Application of cultural constructs in the care of first generation Latino clients in a community mental health setting.

As the Latino population in the United States grows, it is imperative to attend to the appropriateness of the mental health care that is being provided to its members. Latinos experience many of the same behavioral health disorders as other ethnic and cultural groups in the United States, but underutilize services relative to many other groups. Such underutilization may be related to issues such as stigma, language, and acculturation level, all of which often create barriers to treatment. First generation Latinos (i.e., individuals born outside the United States) are especially vulnerable to adverse experiences when seeking and receiving treatment. This may be due in part to acculturation and language issues which may further contribute to future underutilization of services. A well established therapeutic alliance developed through the appropriate use of cultural constructs may help mitigate some of the barriers faced by some Latino groups, especially those who are first generation. This paper reviews several cultural constructs that have been highlighted in the Hispanic behavioral health literature and discusses their potential implications for clinical care. This paper offers a number of practical clinical guidelines for mental health professionals who work with Latino groups. These clinical recommendations are based on a synthesis of selected cultural constructs and the clinical experiences of the authors' work in a large community-based Hispanic mental health clinic.