Latinx/Hispanic Community & Mental Health

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Latinx/Hispanic Community & Mental Health

Miguel Aguilar | Des 505 | Summer 2021



Abstract Mental Health is defined as an individual’s condition of the state of well-being in regards to their physiological or emotional behavior. Mental illness affects a person’s day-to-day life. According to the National Alliance on Mental Health(NAMI 2019), 20.6 percent of U.S. adults experienced mental illness in 2019, about 51.5 million people. This means 1 in 5 adults and only 10 percent of Latinx/Hispanics pursue treatment from a mental health provider. Latinx/Hispanic community lacks resources and information due to a variety of obstacles, such as language barriers, cultural identity, economic status, and stigma. The purpose of this project is to collect thoughtful research and use the design process. To create a mental health awareness campaign for those suffering from a mental illness that will inform and educate and encourage the Latinx/Hispanic community to seek mental health services, manage day-to-day life, and reduce stigma by talking more openly about it. These will be done by creating a mental health first aid kit that will offer accurate information and resources from pamphlets, stickers, bracelets, and positivity cards. These kits would be distributed in different schools, from High School to University.


Chapter 1: Introduction 1.1 Introduction 1.2 Problem 1.3 Purpose 1.4 Importance of Study 1.5 Preliminary Research 1.6 Assumptions 1.7 Project Scope 1.8 Definition of Terms 1.9 Timeline 1.10 PERT Chart 1.11 Hypotheses 1.12 Chapter Summary

Chapter 2: Research Methods 2.1 Introduction 2.2 Problem 2.3 Purpose 2.4 Research Methodology 2.5 Research Findings 2.6 Survey Findings 2.7 Panel of Experts 2.8 Interview Insights 2.9 Personas 2.10 Comparative Analysis 2.11 Mapping Matrix 2.12 Final Hypothesis 2.13 Chapter Summary


Chapter 3: Design Solution 3.1 Introduction 3.2 Problem 3.3 Purpose 3.4 Proposed Solutio 3.5 Rational 3.6 Concept Design 3.7 Design Critirea 3.8 Inspiration 3.9 Design Guide 3.10 User/Environmental Needs 3.11 Beneficiaries 3.12 Storyboard 3.13 Icon Development 3.14 Pamphlet Development 3.15 Loteria Card Concept 3.16 Prototypes 3.17 Pamphelt 3.18 Playing The Loteria Game 3.19 Hablemos/Let’s Talk Kit 3.20 Chapter Summarry

Chapter 4: Conclusion 4.1 Introduction 4.2 Feedback 4.3 Next Steps 4.4 Chapter Summary Bibliography Appendix A Appendix B Appendix C


Chapter 1 Introduction


1.1 Introduction Mental Health determines how we feel, think and act. A Mental illness affects a person’s feelings toward themselves and their day-to-day life because of their thinking, feelings, behavior, and mood. According to the National Alliance on Mental Health (NAMI, 2019), more than half of Latinx/Hispanic young adults between the ages of 18 and 25 may not receive mental health treatment for a serious illness. Latinx/Hispanic communities have more significant barriers to receiving mental health care due to a variety of circumstances.

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1.2 Problem Mental Health in the Latinx/Hispanic community continues to be stigmatized. The misunderstanding of information and lack of resources causes a barrier in seeking mental health services.

1.3 Purpose The purpose of this is to inform and promote mental health awareness in the Latinx/Hispanic community by providing resources and accurate information to help reduce stigma, promote self-care, and get educated to have an open conversation about mental health with others.

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1.4 Importance of Study Mental Health awareness is important for everyone. People are going through difficult situations. They need to be aware of where to seek help and information. Mental Health often comes with a stigma. People are afraid to speak up, but talking about it helps to reduce the stigma. Hispanic/Latinx community has barriers to getting help because of language, culture, and not knowing how to ask for help. Mental Health is important because having an illness and not dealing with it can affect a person’s everyday life.

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1.5 Preliminary Research The topic of Mental Health seems to be avoided especially by the Latinx/Hispanic community. The reasons according to organizations such as NAMI and Mental Health America(MHA). These organizations are dedicated to helping mental health awareness. The reason is that there is stigma around mental illness such as feeling judged because of their illness. Another factor that plays a role is the lack of access to insurance. Many Latinx/Hispanic people do not have an issuance plan. These can be a factor of their legal status or that they are not able to afford it. Another reason is their culture and religious background and the lack of resources and information offered in Spanish. There are not many therapists that understand the culture for providing help or they do speak the Spanish language.

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1.6 Assumptions Latinx/Hispanic people are not aware of where to look for information or resources regarding Mental Health Services but want to learn more about it. Latinx/Hispanic people that immigrated to the United States and either do not know how to speak English or English is not their first Language. The user has very limited knowledge or ignores the topic because of the stigma on Mental Health and ignores the effects Mental Health has in someone’s life if they do not seek help. The user does not know how to speak about Mental Health to family members or friends that might need help. Low-income Latinx/Hispanic members that do not have the resources to pay for professional Mental Health Services but want to reach out to someone for help. Latinx/Hispanic people that are going through a Mental Illness.

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1.7 Project Scope Create an awareness campaign for the Latinx/Hispanic community by educating them on mental illness, accurate information, and seeking help. Decreased stigma on mental health services for Latinx/Hispanic people to be able to have conversations with other people. Such as their parents or children. Create an effective way to help people have self-care for dealing with the pressure of everyday life.

