How Johnson & Johnson supports mental health in Hispanic and Latino communities

There are 62 million Hispanic and Latino people living in the United States — and in 2020, an estimated 7.7 million Hispanic and Latino adults reported suffering from mental illness, according to a survey by the Substance Abuse and Mental Health Services Administration. (SAMHSA).

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Ruby Castilla, MD, Director of Clinical Development, Mood Disorders, Janssen Pharmaceutical Companies of Johnson & Johnson

Comprised of people with roots in more than 20 Latin American countries, Hispanic and Latino communities in the United States represent an ethnically, culturally, and economically diverse population. Yet they face an array of overlapping barriers when it comes to getting the help they need, says Ruby Castilla, MD, director of clinical development, Mood Disorders, at Janssen. Pharmaceutical Companies of Johnson & Johnson.

The reason for this access gap is an intersection of many factors that prevent people from making mental health a priority, says Dr. Castilla, who served as president of the American Society of Hispanic Psychiatry from 2020 to 2022. some, the lack of insurance coverage is a problem. For those who have emigrated from another country, communicating with non-Spanish speaking healthcare professionals is a challenge and if they are among the estimated 8 million undocumented people, the fear of seeking help is another. factor.

“They may also be dealing with traumatic events that happened in the country from which they arrived here,” adds Dr Castilla. In the end, “they have no possibility of saying: ‘I suffer; can I get help? »

Johnson & Johnson is on a mission to create those opportunities needed to improve the mental health of Spanish speakers in this country and around the world. In honor of Hispanic Heritage Month, Dr. Castilla shares more information about the unique mental health needs facing Hispanics and Latinos, and how Johnson & Johnson is actively working to help them meet them. answer.

1.

Support research on gaps in mental health

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Stigma remains a pervasive barrier to accessing mental health care for the entire Hispanic and Latino population, including U.S.-born native English speakers, regardless of education level and income. A study co-authored by Dr. Castilla and supported by Janssen Scientific Affairs, published this summer, confirmed this.

The study used artificial intelligence (AI) to analyze millions of digital conversations about depression across ethnic and racial groups, including Hispanic, non-Hispanic whites, blacks and Asian Americans.

The result?

“We learned that even if you have insurance, are well educated and have every chance of going to the doctor, you don’t go to the psychiatrist if you’re Hispanic,” says Dr. Castilla. Indeed, the Hispanics in the study had the highest rates of conversations showing what she calls an “avoidance mindset” toward their depression.

“People who belonged to the other groups tended to know when they were depressed, and they sought help because they saw depression as a disease that can be treated,” she explains. “But in our research, Hispanics and Latinos tend to believe that depression is just a part of life that you have to go through, like going from childhood to adolescence.”

The problem to be solved was clear to Dr. Castilla and his colleagues. “If there is a huge intrinsic cultural barrier unrelated to education, how can we overcome it? »

As researchers begin to work on the answer and develop culturally appropriate depression treatments for the Hispanic and Latino population, the study’s innovative AI approach is already creating potential for new ways to assess unmet health care needs.

“We are creating awareness that this type of research can be done,” says Dr. Castilla. “We are also opening the doors to more projects and possibilities with other groups in the company.”

2.

Helping Spanish speakers get the resources they need

Given the strong stigma associated with getting help for mental health issues in Hispanic and Latino communities, the wealth of free, medically verified information online can be a powerful tool for breaking down misconceptions. “The American Psychiatric Association (APA) has very good resources, but they’re in English,” says Dr. Castilla. “Our goal has been to develop these same resources for Spanish-speaking patients.”

And that goal will be achieved this month, with the launch of La Salud Mental, an APA website dedicated to culturally competent, evidence-based information and resources in Spanish about mental health and substance use disorders. . It will largely mirror content from the APA’s English site, with content primarily focused on five main topics: depression, mental health stigma, suicide risk, substance abuse and women’s health.

