Latina Mothers' Perceptions of Mental Health and Mental Health Promotion

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  • 230 journalofMulticulturalcounselinganddevelopMentoctober2007vol.35

    2007americancounselingassociation.allrightsreserved.

    latinaMothersperceptionsofMentalhealthandMentalhealthpromotion

    ElizabethM.VeraandWendyConner

    latinamothersperceptionsofmentalhealthandfactorsthatpromote/restorementalhealthwereexploredinthisqualitativestudy.participantsdiscussedthe importance of community, safety, and financial stability in addition toconventionalfactorsthatarerelatedtomentalhealth.implicationsforworkingwithurbanlatinasandtheirfamiliesarediscussed.enesteestudiocualitativoseexploraron laspercepcionesde lasmadreslatinassobresaludMentalylosfactoresquelafomentan/restablecen.lasparticipantesdiscutieronacercadelaimportanciadelacomunidad,lase-guridadylaestabilidadfinancieraademsdeotrosfactoresconvencionalesrelacionadosconlasaludmental.sediscutenlasimplicacionesparaeltrabajoconlatinasresidentesenncleosurbanosysusfamilias.

    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 theGuidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists(AmericanPsychologicalAssociation,2003),whichofferrecommendationsforadaptingservicestomeettheneedsofdiverseconstituents.Understandingculturalbeliefsandvaluesofethnicgroupsisimportanttothe

    developmentoftreatmentapproachesthatareculturallycongruent.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: evera@luc.edu).e-mail: evera@luc.edu).evera@luc.edu).

  • journalofMulticulturalcounselinganddevelopMentoctober2007vol.35 231

    maybeeffectivewiththispopulation,Latinoclientsperceptionsofwhethercounselingisaculturallyappropriateoptionisdirectlyrelatedtotheirutiliza-tionrates.ThisissuemaybeparticularlyrelevanttotailoringmentalhealthservicestomeettheneedsofLatinawomen.Giventhatwomenoftenattendtotheemotionalneedsofthefamilies,understandingtheirperceptionsofmentalhealthandhelp-seekingbehaviorsare important tounderstandingtreatmentdecisionsofLatinofamilies.

    purpose of the studyIncreasingthefieldsknowledgeofhowwomenofcoloringeneral,andthosewhoaremothersinparticular,conceptualizementalhealthanditsmaintenancemaybeinformativetothedevelopmentofculturallyrelevantindividualandfamilymentalhealthpromotionandremediationefforts.Becausemothersareoftenthemonitorsoftheirchildrensemotionalneeds,theirperceptionsofmentalhealthandrelatedinterventionswouldhaveimplicationsforworkingwithLatinasandtheirfamilies.Itisnotassumedthatbeingamother,perse,wouldaffectthementalhealthbeliefsandexperiencesofserviceprovisionsofLatinas.However,giventhepowerfulrolethatmanyLatinamothershaveinprotecting themental health of their families, this populationwas thefocusof thepresent investigation.This studywasguidedbyan interest intheparticipantsbeliefsaboutthefollowingissues:(a)Howismentalhealthunderstoodor conceptualizedbyurbanLatinamothers? (b)What factorsaffectmental health, bothpositively andnegatively? and (c)What formalandinformalmethodsofhelpseekingareusedforthementalhealthneedsofLatinamothersandtheirfamilymembers?

    relevant literatureIncomparisonwiththeamountofliteratureonLatinawomen,arelativelylargerbodyofresearchexistsonwomenofcoloringeneralandtheirdeci-sionstousementalhealthservices.Severalrecentstudieshaveexaminedthehelp-seekingattitudes,explanationsofpsychologicaldisorders,andcopingstrategiesofwomenofcolor(Alvidrez,1999;Brodsky,1996).Alvidrezfoundthat,forlow-incomewomenofcolor,thelikelihoodofmakinganappoint-ment to see amental healthprofessionalwas predictedby problem type,beliefsabouttheoriginofmentalhealthproblems,andhavingafriendorfamilymemberwhohad sought services. Inher sample, stigma regardingpsychologicalproblemsandpreferenceforinformalmeansofhelpseekingwerenotfoundtoberelevantpredictorsofseeingamentalhealthprofes-sional.Alvidrezsstudywasveryhelpfulinclarifyingsomeofthefactorsthatleadwomenofcolor toseektheassistanceofmentalhealthprofessionals,butitdidnotexploreawiderangeofprecipitatingeventsthatmightresult