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1.8 Definition of Terms The definition of terms determines valuable and important vocabulary for the study. These words might be used when talking about the Latinx/Hispanic community and mental health.

Latinx/Hispamic: Spanish-speaking person that lives in the US, that came from a Latin American country. Mental Health: A person’s condition with regard to their psychological and emotional well-being. Mental Illness: Health conditions involving changes in emotion, thinking or behavior. Anxiety: A nervous disorder characterized by a state of excessive uneasiness and apprehension, typically with compulsive behavior or panic attacks. Depression: A constant feeling of sadness and loss of interest, which stops you doing your normal activities. Different types of depression exist, with symptoms ranging from relatively minor to severe. Stigma: When someone sees you in a negative way because of your mental illness. Misinformed: Give (someone) false or inaccurate information. Therapy: The treatment of mental or psychological disorders by psychological means.

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Awareness: Knowledge or perception of a situation or fact. Environment: The totality of surrounding condition. Wellness: Actively making choices for good health. Culture: Beliefs, customs, and traditions of a specific group of people. Prevention: Taking steps to ensure something doesn’t happen. Risk Behaviors: Actions or choices that may cause injury or harm to you or others. Support System: Network of people in your life available to help you when you need them. Behavior: Area of health you have control over. Personality: A special mix of traits, feelings, attitudes and habits.

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1.9 Timeline Week 1

Week 2

Week 3

Set up blog Review past 505 projects Draft 3 research project topics Quiz 1

3 Project proposals “Day in the Life” + persona Quiz 2

10 Parts research proposal Survey draft Library information research Quiz 3

Week 5

Week 6

Week 7

Week 8

Initial ideation Sketches/mock-ups Mid-term report Meetings with panel of experts

Develop design Gather feedback Refine design

Final presentation Final “Project Pitch” written documentation review

Final solution artifact/prototype Final “project pitch” poster

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Week 4 Mid-term “draft” report Mid-Term presentation PERT chart Quiz 4


1.10 PERT Chart Chapters1 & 2

Reflection Presentation

Comparative Analysis

Midterm

Chapter 4

Final

Report

July 29 July 29

Report Presentation

July 7

Prototype

Journals

Lit Research

Research

Books

July 1

Interviews

Web Sources

Feedback Testing Chapter 3

Field Research

Survey

Prototype July 22

Brainstorming

Ideation Mock-Ups

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1.11 Hypotheses By informing the Latinx/Hispanic community about the resources offered for mental health services. This will result in the community seeking professional help and being able to continue with their everyday life knowing that they are getting the help they need.

2

By helping, the Latinx/Hispanic community understand more about mental health and the importance of being aware of any mental health problem someone might be facing. People are going to be able to help themselves, family, or friends.

By using the resources and providing help that some people from the Latinx/Hispanic community might need. They will be able to be more active and stable in their everyday life.

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1

3


1.12 Chapter Summary Chapter one introduced the problem, hypotheses, and assumptions regarding mental health in the Latinx/Hispanic community and defines terms regarding mental illness. Initial research indicates the importance and seriousness of the topic. On how Latinx/Hispanic people lack resources and information about mental health and that stigma around the topic causes mental health services to be avoided. The project seeks to bring accurate information and essential resources to the Latinx/Hispanic community to generate knowledge, awareness and reduce stigma on the topic of mental health.

“Many people in our community don’t even know the signs or symptoms of a mental health problem – lack of information increases stigma, and stigma keeps you from seeking the care you need and deserve.” Teresa Chapa, PhD, MPA Dean of the California School of Professional Psychology Alliant International University Hablemos/Let’s Talk 19


Chapter 2

Research Methods

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2.1 Introduction A variety of research methods are used to bring accurate and reliable information about mental health to the study. One of the most beneficial methods of research was interviews and discussions with the panel of experts that brought important information regarding mental health and their knowledge and experience on the topic. Additional resources include scholarly articles that give facts and statistics about mental illness and how it affects the Latinx/Hispanic population, surveys, research methods, and personas. The research collected is to validate the study.

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2.2 Problem Mental Health in the Latinx/Hispanic community continues to be stigmatized. The misunderstanding of information and lack of resources causes a barrier in seeking mental health services.

2.3 Purpose The purpose of this is to inform and promote mental health awareness in the Latinx/Hispanic community by providing resources and accurate information to help reduce stigma, promote self-care, and get educated to have an open conversation about mental health with others.

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2.4 Research Methodology Literature Review Library online books and articles were used to find and gather accurate information about mental health in the Latinx/Hispanic community and how they perceive mental illness. Websites Websites are used to compare organizations and projects that are related to mental health and distinguish the positives and negatives of each. Interview Served to build on the existing information about the topic and to receive opinions, insights, and professional information from experts on mental health. Survey A survey was distributed to students and the general public through social media to gather data and their opinions on the topic of mental health. Comparative Analysis Evaluating and analyzing existing campaigns and projects to see the advantages and disadvantages of each and determining what is working and what is not working. Panel of Experts Three professionals on the topic of mental health and creating campaigns were asked to give advice, reviews, and feedback through the process of developing the project.

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2.5 Research Findings “Only 10 percent of Latinx/Hispanic pursue treatment from a mental health provider.” (nami. “Hispanic/Latinx.”)

“Research indicates that in many countries, around 80–90% of people with a mental health condition experience the negative impact of stigma.” (Huizen, Jennifer. “Mental Health Stigma in Latin America: Culture, Resources, and More.”)

