How and why we must better support Latino mental health

Latinos are projected to account for as many as 78% of all net new U.S. workers between 2020 and 2030 and 20% of all U.S. workers by 2030. But employers and their benefit advisers need to know that the U.S. health system is unprepared to serve this population's mental health needs. 

The numbers tell an alarming tale. Consider, for instance, that 20% of Hispanic and Latino employees have rated their mental health as "poor" compared with 10% of white employees. Mental, behavioral and neurodevelopmental health emergency department visits by Latinos jumped 61% in a recent five-year period. In the same year the U.S. gained 5 million Latinos it lost 18% of its Spanish-speaking mental health facilities, while only 6% of U.S. physicians identify as Latino. These developments have serious talent implications; 39% of Hispanic and Latino employees have considered switching employers due to their health benefits.

Combined with cultural stigma against counseling and other support, we're headed toward a workforce challenge that most employers just aren't prepared to address. 

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Latinos have been labeled "hard to reach" by state health institutions, academic centers and nonprofits working to address health inequities and reduce costs. But employers can provide direct access to resources and are in one of the most influential positions to provide meaningful support. At the same time, many employers are unfamiliar with Latino cultural values and norms and find it challenging to drive engagement despite offering many benefits.  

We're all too familiar with these challenges in supporting the mental and physical health of our clients' Latino employees. They routinely share their concerns with our health coaches who are physicians licensed in Mexico working in conjunction with licensed physicians in the U.S. These coaches speak native Spanish and also understand cultural factors that impact access to care. They apply that understanding to tailor education, strategies and resources related to the health and mental health needs of each employee. The concerns employees share in these coaching sessions provide the following insights on how employers can better address these issues:

1. H-1B and immigrant considerations
In addition to depression and anxiety, we see a lot of grief in the U.S. Latino community over loss of family, community, identity, status and culture. These feelings can complicate work environments if someone feels a need to hide their identity or become someone different to succeed. Even in workplaces with large Latino populations, the diversity within their backgrounds and experiences can still contribute to a sense of loss. Ulysses syndrome is another psychological phenomenon that is often related to modern migration and the compounding effect of multiple traumas and anxieties. Combined with lack of access to appropriate mental health care, this can result in an inability to work productively and complicate existing mental and physical health conditions. 

2. Lack of connection between mind and body
Many of our mental health relationships start as consults for digestion issues, rapid heartbeat, aches and pains or fatigue – all of which can be caused by stress, anxiety or depression. We probe for non-physical factors and talk about stress or lack of sleep. After building trust, patients are often ready to openly discuss mental health. 

3. Aversion to asking for mental health support
Physical consults are an important gateway to Latino mental health support because the phrase "mental health" itself can cause fear about job security or about their reputation in their family. We regularly consult with patients who express fear of being seen as "weak" or "crazy." Further, a cultural value of "enduring" and being able to push forward no matter what pervades Latino culture. When caregivers understand this cultural perspective, they can provide guidance within it without triggering feelings of shame.

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What can employers do differently? Programs to improve mental health access work only if the employee population engages with them. We've found that building trust up front is essential. 

The first component of that is creating a safe environment to ask for help. The second is expanding access to mental health care, particularly from culturally-attuned providers. We've seen it work; employers offering doing so are seeing ongoing engagement rates of 26% of those enrolled — more than two times the average telehealth engagement rate of 10%. 

Employers should consider incorporating mental health training in the same way they do safety or personal protective equipment training – but remember that saying "mental health" can be counterproductive. Regular workshops on topics like "stress and muscle pain" can get at the root of issues in more comfortable ways.

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Onsite biometric screenings for physical health also have been proven to build trust among Latino employees, providing that physical-care gateway to discussing how mental health affects physical health.  

"Good benefits" were rated by Latinos as one of the most important elements of choosing where to work, according to the HR Policy Association's 2023 Latino Worker Project. Employers with large Latino populations are positioned to address a fast-expanding mental health gap. Proactively doing so can head off costs related to health care, absenteeism and productivity while building appeal as a preferred place to work among the country's fastest-growing employee population.