Aches and pains often stem from family matters
A woman with terrible headaches visits her doctor. The doctor finds out she's going through a divorce.
In this typical scenario, says Julia Rodriguez-O'Donnell, a licensed clinical social worker, "You're not going to resolve the headaches without addressing the stress of the divorce."
In 40 percent to 60 percent of primary-care office visits, a stressful life is contributing to or causing the physical problem, said Rodriguez-O'Donnell, a bilingual mental health therapist who works at the Virginia Garcia Memorial Health Center in Beaverton.
That's why Rodriguez-O'Donnell was hired last year to bring mental health care to Spanish-speaking people at the center, in collaboration with LifeWorks Northwest. A second therapist will join her in August. The program, funded by United Way, will expand to the clinic's Cornelius site in the fall.
For many Latinos, mental health care has the same stigma it did in mainstream America 50 years ago.
"It's the idea that if you go talk to a mental health person, you're crazy," Rodriguez-O'Donnell said. But it's less threatening if a medical doctor says, 'Hey, it sounds like you've got a lot of stress in your life. I'd like you to talk to my colleague down the hall.' "
Rodriguez-O'Donnell spoke about cultural differences and how family matters affect her clients:
Q: How do Latinos differ from Anglos when it comes to mental health issues?
A: Instead of coming in and saying, "I feel sad," or "I feel anxious," they will come in and say, "I have headaches," "I have stomachaches," "My muscles hurt," or "I can't sleep." So naturally they go to the doctor. . . . People get referred to me, and I find out they're really worried about their son, who is not doing well in school. Very quickly, there are other family members who need to get invited in.
Q: And they're open to getting involved?
A: I think again, because we're in the doctor's office -- within the Latino communities there's somewhat of a greater deference to authority. So there's this notion that "Oh, the doctor wants me to come in."
Q: Are the issues similar across the two cultures?
A: Yeah, they are. The top issues would be anxiety, depression and traumatic-related stress and then interpersonal issues. And with this group, particularly with our immigrant clients, there's a tremendous amount of stress related to immigration and separation from significant family members. People are really missing their family. It takes a long time to get connected here. There's language barriers.
Q: Are there any other cultural issues related to families?
A: The other thing is trauma backgrounds with domestic violence . . . either having witnessed domestic violence among their parents or having been victims of domestic violence themselves.
When they come to this country, there's a different level of legal protection for women and children here. They suddenly become aware that this is something they can actually get help around. There are not only legal protections, but there's a different community response to domestic and family violence. I have lots of conversations with my male Latino clients in which we talk about how different the response is.
Q: Such as: "You can go to jail if you do this"?
A: A lot of them already know that by the time they come in my door. A lot of my work is to help them and their families expand their communication skills and improve their dynamics.
I also think parenting issues come up a lot. You have parents coming from their country of origin with different models of parenting -- some of which rely more on physical discipline. They come here, and if their kid shows up at school with a bruise, they're going to have a protective services officer show up at their house.
Q: Do any of them appreciate the changes they have to make?
A: Absolutely. I've had immigrant couples in my office say, "This has been the coolest thing." The dad will say, "I actually watch the kids and help with laundry." The wife will say, "We do these things together now, and I have a job. It's been really different for us, and I really like it."
Q: Does the fact that they have so dramatically uprooted their previous lives give them a kind of permission or excuse to break out of their former behavior patterns?
A: It's both a sense of permission, and you know that saying: "Necessity's the mother of invention." You come here, and you have to reinvent yourself while still holding on to what's most important to you. Everything's up for grabs. Everything's up for reinvention.
Jill Smith: 503-294-5908; jillsmith@news.oregonian.com