Mental Health Disparities and Social Justice in the US-Mexico Border Region

  • Griselda VillalobosEmail author
  • Arthur A. Islas


Mental health services in the border region lag behind the nation. The situation is aggravated by a difference in the type of treatment individuals from different ethnic groups receive. Although the border is a minority majority region, minorities have less access to mental health services. This chapter discusses mental health disparities prevalent on the US-Mexico border which include access to mental health services, lack of mental health providers, and underutilization rates. Data are presented from major studies on the prevalence of mental health disorders and utilization of mental health services by Hispanics, more specifically Mexican Americans. A discussion is provided about the role of culture in mental health service utilization. The chapter concludes with recommendations for addressing mental health disparities on the US-Mexico border, considering the political context of the region.


Mental Health Mental Health Service Mental Health Professional Mental Health Provider Mental Health Agency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Alegria, M., Canino, G., Rios, R., Vera, M., Calderon, J., Rusch, D., et al. (2002). Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino Whites. Psychiatric Services, 53(12), 1547–1555.CrossRefGoogle Scholar
  2. Alegria, M., Shrout, P. E., Woo, M., Guarnaccia, P., Sribney, W., Vila, D., et al. (2007). Understanding differences in past year psychiatric disorders for Latinos living in the US. Social Science & Medicine, 65, 214–230.CrossRefGoogle Scholar
  3. Altarriba, J., & Bauer, L. M. (1998). Counseling the Hispanic client: Cuban Americans, Mexican Americans, and Puerto Ricans. Journal of Counseling and Development, 76(4), 389–397.CrossRefGoogle Scholar
  4. Alvidrez, D., & Bean, F. D. (1976). The Mexican family. In C. Mindel & R. Habenstein (Eds.), Ethnic families in America. New York: Elsevier.Google Scholar
  5. American Academy of Family Physicians. (2001). Mental health care services by family physicians (position paper). Retrieved on December 22, 2010, from
  6. Anderson, R. M. (1995). Revisiting the behavioral model and access to health care: Does it matter? Journal of Health and Social Behavior, 36, 1–10.CrossRefGoogle Scholar
  7. Briones, D. F., Heller, P. L., Chalfant, H. P., Roberts, A. E., Aguirre-Hauchbaum, S. F., & Farr, W. F. (1990). Socioeconomic status, ethnicity, psychological distress and readiness to utilize a mental health facility. The American Journal of Psychiatry, 147, 1333–1340.Google Scholar
  8. Burnam, M. A., Telles, C. A., Hough, R. L., & Escobar, J. I. (1987). Measurement of acculturation in a community population of Mexican Americans. Hispanic Journal of Behavioral Sciences, 9, 105–130.CrossRefGoogle Scholar
  9. Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System Survey Data (BRFSS). (2007). Unpublished data. Information about the BRFSS is available at
  10. Center for Mental Health of the Substance Abuse & Mental Health Services Administration (1998). Cultural Competence Standards in managed care for four underserved/underrepresented racial ethnic groups. Retrieved from Scholar
  11. Diaz-Guerrero, R. (1975). Psychology of the Mexican: Culture and personality. Austin: University of Texas Press.Google Scholar
  12. Escobar, J. I., Burnham, M., Barno, M., Forsythe, A., & Golding, J. (1987). Somatization in the community. Archives of General Psychiatry, 44, 713–718.CrossRefGoogle Scholar
  13. Falicov, C. J. (1982). Mexican families. In M. McGoldrick, J. K. Pearce, & J. Giordano (Eds.), Ethnicity and family therapy (pp. 134–163). New York: The Guilford Press.Google Scholar
  14. Hispanic Americans: Census Facts. (2011, February 3). Infoplease. 2000–2007 Pearson education, publishing as Infoplease.
  15. Hofstede, G. (1980). Culture’s consequences: International differences in work-related values. Beverly Hills: Sage.Google Scholar
  16. Holleran, L. K., & Waller, M. A. (2003). Sources of resilience of Chicano/a youth: Forging identities in the borderlands. Child and Adolescent Social Work Journal, 20(5), 335–350.CrossRefGoogle Scholar
  17. Hough, R. L., Landsverk, J. A., Karno, M., Burnam, M. A., Timbers, D. M., Escobar, J. L., & Regier, D. A. (1987). Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic whites. Archive of General Psychiatry, 44, 702–709.CrossRefGoogle Scholar
  18. Institute of Medicine. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academy Press.Google Scholar
  19. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 617–627.CrossRefGoogle Scholar
  20. Kolody, B., Vega, W., Meinhardt, K., & Bensussen, G. (1986). The correspondence of health complaints and depressive symptoms among Anglos and Mexican-Americans. Journal of Nervous Mental Disorders, 174, 221–228.CrossRefGoogle Scholar
  21. Lafayette De Mente. (1996). NTC’s dictionary of Mexican cultural code words. Chicago: NTC Publishing Group.Google Scholar
  22. Levine, E. S., & Padilla, A. M. (1980). Crossing cultures in therapy. Belmont: Wadsworth.Google Scholar
  23. Lewis-Fernandez, R., Das, A. K., Alfonso, C., Weissman, M. M., & Olfson, M. (2005). Depression in US Hispanics: Diagnostic and management considerations in family practice. Journal of the American Board of Family Medicine, 18(4), 282–296.CrossRefGoogle Scholar
  24. Lusk, M., McCallister, J., & Villalobos, G. (2011). Mental Health Sequelæ among Mexican Refugees Fleeing Violence and Trauma. Comparative Social Welfare. In press.Google Scholar