“The immigration experience and the process of integration can become a source of mental health problems. Latinos and other immigrant communities who encounter these challenges are often at greater risk for PTSD, depression, suicide, and stress associated with acculturation or fear of deportation.” (Cardinal Innovations Healthcare — July 16)

“Only 5 in 1 Latinxs with symptoms of a physiological disorder approach a doctor.”(“Latinx/Hispanic Communities.” Anxiety and Depression Association of America, ADAA)

“Hispanic young adults ages 18-25 with serious mental illness may not receive treatment.” (nami. “Hispanic/Latinx.”)

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2.6 Survey Findings Survey Background A survey was distributed among the general public and students from University. The survey included a short description of the study. The survey has 14 questions relating to mental health. The purpose of the survey was to collect data on people’s knowledge, personal experience, and opinion on the importance of mental health. All surveys were anonymous. There were a total of 66 responses. The largest group that answered were people ages 18 to 25

Survey Results The majority of the participants (38) were Latinx/Hispanic. According to the survey data, 48 percent of the participants believe that parents do not talk to their children about mental health and 50 percent believe that Latinx/Hispanic people have disadvantages when getting mental health services because of language barriers. 46 percent of the participants agree that there should be more education about mental health and 41 percent completely agree.

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2% 2% 9% 9%

47% 47% 42% 42%

Definitely yes Probably yes Probably not Definitely not

Do you think there is enough information and resources available for everyone including minority communities regarding mental health? 47 percent of the participants said that they definitely do not believe that there are not enough resources for minority communities including the Latinx/Hispanic. With only 2 percent saying that definitely yes there is enough resources and information.

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2% 2% 18% 18%

48% 48%

32% 32%

Extremely important Very important Moderately important Slightly important Not at all important Hablemos/Let’s Talk 28

How important do you think having awareness about mental health is? 48 percent believe that mental health awareness is very important and 32 percent believe that is extremely important. The survey revealed that the majority of the people who took the survey believe in mental health awareness with 80 percent.


18% 18%

23% 23%

Would you agree that people would seek more mental health help if there wasn’t stigma around mental illness? The majority of the participants believed that stigma is a large part of why people do not reach out for mental health help. With 59 percent of the participants agreeing with the question asked.

59% 59%

Completely agree Agree Neither agree nor disagree Disagree Completely disagree Hablemos/Let’s Talk 29


2.7 Panel of Experts The panel of experts includes clinical counselors and therapist that specialize in different topics from family therapists to helping the Latinx population, and undocumented immigrants with mental health. It also includes marketing and messaging experts in issues of health and wellness.

Priyam Das, MPH Senior Health Communications Coordinator at SFSU. Hablemos/Let’s Talk 30

Yolanda Gamboa, PhD.

Leslie Jaeyoun Shin, LMFT

Coordinator of Peggy H. Smith Counseling Clinic and Clinical Counselor.

Clinical Counselor at SFSU


2.8 Interview Insights Yolanda Gamboa, PhD. Importance of Seeking Mental Health Services

Similar to physical health, mental health is important for everyone. People between the ages of 18 to 24 are when the mental illness starts to develop. 1 in 5 adults struggles with mental health. (Yolanda Gamboa).

Causes for Latinx/Hispanic to struggle getting Mental Health Help

They wait until the last minute. Which results in them having to go to the hospital because they did not seek help on time. Another factor is stigma. Latinx labels getting help from a physiologist as “loco” because they are afraid to be diagnosed with a mental illness. They prefer to listen to their religion to the “Santos” instead of getting professional help and using at-home remedies such as el “te,” “curandera” or “santera.” They also label mental health as “flojo” because someone is too depressed to get out of bed. (Yolanda Gamboa).

Recomendations for Mental Health Self-Care

Some of the essential activities are sleeping, eating well, and exercise. Also, avoiding sugar. Find any activities that get you moving. Such as meditation, connection to religion, or spirituality. Talking to friends and family. If these activities are not working people need to reach out for counseling. (Yolanda Gamboa).

Approaching a Person that Struggles with Mental Health

Changing the language of how you talk to someone. People can feel triggered if someone talks about mental health as an “illness.” People need to choose their words when speaking to someone and understand the person, so the person does not feel like they are being attacked or judged. (Yolanda Gamboa).

Getting Latinx Parents to Talk about Mental Health

Educating parents about mental health would help their children think more positively about mental health. Sometimes students do not reach for help because their parents tell them that they do not need it or that they should not take medication for their condition. (Yolanda Gamboa).

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2.9 Personas Six personas are created to develop potential real life scenarios. Find the ideal target audience and the beneficiaries. The personas also serve to illustrate the problem with the lack of mental health awareness. To explain why a solution is needed for someone that might be suffering from a mental illness.

Roberto

Daniel

Roberto is a 50-year-old currently working. He has struggled with getting up in the morning. He only wants to stay home. He goes to work but does not feel motivated and struggles to talk about his mental health with his family.

Daniel is a 20-year-old student at SFSU. Daniel has struggled with anxiety and depression. He has a hard time talking to his parents about his mental illness and what he is going through.

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Victoria

Victoria is a 31-year-old therapist. Her mission is to help and support people. She believes people in the Hispanic/Latinx community don’t have enough resources about Mental Health. She wants to help people live better lives.


Lorena

Lorena is 23 years old. She is from Mexico. She struggles to manage her time and has no time to sleep, she does not take care of herself or her mental health. She has a hard time finding resources for mental health.