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    inawomanseekingservicesinthefirstplace.Additionally,theroleoflargersystemic factors such aspovertyor community in jeopardizing thementalhealthofwomenwasnotexplored.Brodsky(1996)examinedtheroleofpovertyandcommunity factors in

    thementalhealthandresiliencyoflow-incomeAfricanAmericanwomen.Resiliencyisdefinedastheabilitytopersevereinthefaceofobstacles(Mas-ten, 2001).Brodsky found that, forwomenwho see the community as aburdenasopposedtoaresource,distancingfromthecommunitywasseenasacopingmechanismthatenhancedresiliencyandmentalhealth.Herfindingschallengedtheextantliteraturethatfoundcommunityinvolvementandbelongingtoberelatedtopositivementalhealthforwomenofcolor(McMillan&Chavis,1986).Yetthefindingscouldhavebeenafunctionofsocial class rather than the ethnicity of theparticipants. Inotherwords,Brodskysparticipantsresidenceinanimpoverishedneighborhood,nottheirethnicbackgrounds,wasmostlikelywhatinfluencedtheirperceptionsoftheneighborhoodasunsafe.ThemostdistinctiveaspectofBrodskysstudyis that it is oneof theonly investigations inwhichwomenof colorwereinterviewedabouttherelevanceofcommunityandneighborhoodfactorsinrelationtomentalhealthandresiliency.Otherthantheaforementionedstudies,therehasbeenrelativelylittlere-

    searchdoneonmothersperceptionsofmentalhealth,barrierstotreatment,ormentalhealthpromotion.WefoundevenlessresearchonLatinamothersperceptionsofmentalhealth.Onerecentstudy(Christie-Mizell,Steelman,&Stewart,2003)focusedonethnicdifferencesinperceptionsofmaternaldistressandneighborhooddisorderinanonclinicalsampleofmothers.ThatstudyfoundthatMexicanAmericanandAfricanAmericanmothersperceivedhigher levelsofneighborhooddisorder thandid theirWhitecounterpartsandthatperceivedneighborhooddisorderwassignificantlypredictiveofma-ternaldistress(afindingthatwasexacerbatedforAfricanAmericanmothersbynumberofchildren).However,themajorityofextantresearchonLatinamothershasfocusedon

    motherswhosechildrenhaveidentifiedpsychologicalorbehavioraldisordersoronthementalhealthproblemsofthemothersthemselves(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-orientedresearchunderscorestheneedforadditionalempiricalstudiesthataddressLatinamothersgeneralperceptionsofmentalhealthbarriersandattitudestowardhelpseeking.Aqualitativeresearchapproachwasselectedforthisstudytogeneratesuchdiscovery-orienteddata.

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    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).GiventhelimitedresearchonLatinamothersperceptionsofmentalhealth,itwouldbeprematuretoconstructtheory.Narrativeinquiryisappropriatewhendiscoveryofphenomenaisthegoalofthestudy.Whereaspaststudies(Alvidrez,1999;Landrine&Klonoff,1994)havelargely

    usedquantitative approaches tounderstandingmental health conceptual-izationandpatternsofserviceutilizationinwomenofcolor(e.g.,symptomandresourcechecklists),existingsurveysoftenfailtoincorporateprotectivefactorsorprocessesthatmaypromotementalhealth,notjeopardizeit.Thedecisiontouseaqualitative,discovery-orientedapproachwasalsobasedontheanticipationofilluminatingprotectivefactorsorfactorsthatareimportanttomaintainingmentalhealth.

    methodparticipants

    Participantsinthisstudywere10Latinamotherswhoresidedinalow-incomeneighborhoodinalarge,midwestern,urbancommunity.Participantswerenominatedbytheirchildrensschooladministrators,bycommunityleaders,andbyotherparentswhosechildrenattendedthelocalpublicelementaryschool.Thecriteriafornominationwerewomenwhowereperceivedassuc-cessfulinovercomingchallengesofraisinghealthychildren(i.e.,anexampleofresiliency)andlivinginalow-incomeenvironment.The10motherswhowereselectedforparticipation,then,werenotthoughttoberepresentativeofparentsingeneralorLatinamothersasagroup,butratherwerethoughttobepotentiallyeffectivespokespersonsforresilientLatinamothersinthecommunity. This participant selectionprocedurehas beenused in otherstudies(e.g.,Brodsky,1996).Mothersrangedinagefrom30to43years.Sixwerefirst-generationMexican

    immigrantswhohadlivedintheUnitedStatesformorethan10years(rang-ingfrom10to18years).Oftheremainingfourparticipants,threewereborninthecontinentalUnitedStatesandwereofArgentinian,PuertoRican,and

