One in five (22%) Hispanics/Latinos have a mental illness and one in 20 have a serious mental illness, according to the latest federal government data (SAMHSA 2023). Yet only 36% of Hispanics/Latinos received mental health services, compared to 52% of whites. During Hispanic Heritage Month (Sept. 15 – Oct. 15), we can celebrate the achievements and contributions of Hispanics/Latinos while also acknowledging the equity work that still needs to be done to increase access to care and decrease stigma around mental health and substance use. Psychiatrists and other mental health professionals can help meet the moment by considering Hispanic/Latino communities’ varied needs, including language fluency and cultural competency.
Dr. Cristina Valentín is a third-year Latina psychiatry resident looking to focus on adult psychiatry with interests in cultural psychiatry and women’s health. She is also a recipient of the APA/APAF Community Diversity Fellowship, designed to develop residents’ culturally competent psychiatric care across traditionally underrepresented communities. As part of Hispanic Heritage Month, Dr. Valentín graciously shared her journey toward providing culturally competent mental healthcare.
Psychiatry Is Inherently Cultural
Psychiatry is shaped by the “learned, propagated, constantly changing” cultures we belong to – the beliefs, values, thoughts and attitudes that affect “how individuals understand mental health and behaviors” (UC Davis).
“The way medicine and psychiatry are practiced in other countries is different,” Valentín said. “Meaning psychiatry is inherently cultural.” Cultural psychiatry involves not only understanding the ways that patients experience mental health and substance use across cultural contexts, but also how psychiatrists can adapt to meet the needs of ethnically diverse patients.
The best approach to avoid stereotyping calls on psychiatrists to listen with an open mind, respect different cultural values, initiate conversations with patients, and ask appropriate questions to offer alternatives, Valentín said. “It’s difficult to learn and memorize the ways that every culture can present with something differently,” Valentín said. “You can’t memorize everything; you have to be humble and thorough, so you don’t miss anything.”
Early Acceptance of Neurodiversity
Although she didn’t immediately know she wanted to be a psychiatrist, Valentín developed an early acceptance of neurodiversity due to familial exposure to mental health conditions. Growing up in Puerto Rico, both of Valentín’s siblings received psychiatric diagnoses: her sister with autism spectrum disorder and her brother with ADHD. “I do think that probably influenced my perception of the world, how sometimes people are just different,” Valentín said. Even now, many years later, Valentín can still recall how strangers sometimes reacted uncomfortably to her sister’s autism disorder.
Initially, as a self-proclaimed geek and “mathlete who liked to draw,” Valentín chose to study architecture at the University of Connecticut. Although architecture was fun, it wasn’t her passion. Once Valentín switched to biology, it was easy to see how her love for health coincided with a larger pattern of being drawn to the service professions, including tutoring, teaching, counseling, and mentoring.
Recognizing the ‘Glimmer’
In medical school, Valentín experienced her “glimmer” moment letting her know she was headed in the right direction. Glimmers, as opposed to triggers, are small moments that spark joy or peace and which cue our nervous system to feel safe and calm. While translating medical materials from English to Spanish for Shriners Hospital in Puerto Rico, Valentín experienced a wave of fulfillment after witnessing the gratitude from the families she was translating for.
Final confirmation that psychiatry was her calling came during Valentín’s rotation in geriatric care. During her weekly visits to the clinic, she witnessed more mental health conditions than she had in primary care, including elderly individuals with depression, anxiety, and Alzheimer’s. Valentín practiced many cultural psychiatry tactics with her geriatric patients, first and foremost listening to them with an open mind. Psychiatrists are in a unique space to have conversations about highly stigmatized topics and offer support and treatment, Valentín said. “People with mental health conditions often don’t have a lot of people that they can talk to about it or who would understand,” Valentín said. “And they are so grateful for someone to listen to them.”
Training the Next Generation
As an undergraduate at UConn, Valentín participated extensively in the Latino Medical Student Association (LMSA), whose mission is to “unite and empower current and future physicians through service, mentorship, and education to advocate for the improved health of the Hispanic & Latina/o/x community in the United States.” The opportunity for advocacy was a chance for Valentín to make a positive impact on the medical field, championing greater understanding between provider and patient. “There is an advocate side of me that is attracted to the field, just because people start to feel heard,” she said.
After starting at her local university chapter, Valentín ascended to the national level as the association’s publications chair, where she held a position to hear what other chapters were doing and a platform to lend assistance. One project involved providing materials and training workshops in Spanish for all LMSA chapters in the region. They created a platform called Juntos Podemos (Together We Can) for chapter leaders to meet regularly and discuss issues and ideas.
To build on her work from LMSA, Valentín chose a residency program serving a diverse Latino population in Ft. Lauderdale, Florida, with plenty of leadership and advocacy opportunities.
Making Psychiatry More Accessible
Valentín hopes psychiatric care will become more accessible in the future because psychiatrists are practicing culturally competent care with their patients. For Valentín, this means combining her passions for advocacy and education to train the next generation of medical students to create change and to prepare future doctors to be culturally humble and equipped to serve underserved populations. “I would love for there to be a near future where people aren’t afraid of talking about mental health. They’re comfortable seeking help when they need it. They’re supportive of others with mental health concerns,” she said.
by Alexa K. Haverlah, M.A.
American Psychiatric Association
- SAMHSA. 2023 Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (p 42)
- U.S. Department of Health and Human Services. 2022. “HealthCare.gov Enrollment by Race and Ethnicity, 2015-2022.”
- UC Davis Health. Redefining Cultural Psychiatry