Elena

Elena is 42 years old and she is a stay-at-home mom. She has been struggling for some time now with a mental illness, but she believes that is something that is going to go away.

John

John is a 37-year-old, works in a Mental Health organization that focuses on helping low-income communities. Over the years that he has worked there, he has seen only a small portion of Latinx/Hispanic people attend the organization. Hablemos/Let’s Talk 33


2.10 Comparative Analysis Four campaigns that talk about mental health awareness were reviewed. This was to understand the disadvantages and advantages of current or past campaigns and products. By comparing them it will help recognize the features needed for the solution of the study and the design of the campaign.

Pros: Promotes wellness and finds

Pros: Offers help with finding a

resources for mental health. Offers talks about culture and stigma for Latinx. Available in English and Spanish.

therapist for Latinx. A podcast where they talk about mental illness stigma.

Cons: Some people may not

Latinx Therapy

know how to reach the site or do not know about the site.

Well Together

Pros: Offers guides and posters,

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term and they are virtual which some people are not able to access.

Pros: Educates Latinx youth about

people can access in Spanish. Information about myths and facts about mental health.

Cons: Not available in Spanish which results in people who do not speak English having a hard time finding the site.

Cons: The sessions seem to be short

mental health and reducing stigma. Trains the next mental health workforce for Latinx. Provides learning activities.

Latino Service Providers

Cons: There are only a few youth

promoters and the program seems to be only available in Santa Rosa.


2.11 Mapping Matrix The mapping matrix evaluates the effectiveness and accessibility of each campaign to determine which one has the most significant impact in comparison to each one and locating the area of improvement.

Inaccessible

Ineffective

Effective Proposed Solution

Accurate information, easy to understand with no confusion, visually pleasing, and easy to access.

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2.12 Final Hypothesis The Latinx/Hispanic community needs to be able to have more open discussions about mental illness, by creating a mental health awareness first aid kit. It is going to provide resources, information, and education on the topic, which will result in decreasing stigma and people being able to seek help and talk to others about mental health.

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2.13 Chapter Summary Chapter two collected research with a variety of methods. The gathering of the results from surveys, interviews, and research indicates that stigma in mental illness is one of the largest causes why Latinx/Hispanics do not seek mental health services. The research also indicates that there are barriers for Latinx/Hispanic people when seeking help and that there is a need for awareness in the community. The research collected helped to gather information on the problem. This leads to a proposed solution to create a mental health awareness campaign for the Latinx/Hispanic youth.

“When a Latino patient does disclose information indicating possible depression, anxiety or another mental health concern, we need to address it immediately.” Diana Lorenzo, MD Psychiatrist Cleveland Clinic’s Center for Behavioral Health

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Chapter 3 Design Solution

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3.1 Introduction This chapter focuses on introducing the process and rationalizing the final proposed solution for the study. Based on the various findings a mental health awareness kit was proposed. The solution will seek to bring a more compressive, resourceful, and simplistic solution to help create awareness in the Latinx/Hispanic youth about mental health. The chapter will discuss the proposed solution and its main objective by sketching, ideating, creating inspiration boards, mockups, prototypes, reviewing similar campaigns, and receiving feedback.

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3.2 Problem Mental Health in the Latinx/Hispanic community continues to be stigmatized. The misunderstanding of information and lack of resources causes a barrier in seeking mental health services.

3.3 Purpose The purpose of this is to inform and promote mental health awareness in the Latinx/Hispanic community by providing resources and accurate information to help reduce stigma, promote self-care, and get educated in order to have an open conversation about mental health with others.

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3.4 Proposed Solution To design a mental health awareness kit that includes pamphlets, a Loteria game, and mechanisms such as stickers, pins, and notebooks to promote awareness in the Latinx/Hispanic community. The kit intends to bring accurate information and education on mental health to the youth and adults. The kit promotes self-care, talking more openly about mental health, and seeking or providing help to others struggling with a mental illness.

3.5 Rational A mental health awareness kit is the proposed solution for the problem because of the continued lack of awareness that the Latinx/Hispanic community has on mental health. Providing accurate information and essential resources will help the people gain knowledge about mental health and guide them to have open conversations about mental health. This also targets to reduce stigma and promote self-care in the community.

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3.6 Concept Proposal Pamphlets Pamphlets, posters, and notes serve as a way to provide information to users about services and ways that they can seek mental help and to familiarize themselves with myths and facts about mental illness. Merchandise for Mental Health Stickers, pins, bracelets, and t-shirts help the individual be able to promote mental health to others by sharing them or wearing them in order to reduce the stigma of mental illness. Loteria Cards Activity cards or challenges will provide a way for people to have self-care in their day-to-day life and to improve self-esteem.

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3.7 Design Criteria Educational Tools and resources that promote self-care Informative and educational about mental health Promotes mental health and seeking help Encourages to talk about mental illness to reduce stigma Accessibility Available in English and Spanish Accessible to students physically and online Engaging Engaging and visual layout for pamphlet Simple for everyone to understand in the Latinx/Hispanic community

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3.8 Inspiration

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The inspiration mainly comes from the colors and layouts. There are a variety of bright colors that come from “Loteria cards” and positivity cards which help to bring a strong message. The simplistic branding in the merchandise also brings graphic appeal because it is no too decorative and gets the message across. The pamphlet’s layout also serves as inspiration because it brings a pleasant appeal and balance between text, picture, and quotes. There is also efficient braiding in all the products.

