As a result of such culture-specific representations of illness, service utilization may be impacted by how Latinos understand and attribute causes to mental illness. General lay theories of causation are guided by the holistic view of illness and are often attributed to supernatural causes, environmental causes (bad air), or strong emotions (embarrassment, envy, and others) (Molina & Aguirre-Molina, 1994). Because it is more socially appropriate for women or children to manifest illness (they are perceived as weaker), it is consistent that studies have found that more often Latina women report higher rates of depres sion than men do. Additionally, there are very low service utilization rates for Latino men, which is consistent with cultural norms that men are expected to be strong and able to control their inner feelings. Consequently, it may be important not only to educate the community about causes of mental illness symptoms, but also to use methods of out-reach that allow individuals to retain their dignidad and cultural norms.
Clearly, cultural values also will play a role in how individuals perceive treatment and finding treatments and interventions that work best. It will be important to culturally tailor treatments and interventions that are responsive to the types of cultural experiences that are relevant for the target audience. Of course, at a basic level it is crucial to use the correct language in order to begin to address relevant cultural issues. To date, relatively few culture-specific treatments have been empirically tested. One example is Constantino and colleagues (1994) who used storytelling as a form of treatment in Latino youth with success. Other individuals have suggested utilizing the natural family support system for improving mental health or at least including family members in therapy sessions (Molina & Aguirre-Molina, 1994). Additionally, Dana (1993) discusses folk healers or spiritual healing, such as curanderismo and espiritismo, as a culture-specific form of treatment that may legitimately help improve mental status of individuals who have strong beliefs that are consistent with these types of treatments.
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