By Jim Morris
Public Health Watch
While still jarringly high, U.S. suicide rates fell in 2019 and again in 2020, the Centers for Disease Control and Prevention reported last month. The year-over-year rate declined by 3 percent overall, falling by 8 percent among women and 2 percent among men.
But there were some stark outliers. Notably, suicides among Latino men increased by nearly 6 percent.
What’s going on?
Plenty, it turns out. Problems that existed before COVID-19 got even worse during the pandemic, health advocates and providers say, including substance abuse, job loss, poor access to care and the stigma of mental illness in the Latino community.
“[Latino men] weren’t getting much help to begin with,” said Fredrick Sandoval, executive director of the New Mexico-based National Latino Behavioral Health Association. “Then services shut down.” Those who sought care often encountered lengthy delays; others simply quit looking.
On top of that, Latino men (and women) lost jobs at disproportionately high rates after COVID-19 arrived. “They were no longer the primary wage-earners,” Sandoval said. “That had a significant effect on their emotional state. It impacts the male’s sense of responsibility, sense of self-worth.” To cope, some turn to alcohol or drugs.
“I was raised not to show emotion, don’t cry,” said a 32-year-old Latino man from Albuquerque, who asked that his name not be used in this article. “If you’ve had to bottle up your emotions your whole life, you have to let them out somewhere.” His outlet was black-tar heroin; he twice tried to kill himself a decade ago.
While the man didn’t want to speak for others, he said he understood how the economic upheaval associated with the pandemic could have driven some Latino men to take their lives. “You can’t provide for your family, you’re sitting there worried about what’s going to happen,” he said. “If you can’t provide, what kind of man are you? That’s the mentality you’re taught.”
According to the CDC, 45,979 deaths were attributed to suicide in 2020, down from 47,511 in 2019. The U.S. suicide rate declined by 3 percent, from 13.9 to 13.5 per 100,000 people. But it was still 30 percent higher than the rate in 2000.
Sandoval said he was encouraged to hear President Joe Biden call for “full parity between physical and mental health care” in his State of the Union address March 1. Biden’s plan includes the summer launch of a three-digit mental-health crisis hotline — 988 — and the placement of mental-health services in “non-traditional settings” such as libraries, schools, homeless shelters and community centers.
“But how do we know we can get more services to Latinos?” Sandoval asked, referring to the plan. “Latinos are treated as hard-to-reach people. That’s a misnomer and a mistake. Latinos are not hard to reach — the system isn’t designed to engage them. It’s a very passive system: We wait for you to come to us for help.”
Instead, local engagement teams should be deployed to events Latinos frequent, such as church bazaars, Sandoval said. “Health care has to be physically present in people’s homes, backyards and neighborhoods, not in a building where staffers sit and wait,” he said. And care should be integrated, not compartmentalized.
“When Manuel comes in to get his blood pressure checked, we also need to ask if he’s thought about hurting himself,” Sandoval said. “He needs to be seen as a whole person.”
Luz Garcini, an assistant professor at the Center for Research to Advance Community Health at UT Health San Antonio, said Latino men did some of the riskiest work and faced some of the worst discrimination during the pandemic. When they lost jobs, “these men had to reinvent themselves to come up with new strategies, new skills to remain in the labor market,” she said, even as they “carried the burden of being the protector of their family, the provider for their family.”
The pressures on such men would have been fierce, but Garcini suspects many didn’t seek help.
“In our Latino culture, we don’t talk about mental health,” she said. “It’s equated with mental illness. For men, it’s very stigmatizing.”
What can be done?
“We need to start advocating at the highest level for more funding for research, for more mental health providers, for protection of safety-net access,” Garcini said. Latinos have the highest uninsured rate of any racial or ethnic group in the U.S., according to recent census data.
Cheryl Aguilar, a therapist and director of. the Hope Center for Wellness in Washington, D.C., said Latino men, not wanting to appear vulnerable, tend to underreport their mental-health symptoms.
“This raises a call to action for us in the mental health community to ensure we’re getting the information out, debunking some of the myths,” she said.
One such myth, ingrained in Latino culture, is that problems are best dealt with at home or alone, and that seeking help reflects weakness. “On the contrary, seeking support takes and shows courage,” said Aguilar, who has many Latino immigrants among her clients. “Once people are connected to services, there is hope.”
The man in Albuquerque agreed. “I’m in a very good place,” he said.
If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1–800–273–8255 (English) or 1–888–628–94 (Spanish).
This article was originally published March 9,2022 by Public Health Watch, a nonprofit investigative news outlet. Find out more at publichealthwatch.org.