The Loteria game brings adored symbols from the Latinx/Hispanic community culture. The game brings family and friends together to play. Loteria has also been used as a teaching tool and to learn about culture and history values. The Loteria game serves as inspiration for this project because it will be used as a game tool to bring families and friends together to learn about mental health and its importance.

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3.9 Design Guide The color green relates to mental health awareness and it’s also representative of nature. The blue is for tranquility and simplicity. Red is used to symbolize asking for professional help, and yellow is a symbol of positivity and fun. The typeface used is Futura, the reason is that it’s very clean, elegant, and beautiful and also, it’s easy to read.

Color Palette

Typefaces

Logo

Futura Demi

#A8C152

#000000

Aa Bb Cc Dd Ee Ff Gg Hh Ii Jj Kk LlMm Nn Oo Pp Qq Rr Ss Tt Uu Vv Ww Xx Yy Zz 0 1 2 3 4 5 6 7 8 9 . ! ? . “ ‘ () ^ & %

Futura Medium

#BDE1ED

#BDE1ED

Aa Bb Cc Dd Ee Ff Gg Hh Ii Jj Kk Ll Mm Nn Oo Pp Qq Rr Ss Tt Uu Vv Ww Xx Yy Zz 0 1 2 3 4 5 6 7 8 9 . ! ? . “ ‘ () ^ & %

Futura Book

#FFF200

#FFFFFF

Aa Bb Cc Dd Ee Ff Gg Hh Ii Jj Kk Ll Mm Nn Oo Pp Qq Rr Ss Tt Uu Vv Ww Xx Yy Zz 0 1 2 3 4 5 6 7 8 9 . ! ? . “ ‘ () ^ & % Hablemos/Let’s Talk 47


3.10 Users/Environmental Needs Surveys and interviews are used to research and collect information on what is missing and needed to get Latinx/Hispanic communities to seek and be aware of mental health services. One of the main observations through the survey is that people believe that there are not enough resources and information for the Latinx/Hispanic community available in Spanish such as therapy or engaging campaigns. Experts on mental health and communication coordinators on health were interviewed. The main observation from this has been that stigma around mental illness and lack of education in the Latinx/Hispanic community has prevented them from seeking help and speaking to others about the topic.

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3.11 Beneficiaries The target users are Latinx/Hispanic students between the ages of 16 to 25. The reason is that people that are the most affected by a mental illness are young adults. The main beneficiaries of the research and campaign are students, parents, family, and friends. The students or young adults will gain knowledge, have resources, and tools for mental health. Parents might not know the subject. They are going to be able to learn from their children and do activities with them. To help reduce stigma and be able to have conversations on mental health. Family and friends will also benefit because the students are going to be able to support, and talk with them if they need help.

Students and Young Adults

Family and Friends

Teachers, Counselors, and Schools

The Latinx Community in general

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3.12 Storyboard 1

4

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2

5

1

The student has been struggling to get open lately.

2

He has to go to school because he is studying in high school.

3

Student gets introduced to this new package about mental health.

4

He reads the information on the kit.

5

He goes and does activities listed in the kit for a few weeks.

6

He enjoys the kit and introduces it to his family and friends.

3

6


3.13 Icons Development

The icons were made with simplicity in mind. The first ideations are in black and white. The objects were made to look recognizable and visually appealing. The details added later were to give the cards more unique and personalized details. Then color was added to make the objects stand out, for them to look more vibrant and fun to be more appealing and gravitating for the user. Recognizable symbols try to be implemented for the user to easily identify find them.

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3.14 Pamphlet Development The brochure’s design consists of adding colors and accurate information. It has simple information that most people can understand and it contains illustrations and text so that people can engage with the brochure and not be bored by it.

Cover

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Middle

Back

Inside Front

Inside Middle

Inside Back


3.15 Loteria Card Concept The Loteria game cards are meant to inform the Latinx/Hispanic community on important topics for mental health awareness. They are designed to promote self-care and create education on each topic. The Loteria cards can be played with family and friends. The icons for each card are colorful like the original Loteria cards. The images are simple and represent each of the topics or activity.

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3.16 Prototypes

Merchandise to promote awareness to the entire Latinx community, not just family and friends or school. They build overall awareness for people to notice and promote mental wellness.

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Prototypes

In the second iteration, the design of the inside of the pamphlet was removed based on feedback. The simple white background makes the focus be on the information so that the text and graphics pop out more.

1. Brunswick, Rutgers University-New. “Mental Health Stigma, Fueled by Religious Belief, May Prevent Latinos from Seeking Help.” Newswise, Newswise, 1 Apr. 2019 2. Cardinal Innovations Healthcare — July 16. “Rethinking Mental Health in the Latino Community.” Cardinal Innovations Healthcare, 1 May 2020 3. nami. “Latino Families Find Answers on NAMI Español Webpage By Moryt Milo.” Latino Families Find Answers on NAMI Español Webpage By Moryt Milo -, 3 Mar. 2021 4. NAMI. “Mental Health Challenges and Support: LATINX COMMUNITIES.” NAMI California, 22 Oct. 2020

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3.17 Pamphlet in English

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Pamphlet in Spanish

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3.18 Playing The Loteria Game The Loteria Game: 12 Different Boards 54 Different Loteria Cards 12 Player Game 20 Minutes to 1 Hour 3 Categories Cards: Questions, True or False, Challenges How does it work: Each player grabs a board. A person calls the card and names a person to answer the question, challenge, or true or false. People get to take the card to be able to look at it later and do the challenge or reflect on it later in the journal.