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    multiracialethnicbackgrounds.OnemotherwasbornontheislandofPuertoRico.Allmothershadworkedoutsidetheirhomesinpositionsthatrangedfrompaidemploymentassecretariestovolunteerworkasteachersaidesorcrosswalkguards.Nospecificdataweregatheredontheincomesearnedbytheparticipantsbecauseitwasdeterminedthroughconsultationwithleadersinthecommunitythatsuchaquestionwouldbeviewedasculturally inap-propriate.Sevenofthemothersweremarriedtothefathersofatleastoneoftheirchildren,andthreewereinnonmarital,cohabitatingrelationships.Thenumberofparticipantschildrenrangedfromonetothree.Theagesofthechildrenrangedfrom18monthsto12years.Themotherswereinvitedtoparticipateinthestudybytheprimaryinvesti-

    gator(firstauthor)atatimethatwasconvenientforthemintheirchildrensschoolsetting.Motherswhowereemployedbyorvolunteeredattheschoolreceivedpermissionfromtheprincipaltoparticipateintheinterviewsduringtheirworkdays.Informedconsentwasobtainedpriortothebeginningoftheinterviews,andtheparticipantswereassuredthattheinformationgatheredwasanonymousand thatpseudonymswouldbeused in thedescriptionofthefindings.Aftertheinterviewswerecompleted,giftcertificatestoalocalgrocerystorewereofferedtoparticipantsastokensofgratitude.Noincentivewasofferedtomotherswhentheywereinvitedtoparticipate.

    procedureIndividualinterviewswereconductedforthisstudybyabilingual,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?

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

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

    transcribedinterviewsinthisstudy.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,andfosteringinterdependencewereassociatedwithpositivemental health.Every participant talked about theconnectionbetweenparentalandchildmentalhealth.Parentswereviewedasrolemodelswhotaughttheirchildrenhowtobehealthypeople.Toquoteoneofourparticipants,happyparentsmakehappychildren.Interpersonalcomponentsofmentalhealthwerenotdiscussedtotheexclu-

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

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

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    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,itsdaycarecenters,aclose-byjob,parkdistrictprograms. (Interviewer:Howdo thesehelppromotemental health?)When you canprovideforyourkidsanddontfeelguiltyaboutnotbeingwiththemorwonderiftheyaresafe,youhavepeaceofmind.Knowingyourkidsaresafeishavingmentalhealth.

    Onasimilarnote,neighborhoodfactorssuchasaffordablehousingwerelinkedtomaintainingmentalhealth.Carolina,a30-year-oldmotheroftwo,toldastoryaboutafamilythathadbecomehomelessbecauseofgentrificationintheneighborhood,whichhadpromptedlocallandlordstoraiserents.Sheconcludedthatifyouloseyourhome,everythingisupforgrabs.Yougotoashelter,youmoveinwithanotherfamily,buteverythingchanges.Thisiswhyparentshavetocometogethertofightgentrificationandotherthreats.Usingcommunityresourcesonaregularbasiswasviewedasanavenueto

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

    EspeciallyforLatinas,wedontneedtosithomealoneinthehouse.Ifyoucantgetajob,whileyourkidsareinschool,youneedtostayactive,involvedwithpeople,caringforyourkids,yes,butalsogoingtochurch,exercising,volunteering,whateveryoucangetyourselfinto.

    Community-sponsoredprograms for families and youthwerementionedbyhalftheparticipantsasresourcesthatcanprotectmentalhealth.Yetoneparticipant, Linda, a 30-year-oldmother of two, expressed a concern that

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    thereweremisperceptionsof someof the existingprograms that affectedhowmuchtheywereusedbythecommunitymembers:

    Alotofparentsseetherec[reation]centersandarentsureiftheyarereallygoodfortheirkids.Theythink,Whatifthisiswherethegangbangershangout?evenifitisnottrue.Itisreallyimportantforparentstoknowthatitissafeforyourkidshere.

    Mistrustduetoperceivedcommunitydangerswasmentionedasan issuethatpreventedsomemembersofthecommunityfromtakingadvantageofavailableprograms,althoughsuchproblemshavethepotentialtoenhancefamilymentalhealth.Theseresponsesreflectedanawarenessofformalmentalhealthservicesinthecommunitybutunderscoredtheimportanceofsuchresourcesbeingtrustworthyandsafe.

    WhatthreatensMentalhealth?Manyconventionalthreatstomentalhealthwereidentifiedinresponsetothisquestion.Allparticipants listeddivorce,drugs,conflict,neglect, illness,andabuseaslifeeventsthatarehighlydisruptivetoonesmentalhealth.Halfoftheparticipantsgaveequalemphasistolackofresourcesandnegativecommunityinfluences.Forexample,alackofopportunitiestostaybusywithonesfamilywasmentionedasathreattomentalhealth.Additionally,gangsandrelatedviolenceinthecommunitywerelistedasfactorsthreateningmentalhealthinfamilies.Cristina,a43-year-oldmotherofthree,stated,

    Someofthethingsinthestreetthatfamiliesareexposedto...thatkindofnegativityisahardthingtoovercome.Youtakethelittleonestotheparkandsometimesyougetnervouscauseofwhoelseisthere.Maybesomethingisabouttogodown,youdontknow.Buthavingtoworryaboutwhatyoudontexpect,thatisaproblem.

