Why Does Mental Health Stigma Persist in Mexican-American communities, and What are its Consequences?

“Just Don’t Talk About It”

This question matters because stigma doesn’t just prevent people from getting help, it shapes how entire communities understand suffering and their own identity. In Mexican-American families, mental health issues are often kept quiet. This silence is shaped by cultural values like familismo, gender roles that define who is allowed to express pain, and generations of lived experience with institutions that often feel unwelcoming or unsafe. My research looked closely at the beliefs, values, and barriers that surround mental health in Mexican-American communities. Stigma is deeply entangled with identity. It’s reinforced by family dynamics, cultural expectations, religious beliefs, and the pressure to appear strong in the face of hardship. In some families, seeking help can feel like betrayal. In others, it simply isn’t spoken of at all. For young adults trying to navigate their own mental health, this silence can be isolating. It can also be dangerous. When pain goes unspoken, it often goes untreated.

Silence Is Learned

In many Mexican-American families, mental health isn’t something you grow up talking about. Silence becomes the default. But that silence doesn’t come from nowhere. It’s constantly reinforced by cultural values, expectations about gender roles, and learned beliefs about shame, responsibility, and strength. One major force behind this is familismo, a cultural value that centers the family as the emotional and moral nucleus of life. As Brewer et al. (2024) write, “familismo increases family cohesion in Latino communities and is critical in shaping family decisions.” This value can provide comfort and strength, but it also reinforces the idea that mental health struggles should be handled privately, within the family, if at all. When a loved one is suffering, families may avoid reaching out for outside help in order to protect their image, preserve unity, or avoid bringing shame. “Mental health needs are not expected to be publicly disclosed, but rather are reserved for and addressed within the family context” (Brewer et al, 2024). The result is often isolation, especially for individuals whose suffering exceeds what their families feel equipped to manage. This silence isn’t limited to people with mental health conditions, rather it extends to those around them. Brewer et al. (2024) show that family members can internalize stigma simply for being related to someone with a mental illness. This “courtesy stigma,” as defined by Goffman and cited in their study, attaches blame or shame to relatives, who may feel judged, responsible, or even contaminated. It’s not just that families stay silent to protect the individual. They also stay silent to protect themselves.

De La Torre-Lopez (2024) echoes this dynamic in her examination of stigma among Mexican men. Her thesis explains how cultural ideas about masculinity, strength, and sacrifice push men to suppress their emotions and avoid seeking help. But these beliefs don’t just affect the individual. They ripple outward, influencing family expectations and reinforcing silence across generations. She writes, “culturally specific standards and factors… affect the way in which men within the community perceive and cope with their mental health,” including pressure “to suppress their psychological challenges in a discreet manner”.

When families are taught that silence is strength, speaking up can feel like betrayal. But silence doesn’t make pain disappear, it only makes it harder to name. Without names, it becomes nearly impossible to seek care. Recognizing that this silence is learned is the first step in unlearning it.

The Weight of Expectation: Gender and Mental Health

For Mexican-American women, the silence around mental health is often intensified by cultural expectations about gender. From a young age, many women are taught to prioritize the needs of others, uphold the family’s emotional well-being, and carry hardship without complaint. These expectations shape how women interpret suffering and whether they feel allowed to seek help.

As Amaro and Russo (1987) point out, Hispanic women are overrepresented in the lowest socioeconomic brackets, experience higher rates of single parenthood, and are more likely to raise children under economic strain. All of these are risk factors for psychological distress. Yet culturally, many Mexican-American women are socialized to endure rather than express. Ideals like marianismo, the expectation to be self-sacrificing, pure, and morally strong, can make depression or anxiety feel like moral failings instead of treatable conditions. When a woman breaks under pressure, she may not be seen as someone in need of care, but as someone who has failed her role.

Lopez et al. (2018) underscore this dynamic through their study of Hispanic women receiving depression care in primary clinics. They found that stigma about mental illness and antidepressant medication varied significantly by education level. Women with lower educational attainment were less likely to recognize depression symptoms and more likely to hold stigmatized beliefs about treatment. This reflects how deeply cultural norms are internalized. Even among women with higher education, stigma around antidepressants remained high, suggesting that cultural beliefs may outweigh individual health literacy when it comes to trust in care.

When a woman is expected to be the emotional anchor of the family, seeking help can feel like admitting weakness. It can also feel selfish. In this context, many Mexican-American women stay silent not because they don’t suffer, but because they’ve been taught that suffering in silence is a virtue. But as the researchers note, stigma is a barrier that worsens outcomes. Without culturally relevant interventions that recognize the intersecting pressures of gender, class, and cultural identity, many women will continue to fall through the cracks.

What Fills the Silence When Professional Care Is Avoided?

When formal mental health care is out of reach because of cost, language, mistrust, or cultural beliefs, Mexican-American families often step in. López et al. (2012) explain that "families can serve as a source of support or conflict that is associated with a reduction or increase in the likelihood of relapse" (p. 517). This support can be vital, but it can also delay diagnosis and treatment, especially when symptoms fall outside familiar ways of understanding distress.

To address this, the researchers developed La CLAve, a Spanish-language program that teaches people how to recognize key signs of psychosis. The name is a mnemonic where C stands for creencias falsas (delusions), L for lenguaje desorganizado (disorganized speech), and A for alucinaciones (hallucinations). After completing the program, participants were far more likely to identify these symptoms. The authors write, "Prior to the psychoeducational program… less than half of the participants identified at least one of the three psychotic symptoms… After the training… participants significantly increased their identification of symptoms" (p. 517). This increase in recognition matters because it helps people seek care earlier.