  25. Malgady, R. G., & Zayas, L. H. (2001). Cultural and linguistic considerations in psychodiagnosis with Hispanics: The need for an empirically informed process model. Social Work, 46(1), 39–49.CrossRefGoogle Scholar
  26. Mark, T. L., Shern, D. L., Bagalman, J. E., & Cao, Z. (2007). Ranking America’s mental health: An analysis of depression across the states. Alexandria: Mental Health America.Google Scholar
  27. Marsiglia, F., & Holleran, L. (1999). I’ve learned so much from my mother: Narratives from a group of Chicana high school students. Social Work in Education, 21(4), 220–238.Google Scholar
  28. McGuire, T. G., Alegria, M., Cook, B. L., Wells, K. B., & Zaslavsky, A. M. (2006). Implementing the Institute of Medicine definition of disparities: An application to mental health care. Health Services Research, 41(5), 1979–2005.CrossRefGoogle Scholar
  29. Mezzich, J., & Raab, E. (1980). Depressive symptomatology across the Americas. Archives of General Psychiatry, 37, 818–823.CrossRefGoogle Scholar
  30. Mindel, C. H. (1980). Extended families among urban Mexican Americans, Anglo and Blacks. Hispanic Journal of Behavioral Sciences, 2(1), 21–34.Google Scholar
  31. Miranda, J., & Cooper, L. A. (2004). Disparities in care for depression among primary care patients. Journal of General Internal Medicine, 19, 120–126.CrossRefGoogle Scholar
  32. Miranda, J., Azocar, F., Organista, K. C., Muñoz, R. F., & Lieberman, A. (1996). Recruiting and retaining low-income Latinos in psychotherapy research. Journal of Consulting and Clinical Psychology, 64, 868–874.CrossRefGoogle Scholar
  33. National Alliance on Mental Illness. (2010). Mental illness: Facts and numbers [Fact sheet]. Retrieved from Google Scholar
  34. Pearcy, J. N., & Keppel, K. G. (2002). A summary measure of health disparity. Public Health Reports, 117, 273–280.CrossRefGoogle Scholar
  35. Pew Hispanic Center and Henry J. Kaiser Family Foundation. (2002). 2002 National survey of Latinos: Survey brief. March 2004, pp. 1–5.Google Scholar
  36. Poonam, S. (2002). Suggestions for psychologist working with Mexican American individuals and families in health care settings. Rehabilitation Psychology, 47(2), 230–239.CrossRefGoogle Scholar
  37. Rogler, L. H., & Cortes, D. E. (1993). Help-seeking pathways: A unifying concept in mental health care. The American Journal of Psychiatry, 150, 554–561.Google Scholar
  38. Shapleigh, E. (2010). Texas 29th Senatorial District. Texas borderland: Frontier of the future. Retrieved October 31, 2010, from
  39. Snowden, L., Masland, M., Ma, Y., & Ciemens, E. (2006). Strategies to improve minority access to public mental health services in California: Description and preliminary evaluation. Journal of Community Psychology, 34(2), 225–235.CrossRefGoogle Scholar
  40. Substance Abuse and Mental Health Services Administration. U. S. Department of Health and Human Services. (2005). Mental health services expenditures, 2001. In National expenditures for mental health services and substance abuse treatment 1991–2001 (Chapter 3). Retrieved from
  41. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality (2010). Mental Health, United States, 2010. Retrieved from Scholar
  42. Sue, S. (2003). In defense of cultural competency in psychotherapy and treatment. American Psychologist, 58(11), 964–970.CrossRefGoogle Scholar
  43. Sue, S., Fujino, D. C., Hu, L. T., Takeuchi, D. T., & Zane, N. W. S. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Counseling Psychology, 59, 533–540.CrossRefGoogle Scholar
  44. Thomas, K. C., Ellis, A. R., Konrad, T. R., Holzer, C. E., & Morrissey, J. P. (2009). County-level estimates of mental health professional shortage in the United States. Psychiatric Services, 60(10), 1323–1328.CrossRefGoogle Scholar
  45. Torres, J. B., & Solberg, S. H. (2002). The myth of sameness among Latino men and their machismo. The American Journal of Orthopsychiatry, 72(2), 163–181.CrossRefGoogle Scholar
  46. Triandis, H. C., Marin, G., Lisansky, J., & Betancourt, H. (1984). Simpatia as a cultural script of Hispanics. Journal of Personality and Social Psychology, 47, 1363–1375.CrossRefGoogle Scholar
  47. U.S. Department Health and Human Services. (2001). Mental health: Culture, race, and ethnicity-a supplement to mental health: A report of the surgeon general. Rockville: Public Health Service, Office of the Surgeon General.Google Scholar
  48. U.S. Census Bureau (2010). State & County Quick Facts. Retrieved from Scholar
  49. United States Census Bureau. (2010b). Income [Data file]. Retrieved December 19, 2010, from
  50. United States Census Bureau. American Community Survey, 2008 [Data file]. Retrieved May 30, 2009, from
  51. Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., & Catalano, R. (1999). Gaps in service utilization by Mexican Americans with mental health problems. The American Journal of Psychiatry, 156(6), 928–934.Google Scholar
  52. Wells, K. B., Golding, J. M., Hough, R. L., Burnam, M. A., & Karno, M. (1989). Acculturation and the probability of use of health services by Mexican Americans. Health Services Research, 24, 237–257.Google Scholar
  53. World Health Organization. (2010). Mental health: Strengthening our response [Fact sheet No. 220]. Retrieved from

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Department of Social WorkUniversity of Texas at El PasoEl PasoUSA
  2. 2.Department of Family and Community Medicine, Paul L. Foster School of MedicineTexas Tech UniversityEl PasoUSA

Personalised recommendations