    In addition to safety, direct family influenceswere seen as affecting thementalhealthofchildren.Sevenparticipantsdiscussedconcernsaboutthecommunitys number of teenage parents viewed as being ill-equipped toprovide for their childrens emotional needs. For parents in general, notspendingtimewithonesfamilywasidentifiedascontributingtoaclimatethatthreatensmentalhealth.Insomecases,thereasonsforthiswereeconomic.Threeparticipantsdiscussedsituationsinwhichparentsworkedtwoorthreejobsandwereneverphysicallypresentwhentheirchildrenwerehome.Allparticipantsdescribedthestressorsofbeingsingleparentsthatcompromiseones ability to be emotionally present in the family. Linda, a 30-year-oldmotheroftwo,stated,

    Lotsofparentsinthiscommunityareliterallynottherefortheirkids.Thekidsgohometoanemptyhouseeveryday.Othersstartoutbeingtherebutcanthandleallthepres-sureofbeingalonewiththekidsandfallthroughthecracks.Youarehanginginthere,holdingajob,payingrent,andonedayitgetstobetoomuchanditallfallsapart.

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    Whetherabsencewasdefinedasphysicaloremotional,beingunavailabletoonesfamilymemberswasviewedasanimportantthreattomentalhealth.

    WhatareacceptaBleWaystorestoreMentalhealth?Manyinformalandformalmechanismsforaddressingmentalhealthprob-lemswerediscussedbytheparticipants.Theimportanceofconsultingwithtrustedindividuals,suchasfamily,friends,clergy,orpeersinthecommunity,wasdiscussedbyeightparticipants.Fiveoftheseparticipantsdescribedsuchindividualsasmentors,orpeoplewhohavedifferentperspectivesonsitu-ationswhoseadvicewouldbevaluableandwelcomed.Thegeneralissueoftrustworthinesswasmentionedinalloftheconversa-

    tions.Giventhattheproblemsdiscussedbytheparticipantswereofamorepersonalnature(i.e.,familyproblems),participantsstressedtheimportanceoffindingsomeonewhocouldprotecttheirprivacy.Thethemeoftrustwor-thinessextendedtotheparticipantsopennesstoformalsourcesofsupportaswell. In terms of formal strategies to addressmental health problems,participantslistedcounselors,socialworkers,andpsychologistsasbeinggoodresources,especiallyiftheywereknownquantities.Schoolcounselorsandpsychologistsaffiliatedwiththeparticipantschildrensschoolswereseenaspotentialresources.Allparticipantsseemedknowledgeableabouttheclinicsinthecommunitythatofferedmentalhealthservicesandmentionedseveralbyname.The formal sourcesof supportwere identifiedaspreferredoverinformalresourcesonlywhentheproblemwasofalargeenoughmagnitudeandinformalresourceswereinsufficient.

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

    Thereareopportunitiesforfamiliestogethelpwhentheyneeditandtostayinvolvedinthingsthataregoodforthem,butyouhavetolookforthosethings.Theyarenoteverywhereordeliveredonaplatetoyou.Youhavetocheckthingsoutandgetit.

    Thisstatementillustratestheparticipantssentimentsthatitwasuptopar-entsnotonlytobeawareofwhatisavailablebutalsotobeactiveinpursuingandevaluatingthequalityofresourcesfortheirfamilies.Inadditiontocommunityprograms, fourparticipantsexpressedadesire

    formentalhealthprofessionalstobeactivemembersofthecommunity.Theimportanceofmentalhealthprofessionalsknowingthestrengthsandneeds

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    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 ethnicheritagesmay also shape theirworldviews to bemorecollective, regardlessofwhether theywereparents (Marin&Marin,1991;McNeilletal.,2001).Thelow-incomestatusoftheneighborhoodcombinedwiththecollectiveorientationoftheparticipantsmayhaveexacerbatedtheimportanceofcommunity,aswasfoundinBrodskys(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).

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    Fourth,theabilitytoformongoing,collaborativerelationshipswithinthecommunitymaybeakeytodecreasingtheunderutilizationofservicesbyLatinamothersandtheirfamilies.Participantsinthisstudyempha-sizedtheimportanceoftrustworthinessandfamiliarityintheutilizationof formal community services. Althoughmany service providersmaywork 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).Theimplicationsofthisstudymustbetemperedinthattheparticipantswere

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

    moreculturallyrelevant.Futureresearchshouldfocusonclarifyingtheinteractionofethnicityandsocioeconomicstatusastheyaffectmothersperceptions ofmental 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 thesequestions, largerproblemsof theunderutilizationofpsychologicalservicesbypeopleofcolorandracialdisparitiesinmentalhealthproblemsmightbebetterunderstood.

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