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Activity in Spanish

Cards the get call/ informative back Topic header Information text in Spanish

Logo/Icon in color

Information text in English Activity in English

Activity check box

Playing Board

1. Campbell, Glenn. “Overcoming Mental Health Stigma in the Latino Community.” Consult QD, Consult QD, 21 Nov. 2017 2. Huizen, Jennifer. “Mental Health Stigma in Latin America: Culture, Resources, and More.” Medical News Today, MediLexicon International, 27 Jan. 2021 3. nami. “Latino Families Find Answers on NAMI Español Webpage By Moryt Milo.” Latino Families Find Answers on NAMI Español Webpage By Moryt Milo -, 3 Mar. 2021 4. NAMI. “Mental Health Challenges and Support: LATINX COMMUNITIES.” NAMI California, 22 Oct. 2020

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3.19 Hablemos/Let’s Talk Kit

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3.20 Chapter Summary Chapter three focused on the solution. The proposed solution not only focused on educating Latinx/Hispanic youth. It served as a way to encourage people to speak up, share what they are feeling. With the goal to reduce stigma in the topic of mental health in the Latinx/Hispanic community. The solution also makes the topic of mental health not be seen as something negative by bringing something that some Latinx/Hispanic people can relate to such as the Loteria. The current stigma of mental illness and the lack of resources. It is what is currently stopping families and students to reach out for help. There needs to be a change for more people to accept help and speak up. This solution aims to make a small contribution to help Latinx/Hispanics with mental health awareness.

“Mental health…is not a destination, but a process. It’s about how you drive, not where you’re going.” Noam Shpancer, PhD Author Phychology at Otterbein University Hablemos/Let’s Talk 61


Chapter 4 Conclusion

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4.1 Introduction Chapter four brings the study together. It would highlight the feedback that was received from experts and potential users. The feedback received will determine the strength and weaknesses of the design. The key recommendations will be highlighted to determine what still needs to be improved and modified in the study. The chapter will conclude with the improvements that are going to be made in the future and the next steps of the study.

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4.2 Feedback “This is a great! You have a lot of content that you have been able to put in an easy to read format. I really like your loteria cards.”

Priyam Das, MPH

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Feedback to maybe incorporate the back cover to keep case tense in sentence cases like “Try everyday to find a tiny bit of courage.” Page 2 lowercase “h” in health in the content. Title is okay. The warning Signs. The title for mental warning needs to be revised because it currently does not make sense. Putting the green squares in the back on page 2, so the circles where to overlap. This can help text pop out. -Priyam Das


“Visually captivating, good incorporation of cultual aspects using an iconic game for the Latinx Community the LOTERIA!!” The myth on laziness needs some work. This is what I suggest “A person who is perceived as lazy, may actually be struggling with symptoms of depression.” or “Family members unaware of depression symptoms may perceive a family member as lazy.” - Fact: A person experiencing symptoms of depression including trouble getting out of bed, inability to concentrate, withdraws, sleeps most of the day, and doesn’t come out of their room, stops going to class or doing their homework. These signs and symptoms can be perceived by family members as laziness due to their lack of awareness about mental health issues. Make sure you have up to date stats and that you list in a footnote where you retrieved your info. In regards to the visual of the cards: I would like to discuss how you chose the icons Have brighter colors that stand out

Yolanda Gamboa, PhD.

Have the wording curve around the picture at the bottom and top of icon (as you did in the right hand corner for sleep in the slide with the buttons to promote these cards). Increase the font so that is the first thing that stands out

-Yolanda Gamboa

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4.3 Next Steps Expanding the Message Make the awareness kit and the activities available to other communities also, since this is designed in both English and Spanish. To also serve not only youth, but people of all ages. Availability Make it available online such as a website, so that people who don’t not received the kit will be able to download and print it online. Digital Game Make the Loteria card game available in app, so that people can take the cards and complete the challenges, play online, or have important information easily available to them when they need it.

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4.4 Chapter Summary Chapter four brought feedback and recommendations from experts on mental health and campaign coordinators to illustrate their opinion on the solution. The majority of the feedback was positive. Saying that the solution brought a cultural aspect from the Latinx/ Hispanic community to mental health awareness. Another highlight is that information that was given in the awareness kit is easy to understand because of the formats of the game and the pamphlet. The Hablemos/Let’s Talk mental health awareness kit brings a small portion of the solution to bring awareness to the Latinx/Hispanic community for mental health, a topic that is often overlooked or ignored. Mental health is important because a mental illness can affect anyone, but if there continues conversations, resources, and important information given to people. There can be changes in how mental health is perceived and people might have a change of opinion on seeking help if there is less stigma and judgment on the topic. Hablemos/Let’s Talk hopes to bring a part of the solution that will help the Latinx/Hispanic community with mental health.

