Culture can affect access to alcohol, drug abuse treatment for rural youth.

Cultural stereotypes about Hispanics could impede Latino youth from seeking help for drug and alcohol abuse. In turn, substance-abuse treatment providers must better understand how their own attitudes toward culture can affect the provision of sufficient behavioral health services, according to a new study. To do this, providers must first assess their own notions of culture and address any hidden biases.

The study obtained first-hand information from practitioners to propose the development of culturally relevant, quality care for rural adolescent populations that have limited access to behavioral health care. Researchers with the PIRE Behavioral Health Research Center of the Southwest and the University of Montana found four commonly held cultural stereotypes that health care providers’ believed inhibited Hispanic youth from seeking help for substance abuse – family, religion and spirituality, gender roles and socioeconomic factors.

“By just focusing on those factors, even the best-intentioned prevention and treatment models will result in a simplistic response to the complex social, political and economic realities that create health disparities among ethnic minority populations,” said Dr. Cathleen Willging, Ph.D., primary investigator on the study. “This often results in many communities viewing mainstream health and human service institutions with suspicion. Although social stigmas associated with behavioral health problems no doubt influence how some Hispanic families seek help, it is important to note the role that a history of discrimination and racism plays in such a process.”

Researchers interviewed 42 behavioral-health providers over a three-month period in 2005. Study participants included drug and alcohol counselors, mental health therapists, nurses and physicians, and prevention specialists in four counties in rural, southern New Mexico. This area includes some of the highest rates of unemployment and highest percentage
of people living in poverty in the country.

Researchers found practitioners believed that Hispanic families were circumspect about seeking behavioral health services because of distrust of Anglo providers, to avoid stigma of mental illness and substance abuse and the need to demonstrate self-reliance. Providers most notably considered Hispanic cultural heritage and values as obstacles to general well being. This perception, researchers report, indicates that the behavioral health providers tend to focus on culture as a site for change, thereby de-emphasizing the important role of socioeconomic status in determining the social context of illness, help seeking and recovery.

From this study, changes to substance abuse treatment services can be made to better provide care for rural adolescents and their families.

Researchers recommend a series of modifications to the training of behavioral health care providers. Culturally competent care includes not only providing appropriate Spanish-language services, but also education and employment opportunities for youth and families — even those lacking legal residency. Furthermore, state and local governments should consider mechanisms that encourage the training, hiring and licensing of local behavioral health professionals who represent the cultural background of the communities in which they serve.

“Training can demonstrate how different experiences, knowledge and values cannot just be acknowledged but must be integrated and appreciated,” said Dr. Gilbert A. Quintero, another researcher on the study. “Such training should first encourage providers to think reflexively about their own value systems and the status and privilege that they bring to clinical encounters with patients of varying cultural, ethnic and class backgrounds.”

For more information at http://www.pire.org>