Five Questions With: Yovanska Duarte-Velez

Yovanska Duarte-Velez is a Bradley Hospital child and family psychologist and the director of the Mi Gente Program at Gateway Healthcare. She has particular expertise treating high-risk Latinx youths and adults, and her research interests focus on developing and tailoring treatments for minority populations according to their needs and cultural values.

Duarte-Velez, who holds a doctorate in clinical psychology, discusses why the Mi Gente program was created and the need for behavioral health care within Latinx communities.

PBN: Why did you create a special clinic targeting Latinx youths, as opposed to, say, increasing or adding bilingual services to existing clinic programs?

DUARTE-VELEZ: One of the most meaningful elements to serving groups with specific cultural characteristics and needs is to create safe and familiar spaces for them. So, it was especially important for us to create a program Latinx youths and their parents could identify with, develop trust in and refer other families in similar situations to with confidence.

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Some Latinx families mistrust the mental health system, and some do not believe in the concept of “mental health.” For others, it can be difficult to accept and manage mental health issues in the face of communication barriers. All of this underscored the need for a program in which Spanish-speaking families could speak with Latinx professionals in their own language.

In addition to the trust, we wanted to create a program with the expertise to focus on the mental health issues most prevalent among Latinx youths. These are depression, trauma and suicidal thoughts – each of which can be very frightening for families. Creating a program such as Mi Gente allows us to combine our resources around the common goal of providing specialized, high-quality services to Latinx youths with mental health needs.

PBN: How big is the need for behavioral health care within the Latinx community?

DUARTE-VELEZ: Depression is the most prevalent mental health disorder among Latinx youths. Over many years, Latinx high school students have consistently reported significantly higher rates of feeling sad and hopeless when compared with their Black and white peers, according to national surveys.

Latinx high school students are reported to also have higher rates of suicidal attempts. And while we do not have national survey data specific to trauma, research has shown Latinx youths [tend] to be more prone to having experienced traumatic events. These might stem from events they were exposed to in their country of origin or during their immigration journey, or due to community violence or discrimination faced in the United States.

Despite these obvious mental health needs, there are few evidence-based treatments available for Latinx families that take into consideration their culture and native language.

PBN: Are there factors that put Latinx youths at greater risk of behavioral disorders?

DUARTE-VELEZ: Yes, there are absolutely particular factors that impact the Latinx youth community differently than other cultural and ethnic groups, especially with regard to their generational status (how many generations a family has been in the U.S.), socioeconomic background, and family and community resources.

For example, the needs of a family that recently arrived in the United States are not the same as for those who have been here for multiple generations. Families whose children were born in the U.S. while their parents were born elsewhere encounter the challenge of youths and adults acculturating to the U.S. at a different pace. Often, youths both speak English and get to see the world from an American perspective, while many parents see the world only through their own Latin culture perspective.

Additionally, many parents do not learn English and, unfortunately, a lot of youths – in time – speak less Spanish, creating a communication disconnect. As a result, we have youths growing up with two competing worldviews and expectations. These “acculturation conflicts” can increase tension and problems that, in combination with other factors, may lead to mental health issues or to exacerbate them.

PBN: How do you think this program can play a part in fighting the stigma around mental health in the Latinx and Hispanic community?

DUARTE-VELEZ: One of our commitments as a program is to normalize among the Latinx community that it is equally important to take care of our mental health as it is to take care of our physical health – that the two are intimately connected. For this program, Bradley Hospital received support from the CVS Health Foundation Hometown Fund to make possible the addition of a community health worker to our team. This CHW will be key to our mission to reduce mental health stigma by promoting mental health in the community and through outreach activities and psychoeducation.

Additionally, our CHW will enable us to provide greater wraparound service by connecting families with other community programs based on their needs. As we serve more youths and families, our hope is that their own experience with Mi Gente will develop a more positive sense of mental health services and that they become agents of change in their own community. Hopefully, we will be able to expand our program in the future and serve as a model for other communities.

PBN: Why is it important to invest in evidence-based practices? What are some of the evidence-based protocols used in the program?

DUARTE-VELEZ: Just as the words suggest, evidence-based practices are “practices with evidence,” meaning they are interventions that have been tested in research studies and demonstrated more positive results when compared with other interventions. Not many interventions have been specifically tested with Latinx youths. However, the treatment protocols used in Mi Gente have evidence supporting their use for Latinx youths with depression, suicidality and trauma.

For youths who report depression as their main concern, we use cognitive behavioral therapy and interpersonal therapy protocols adapted especially for the Latinx community. When depression is complicated with suicidal thoughts – or a recent suicidal crisis has occurred – we use the socio-cognitive behavioral therapy for suicidal behaviors protocol developed specifically for Latinx youths with these issues. If a patient presents with trauma as their primary concern, trauma-focused cognitive behavioral therapy is the best approach considering all the studies that support this treatment for diverse populations.

Claudia Chiappa is a PBN staff writer. You may contact her at Chiappa@PBN.com.