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Bibliography Blossom, Priscilla. “It’s More Important Than Ever To Remove the Stigma Around Latinx Mental Health.” Oprah Daily, 26 Mar. 2021, www.oprahdaily.com/life/health/a29518665/latinos-mental-health-stigma/. Brunswick, Rutgers University-New. “Mental Health Stigma, Fueled by Religious Belief, May Prevent Latinos from Seeking Help.” Newswise, Newswise, 1 Apr. 2019, www.newswise.com/articles/mental-health-stigma-fueled-byreligious-belief-may-prevent-latinos-from-seeking-help. Cabassa, Leopoldo J, et al. “Latino Adults’ Access to Mental Health Care: a Review of Epidemiological Studies.” Administration and Policy in Mental Health, U.S. National Library of Medicine, May 2006, www.ncbi.nlm.nih.gov/ pmc/articles/PMC2551758/. Campbell, Glenn. “Overcoming Mental Health Stigma in the Latino Community.” Consult QD, Consult QD, 21 Nov. 2017, consultqd.clevelandclinic.org/overcoming-mental-health-stigma-in-the-latino-community/. Cardinal Innovations Healthcare — July 16. “Rethinking Mental Health in the Latino Community.” Cardinal Innovations Healthcare, 1 May 2020, www.cardinalinnovations.org/Resources/Blog/RethinkingMental-Health-in-the-Latino-Community. Chapa, Teresa. “Hispanic Heritage Month: Focus on Latino Mental Health.” Each Mind Matters, www.eachmindmatters. org/guest-blog/hispanic-heritage-month17/. Cruz, Maricela De La. “Nearly 1 Million Latinos and Hispanics in California Are Unable to Receive Mental Health Services.” KCRA, KCRA, 23 June 2021, www.kcra.com/article/4-million-latinos-hispanics-california-mental-healthservices/36271619.

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Cruz, Maricela De La. “Nearly 1 Million Latinos and Hispanics in California Are Unable to Receive Mental Health Services.” KCRA, KCRA, 23 June 2021, www.kcra.com/article/4-million-latinos-hispanicscalifornia-mental-health-services/36271619. Huizen, Jennifer. “Mental Health Stigma in Latin America: Culture, Resources, and More.” Medical News Today, MediLexicon International, 27 Jan. 2021, www.medicalnewstoday.com/articles/mental-healthstigma-in-latin-america#in-latin-america. “Latinx/Hispanic Communities.” Anxiety and Depression Association of America, ADAA, ADAA, 10 June 2021, adaa.org/find-help/by-demographics/latinx-hispanics. “Mental Health in the Latino/Hispanic Community.” Vertava Health, 23 July 2020, vertavahealth.com/blog/mental-health-latino-hispanic-community/. “Mental Health Issues Facing the Hispanic-Latino Community.” Sunshine Behavioral Health, 2021, www.sunshinebehavioralhealth.com/resources/mental-health-issues-facing-the-hispanic-latino-community/. nami. “Hispanic/Latinx.” NAMI, www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/ Hispanic-Latinx. nami. “Latino Families Find Answers on NAMI Español Webpage By Moryt Milo.” Latino Families Find Answers on NAMI Español Webpage By Moryt Milo -, 3 Mar. 2021, namisantaclara.org/2021/03/latino-families-find-answers-on-nami-espanol-webpage-by-moryt-milo/. NAMI. “Mental Health Challenges and Support: LATINX COMMUNITIES.” NAMI California, 22 Oct. 2020, namica.org/mental-health-challenges-in-latino-communities/. Oxford Learner’s Dictionaries: Find Definitions, Translations, and Grammar Explanations at Oxford Learner’s Dictionaries. Oxford English Dictionary Online, 2021, www.oxfordlearnersdictionaries.com/us/.

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Appendix A Priyam Das, MPH Senior Health Communications. Coordinator at SFSU. She works with health educators to develop strategic health messaging and marketing for campaigns and initiatives. In an interview with Priyam a conversation on what are the best ways to create a campaign for mental health and also a campaign in general. Priyam gave advice on if the campaign should be more visually rather than having too much information that not everyone might understand. She also gave advice on how to distribute because now more campaigns are done through social media because this is what currently most people are using. Priyam also added that a physical campaign might be helpful, since more people are doing virtual campaigns now. Yolanda Gamboa, Phd Coordinator of Peggy H. Smith. Counseling Clinic and Clinical Counselor at SFSU. Professional Areas of Interest include Chicanx and Latinx populations and underrepresented students. In an interview with Yolanda there was a conversation about Latinx and mental health. She talks about personal encounters when working with people of the Latinx community. She also, gave personal thoughts on why many Latinx people do not seek mental health help. Yolanda, also talk about culture and the importances that it has when it comes to mental health in the Latinx community. She also talks about how there is also a need for more Spanish speaking counseling and how many people might not be familiar with the right vocabulary when it comes to giving a diagnosis in Spanish. Leslie Jaeyoun Shin, LMFT Clinical counselor professional areas of interests include self-esteem, personal growth, depression, and anxiety therapy. In an interview with Leslie there was a conversation of the importance of mental health in general. She also talks about how many of the resources are only available in English. Another part that she added is how there should be more discussion on mental health to reduce stigma. She also talks about how if you see someone struggling that you should reach out to them and listen to them.