In weekly meetings hosted by the APA, a group of Johnson & Johnson Hispanic-focused psychiatry experts work as a review board, auditing translated material that includes captioned text, videos, and images.

“The tricky part of creating educational resources across cultures is that certain terms and contexts don’t translate directly,” says Dr. Castilla. “Sometimes when we look at a webpage that’s been directly translated into Spanish, we find that it doesn’t make sense.” Staying aware of these differences, while maintaining nuances of empathy, is one of the main goals of the project.

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You cannot imagine how difficult it is to find mental health professionals who speak Spanish. We need to create a bright new generation of doctors, clinicians, nurses, and psychologists who care about the mental health of the Hispanic community.

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The process of retaining meaning and relevance across cultures goes beyond comparing Spanish to English. “Sometimes we have really good discussions at these meetings about regional differences, for example: ‘For Colombians, it’s different from Brazil, Argentina or Puerto Rico,'” says Dr Castilla. “Or, ‘We don’t say that in Mexico.’ We must therefore also take these contexts into account.

It is also important to consider the impact of cultural differences on the processing pipeline.

“We recently assessed the case of a female victim of domestic violence. She was afraid to contact the doctor because she had no papers and feared that she and her family would be deported,” says Dr Castilla. “At La Salud Mental, we try to include resources where someone in these circumstances can seek help, especially in states with large Spanish-speaking populations like Florida, California, and Texas.”

3.

Mentoring of students in medical fields

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Dr. Ruby Castilla at the 2022 American Psychiatric Association Annual Meeting with some of her mentees. From left to right: Drs. Pamela Montano, Nancy Colimon, Whitney Cordoba, Ruby Castilla and Laura Jiménez.

Hispanics and Latinos are vastly underrepresented in the medical field. And when they attend medical school, research shows they are less likely to graduate than their non-Hispanic white counterparts, especially when students come from disadvantaged backgrounds before enrolling.

“Many drop out of school because they don’t have a network and they don’t have role models,” says Dr Castilla. “They need a guide.”

Enter Johnson & Johnson, which has committed $100 million to invest in and promote health equity in healthcare. Helping to create a more diverse medical workforce is a crucial part of this mission. Working with the National Hispanic Medical Association, the company annually connects five medical students with practicing medical professionals in monthly one-on-one mentoring sessions to ensure they get the information and contacts they need. need to thrive in their program and graduate.

If a medical student is a native Spanish speaker, they are matched with a mentor who they can easily converse with. “You can’t imagine how difficult it is to find mental health professionals who speak Spanish,” says Dr. Castilla. Other challenges mentors advise on include financial aid issues, housing, and childcare.

“We need to create a bright new generation of doctors, clinicians, nurses and psychologists who care about the mental health of the Hispanic community,” says Dr. Castilla. “They need someone to show them that there’s more than one way to navigate between medical school and the residency training program.

4.

Reaching local communities

As an active member of the Hispanic Organization of Leadership and Achievement (HOLA), the company’s resource group for Hispanic and Latino employees, Dr. Castilla currently leads the group’s Hispanic medical initiatives, 50% of which are aimed at raise public awareness about mental health. These initiatives typically involve partnerships with nongovernmental organizations that support Hispanic and Latino populations. “At HOLA, we have been privileged to have a leader like Joaquin Duato, who has made possible projects that have a huge impact on Hispanic communities,” says Dr. Castilla.

An example: a series of free talks in Spanish on mental health, created by HOLA in partnership with the American Society of Hispanic Psychiatry and held monthly at the Newark, New Jersey-based organization La Casa de Don Pedro, not far from the world of Johnson & Johnson. head office in New Brunswick. The first half hour features a medical professional presenting in Spanish, such as a psychiatrist speaking about anxiety. The second half hour is an open space in which participants can ask questions, which Dr. Castilla says often include concerns about family members.

“It’s one of the most rewarding programs we have,” she says.

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