Susan Emley Keefe

Mexican Americans and mental health: A selected review and recommendations for mental health service delivery

Eight working assumptions are generated from the literature in three problem areas and evaluated with recently published quantitative data, paying particular attention to variation within the ethnic group. Assumptions that Mexican Americans have few emotional problems, primarily use a folk medical system, do not rely on clergymen for emotional support, and have negative attitudes toward mental health services are rejected. Two assumptions are qualified: Mexican Americans have some emotional problems at different rates than Anglos and some Mexican subgroups are relatively unaware of mental health services. There is confirmation of the Mexican American extended family support system and mental health policies which variously discourage utilization by Mexican Americans. Implications for mental health service delivery are discussed.

Help-seeking behavior among foreign-born and native-born Mexican Americans

For many aspects of help-seeking behavior, generalizations about ethnic minorities obscure important intraethnic variations. This paper examines the distinction between foreign-born and native-born Mexican Americans and its impact on correlated traits which are significant in the help-seeking process: socioeconomic status, level of acculturation, intensity of religious affiliation, the presence of an extensive social support system, and familiarity with public agencies. Two case studies are presented to illustrate differences in the search for help for emotional problems. Intraethnic diversity is demonstrated with regard to attitude toward and availability of potential sources of help, selection of helping agents in times of emotional need, frequency of consultation, and the relationship between ethnicity and mental health.

Folk Medicine Among Urban Mexican Americans: Cultural Persistence, Change, and Displacement

Two large-scale surveys and in-depth interviews with 24 Mexican Americans in three Southern California towns indicate that folk medicine is a persistent but ancillary health care system. Most Mexican Americans know something about folk medicine, but fewer maintain strong belief in it and only a small number of Mexican Americans consult folk healers. Scientific medicine is the primary health/mental health system, having replaced in large part the folk medical system. Folk medicine endures as an alternative, however, primarily in the treatment of health problems that are judged minor and require little extrafamilial attention or that are judged severe and persist despite professional scientific health care. There is also evidence that folk medical terms and treatments have changed and become integrated with scientific medicine in the minds of many Mexican Americans. The findings contrast with research in south Texas and in rural areas where folk medicine appears to be more significant for the general Mexican American population. Dos encuestas a gran escala y entrevistas profundas con 24 México-Americanos en tres ciudades del sur de California indicaron que la medicina tradicional es un sistema de cuidado de la salud persistente pero secundario en importancia. La mayoría de los México-Americanos conocen algo sobre la medicina tradicional pero pocos creen en ella y un número reducido de México-Americanos consultan a curanderos. La medicina científica es el principal sistema de salud física y mental habiendo reemplazado en gran parte a la medicina tradicional. Esta ultima continua sin embargo, como una alternativa para el tratamiento de problemas de salud que se consideran menores en importancia y que requieren poca atención fuera de la familia o para problemas que se consideran severos y persisten a pesar del cuidado profesional científico. Existe también evidencia de que los términos y tratamientos derivados de la medicina tradicional han cambiado y se han integrado a la medicina científica en las mentes de muchos México-Americanos. Los resultados de estos estudios contradicen los resultados de investigaciones en el sur de Texas y en áreas rurales donde la medicina tradicional parece ser mas importante para la población México-Americana.

Southern Appalachia: Analytical models, social services, and native support systems

ConclusionsThe model of ethnicity has been applied in this paper to Appalachian natives. The problems suffered by Appalachians in terms of high dropout rates, institutional discrimination, prejudice, and stereotyping are familiar to other ethnic minority groups. Yet because the majority of the population in Appalachia are racially indistinct from mainstream Americans, there is resistance to the notion of ethnic difference. This has significant repercussions. Ironically, service providers and others in the region often recognize the distinctive nature of native Appalachians while, at the same time, reaffirming that they are white Americans like anywhere else. This is often said with good intentions. The result, however, justifies a lack of action taken to improve services for native Appalachians. If they are perceived as no different, inequalities go unrecognized and unredressed. If, on the other hand, differences are perceived only on the basis of socioeconomic class and/or rural residence, social services may miss the cultural dimension that may be all-important in identifying problems and potential means of improvement. It is hoped that application of the notion of ethnicity to mountain people will be helpful in the structuring of human services in the region.

Book Reviews : Shirley Achor Mexican Americans in a Dallas Barrio. Tucson: University of Arizona Press, 1978. Pp. xi + 202.

There are several good reasons for writing a book on the topic Achor has chosen. First, there has been no general book-length study of Mexican Americans published since Grebler, Moore, and Guzman (1970). Second, there is a dearth of information about urban dwellers who constitute the majority of the Mexican American population. Third, in light of the preponderance of early studies stressing homogeneity and traditionalism as well as acculturation and stress, there is a need to reexamine Mexican

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Little direct research has examined intergenerational familial mental health variables in relation to school-based mental health services in rural communities. However, theory and empirical findings suggest they are critically important to consider. In an effort to guide practice and future research in this area, we describe Bronfenbrenner’s ecological model of behavior to contextualize the importance of the family and other environmental variables in the understanding of student mental health concerns. The literature on the relationships between student mental health and family variables as well as their relationships with school-based mental health services, particularly in rural environments, is reviewed. We describe a model of investigation and integrate original findings from a contextual examination of depression in a particular rural community, and discuss a school-based mental health clinic that serves that same community. Finally, evidence-based suggestions for working with students and families in the context of school-based mental health practice are offered.