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Appendix B Interview with Dr. Yolanda Gamboa Why is getting Mental Health services important in your opinion? Similar to physical health, mental health is important for everyone. People between the ages of 18 to 24 is when mental illness starts to develop. 1 in 5 adults struggle with mental health. Why do you think people in the Latinx community or in general struggle to reach out for help? It has to do with the stigma that mental health has in the Latinx community. Some of the most suffered mental health problems include anxiety and depression. Mental health is also one of the leading causes of suicide. Lack of income people are afraid that they can not afford it. English only services they are not able to find help in Spanish. They wait until the last minute which results in them having to go to the hospital because they did not seek help on time. Another big factor to stigma is that Latinx labels getting help from a physiologist as “loco” because they are afraid to be diagnosed with a mental illness. They prefer to listen to their religion to the “santos” instead of getting professional help, and using at home remedies such as el “te,” “curandera” or “santera.” They also label mental health as “flojo” because someone is too depressed to get out of bed. Do you think that there are enough resources available to get informed about Mental Health in the Latinx community? Some resources available for the Latinx community are “Instituto Familiar de la Raza” in San francisco. “Clínica de la Raza” in Oakland. “Clinical del Sol” also in Oakland. All these organizations help the Latinx community with their physical health and mental health. Other resources include the “Dream Resource Center” in SFSU. “Active Minds” is a program at SFSU that focuses on bringing awareness to mental health. In the years that you have worked at SFSU, have you seen an increase of Latinx community reach out for help? Does not have the exact statistics but does have seen people reach out for help in spanish and has done therapy in spanish. However, there is missing bilingual services and training in spanish.

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How will you approach a person that does not believe in counseling? What would you say to them? Changing the language on how you talk to someone. People can feel triggered if someone talks about mental health as an “illness.” People need to choose their words when speaking to someone and understand the person, so the person does not feel like they are being attacked or judged. Do you think that by giving people accurate information and resources they will be willing to seek help? There are not many people that reach out for help and there are not enough people educated on the topic. Do you recommend any activities for managing anxiety or depression? Some of the activities that are essential are sleeping, eating well, and exercise. Also avoiding sugar. Find any activities that get you moving. Such as meditation, connection to religion or spiritually. Talking to friends and family. If these activities are not working people need to reach out for counseling. For some who don’t have a background in mental health, but you see someone struggling to get help. How can you help or reach out to this person? There are workshops at school (SFSU) such as ‘How to help a Friend.” It is important to listen without judging. Reflecting on what they tell you and do not make them feel that they are not being listened to and show them support. Do you think younger people are more open minded on getting help with a Mental illness then older people? Younger people can be more open minded because there is a lack of education with older people. Mental Health should be explained in a way that people can understand it. Do you recommend having a daily routine to help with a Mental Illness? Having daily routines such as exercise and management will help with a person’s stress.

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Do you think that if parents talk to their children about Mental Health they will get help sooner? Definitely yes. Educating parents about mental health would help their children think more positively about mental health. Sometimes students do not reach for help because their parents tell them that they do not need it or that they should not take medication for their condition. Besides therapy what are other recommendations you suggest people do for dealing with anxiety or depression? Why do some people prefer to get medication instead of therapy? Medication is prescribed to patients suffering from a developed mental health condition. People that suffer anxiety and depression usually take counseling instead of medicine. People also need to know that medication takes time to take effect, it does not work in an instant. It all takes time whether it is medication or therapy. , Do you think there should be more counseling offered in Spanish? It’s there enough? “Our Lady of the Lake University” offers professional help in spanish. There is a lack of programs that teach counseling in spanish people sometimes have a hard time finding help because most professional counselors that are educated with all the correct terminology and diagnosis information speak English. That makes the Latinx community have a hard time finding professional help in spanish. Do you know of any programs that offer support for the Latinx/Hispanic community? Some programs that offer help on campus are Peggy H. Smith Clinic at SFSU. They offer counseling to students, part of it is covered by the tuition fee. The Ethinic Studies Building and department offer counseling for the low income communities the charge between 0 to 20 dollars depending on your income. There are many resources and groups on campus that offer help. In Latinx there is also “familismo” which means to rely for help with other family members and having strong loyalty to the family. Another one is “fatalismo” that is a belief in a higher power such as god because many Latinx leave their health in god’s hands.

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Appendix C Survey What is your age? 17 or less, 18 - 25, 26 - 35, 36 - 45, 46 - 55, 56 - 66, 67 or more What is your Gender? Female, Male, Non-binary, Prefer not to disclose, Prefer to self-describe Race/Ethnicity African American/African/Black/Caribbean, Asian/Pacific Islander, Caucasian, Hispanic/Latinx, Native American, Prefer not to answer, Other What is your education level? No formal education, High School or less, College University, Masters, Doctorate/ PHD, Prefer not to answer Have you ever been diagnosed as having a mental illness by a doctor or mental health professional? Yes, No, Never been diagnosed, but suffer from a mental illness, Prefer not to answer

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How often have you been to therapy regarding a mental illness? Very often, Often, Somewhat often, Not often, Never, I don’t suffer from a mental illness,Prefer not to answer How important do you think therapy is for treating a mental illness? Strongly important, Important, Neither important or not important, Not really important, Not important at all How important do you think having awareness about mental health is? Very important, Important, Neutral, Somewhat important, Not important Do you think there is enough information and resources available for everyone including minority communities regarding mental health? Plenty, Enough, Neutral,Somewhat enough, Not enough, Don’t know


In your opinion do you think Latinx/Hispanic have a disadvantage when it comes to getting informed about mental health because of the language barrier or legal status? Yes, No, Somewhat, Unsure On a scale of 1 to 10 how much do you think parents talk to their children about mental health? (10 = very much and 1 = never) 1, 2, 3, 4, 5, 6, 7, 9, 10 Would you agree that people would seek more mental health help if there wasn’t stigma around mental illness? Completely agree, Agree, Neither agree nor disagree, Disagree, Completely disagree Would you agree that people in general need to be more educated on mental health? Completely agree Agree Neither agree nor disagree Disagree Completely disagree

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