But early care is not guaranteed. In many Mexican-American families, mental illness is still surrounded by silence. Even when symptoms are clear, cultural stigma may keep people from reaching out. The researchers emphasize that "the long-term goal of this project is to reduce the time it takes for persons with schizophrenia and other psychotic disorders to obtain care" (p. 517). When that time stretches on, families carry the burden alone, and the person suffering may never reach the support they need.

When Seeking Help Makes Things Worse

Even when Mexican-Americans overcome the stigma and silence around mental health and finally reach out for professional help, they don’t always find safety or support. For many, the act of seeking care is met with new kinds of harm.

Escobar et al. (2021) interviewed mental health providers working along the South Texas–Mexico border and found that cultural mismatch between providers and patients was one of the most consistent challenges. Therapists reported that patients often lacked basic knowledge about mental health, not because they were uninformed, but because mental illness had never been framed in culturally relevant terms. When symptoms were finally severe enough to prompt help-seeking, patients were often misdiagnosed or placed on the wrong medications. In some cases, families created makeshift “pharmacies” at home, recycling medications between relatives in the absence of trust or access to formal care. One provider noted that families “go into Mexico and get medication there,” (Escobar et al., p. 3) leading to further harm.

The study revealed how deeply beliefs about “being loco” (Escobar et al., p. 4) continue to stigmatize care. Even younger patients, more open to therapy, still wrestled with the fear that simply walking into a therapist’s office confirmed they were broken. Additionally, Families often withdrew from the care process over time out of exhaustion, emotionally worn down by systems that failed to help or made them feel unwelcome.

Aguilar-Gaxiola et al. (2002) showed how these barriers extend beyond the clinic room and into policy itself. In their study of mental health services in Fresno County, they found that more than 90% of Mexican-Americans with a mental disorder had received no professional mental health care at all. Those who did often faced language barriers, cultural insensitivity, and a lack of trust in providers. One of the key findings was that patients were more likely to seek emergency services after conditions had worsened, in part because of the difficulty in finding culturally appropriate outpatient care. The result: families delayed care, problems escalated, and trust in the system eroded further.

What both studies show how just getting in the door isn’t enough. If the system doesn’t understand you, doesn’t speak your language (literally and culturally), and doesn’t respect your worldview, it can make things worse much worse. When Mexican-Americans seek professional help and are met with bias or misdiagnosis, it doesn't just affect one appointment. It affects the entire community’s relationship to care.

Conclusion: “Ponte Las Pilas” and the Silence That Follows

For much of my life, I never saw my mental health struggles taken seriously. Not by doctors, and certainly not at home. Whenever I tried to talk about feeling down or overwhelmed, I was met with sayings like “Ponte las pilas”, literally meaning, “put in your batteries.” It was meant to motivate, or to snap me out of it. But instead, it told me that what I was feeling wasn’t real and that I just wasn’t trying hard enough.

I now know that this reaction isn’t unique to my family. Many young Mexican Americans face the same response: encouragement to toughen up, keep going, or suffer quietly. Part of that comes from machismo, but part of it also comes from older generations who survived poverty, migration, and trauma. When you’ve had to fight just to feed your family or cross a border, depression can seem like a luxury. I understand that. But it doesn’t make it any less painful to be told your suffering doesn’t count.

This project helped me see how cultural values like familismo and machismo can offer strength and stability, while also reinforcing stigma and preventing treatment. I focused mostly on young people and families, however future research could explore how older generations experience and respond to mental health challenges, especially given the impact of past hardships and cultural expectations around resilience.

For me, this research is personal. It’s about finding the words that were never given to me, and maybe helping others do the same.

Works Cited:

Escobar, R., Gonzalez, J.M., Longoria, D.A., & Rodriguez N. (2021). Challenges Faced by Mexican Americans when accessing Mental Health care service utilization along the South Texas – Mexico border. Journal of Mental Health and Social Behaviour, 3(1),128. https://doi.org/10.33790/jmhsb1100128

Brewer, K. B., Washburn, M., Yu, M., Giraldo-Santiago, N., Pickford, M., Hostos-Torres, L. R., & Gearing, R. E. (2024). Stigma Toward Families With Mental Health Problems in Latino Communities. Families in Society, 0(0). https://doi.org/10.1177/10443894241237018

De La Torre-Lopez, Cynthia M., "Immigration, Machismo, and Cultural Stigmatization: Causes of Lack of Mental Health Treatment Utilization Among Mexican Men in the U.S." (2024). University Honors Theses. Paper 1559. https://doi.org/10.15760/honors.1591

Amaro, H. and Russo, N.F. (1987), HISPANIC WOMEN AND MENTAL HEALTH. Psychology of Women Quarterly, 11: 393-407. https://doi.org/10.1111/j.1471-6402.1987.tb00914.x

Lopez, V., Sanchez, K., Killian, M. O., & Eghaneyan, B. H. (2018). Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women. BMC public health, 18(1), 646. https://doi.org/10.1186/s12889-018-5516-4

Aguilar-Gaxiola, S. A., Zelezny, L., Garcia, B., Edmondson, C., Alejo-Garcia, C., & Vega, W. A. (2002). Mental Health Care for Latinos: Translating Research Into Action: Reducing Disparities in Mental Health Care for Mexican Americans. Psychiatric Services, 53(12), 1563–1568. https://doi.org/10.1176/appi.ps.53.12.1563

López, S. R., Barrio, C., Kopelowicz, A., & Vega, W. A. (2012). From documenting to eliminating disparities in mental health care for Latinos. The American psychologist, 67(7), 511–523. https://doi.org/10.1037/a0029737

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