eroding any taboo is to talk about it — even when it’s uncomfortable. And yet, talking about mental health doesn’t necessarily guarantee there will be someone to listen. Unable to talk with her family, Jimenez reached out to mental health practitioners during her time of need, but doing so did not always yield positive results. “When I was seeing counselors at my school, there were a lot of things I didn’t want to say,” Jimenez says, adding that finding culturally competent therapists is not always easy.
“It’s really important to have more women of color therapists because there is a lot of really specific misogyny that you can’t speak about to white women or to a man,” Jimenez continued. “[There’s] this whole culture around my family as immigrants. They have their own issues of dealing with civil war in their country; [it’s] something that a lot of white Americans wouldn’t really understand.”
Cultural competence and diversity are noticeably missing from the current mental health sector. As of 2013, the psychology workforce was 83.6% white, and for many people of color, this presents challenges. For many Latinxs seeking therapy, 50% do not return after their first session. These high dropout rates likely stem from a lack of cultural understanding and an inability for therapists to make Latina clients, and clients of color, feel truly heard.
Eglys Santos, a therapist working out of the Bronx, feels that Latinas’ shame around trauma and mental health can make feeling understood by therapists and other professionals especially important. “I have seen often how this belief interferes with the therapeutic relationship because [individuals] tend to share what they feel is permissible to share,” Santos tells Refinery29.
Ultimately, talking about mental health is only the beginning. While discussions in literature undoubtedly help to shape culture, mental health discussions in the Latinx community need to be had more often and by more people. Beyond this, it’s crucial that culturally-specific resources are made available to Latinas, and other youth of color. “Therapy isn’t effective if you don’t feel comfortable with the person you’re speaking with,” Jimenez says. “You’re not going to be able to get help or say all of the things that are on your mind.”
This year, for the first time in decades, Latina suicide rates decreased. In previous years, Latinas faced a significantly higher risk of suicidal ideation and attempts than other girls their age, including their Black, Asian, and white counterparts. But, in 2017, Latina suicide rates trended downward from previous years, such as 2015 when Latina teens had the highest rate of suicide attempts and 15% of Latinas attempted to take their own lives. Still, despite these seemingly promising changes, Dr. Zayas is unconvinced that there has been sufficient progress in supporting young Latinas.
“If I’m to look at 30 years of data, I think it’s a blip,” Dr. Zayas says, adding that he believes this year's data could be an outlier and that the decrease could be due to this year’s sampling. “I have no reason to believe that our girls are attempting suicide any less. There’s nothing to indicate to me that our girls are better off now.”
Throughout decades of research, Dr. Zayas has seen these troubling mental health trends in the Latinx community get routinely overlooked. “Until it happens in the white population, in big numbers, it doesn’t get attention,” Dr. Zayas says.
Still, despite widespread awareness and support, Dr. Zayas believes there are many things that can be done to help improve the situation for young Latinas, including school programs for immigrant families and group therapy, that address the many cultural, generational, and religious rifts between children and parents in the contemporary U.S.
Like Dr. Zayas, Sánchez, too, thinks there need to be more organizations and resources that deal specifically with suicide among Latinas. One organization, Life is Precious, in the Bronx has been working to curb Latina suicide since 1989. But, according to Sánchez, there should be similar resources all around the country. Beyond this, she also feels that many mental health struggles can be addressed in therapy, but not without the support of the community.
As for Jimenez, having access to free therapy proved crucial in her healing process, despite the fact that mental health services are often seen as unnecessary and privileged. "Therapy has been stereotyped as a white people thing that’s expensive and silly,” Jimenez says. “[But] that was the only way I got help.”
Even so, Jimenez still hasn’t found a way to be fully open with her mother about her mental health struggles. She has continued therapy, and though her mother now knows she is seeking help, she has no idea about her past suicide attempts. “She’s aware I’m depressed and anxious but she doesn’t know the severity,” Jimenez says.
Jimenez is now on a path to recovery, and doesn’t often think back on her past traumas and suicide attempts. “I feel kind of disconnected from it now. It’s not a part of my life that I think about a lot,” Jimenez says. And though her situation has improved, Jimenez laments that she cannot be more open with her family about past, and persisting, struggles with depression. “There are a lot of things that I still don’t know how to talk to my family about,” Jimenez concludes. “And I don’t know if we’ll ever talk about it.”