The Latino Psychiatric Patient: Assessment and Treatment
According to the 2000 U.S. Census, 12.5 percent of the U.S. population—35.5 million people—are of Hispanic origin. It is expected that Hispanics will be the second largest racial or ethnic group in the United States, after non-Hispanic whites, by the year 2010. However, the specific characteristics and health needs of this important ethnic group are still not being covered comprehensively by mainstream psychiatric literature. The Latino Psychiatric Patient attempts to fill this gap by providing a valuable introduction for the mental health professional to the current status of the Latino population in the United States as well as the particular challenges that are encountered in the psychiatric treatment of Latino patients.
The book is divided into three sections. The first, "Overview and Treatment Issues," summarizes the demographic characteristics of the Latino population and outlines the differences between Latinos and the general U.S. population in physical and mental health indicators. This section presents the challenges posed by the heterogeneity of the group in terms of nation of origin, race, and degree of acculturation. The data on health and social parameters are presented comprehensively without being too extensive.
The discussions of cultural differences and assessment of Hispanic patients are interesting but are perhaps too brief and introductory, especially in view of the fact that they are central to the book's main goal. Cultural factors are discussed at only a basic level, without consideration of the differences between Hispanics with different backgrounds and the differences between the Hispanic and non-Hispanic white populations in terms of the value assigned to work and class advancement. Little attention is given to the immigration difficulties that are usually encountered by this ethnic group and how the instability and uncertainty created by these difficulties can take its toll on the mental status of Hispanic patients.
The second section of the book, "Cultural and Psychiatric Issues," outlines demographic characteristics, history, provision of medical services, and various other characteristics of selected Latin American countries. I consider this section to be of great value to non-Hispanic mental health professionals, providing much-needed background knowledge for understanding Latino patients. Each selected country has a dedicated chapter, making this section a good reference source for obtaining information about a particular client's country of origin. An unfortunate consequence of this approach is that it makes the section too repetitive for the general reader while overlooking the common features of the region.
The book's third section, "Special Issues and Populations," reviews substance abuse and domestic violence in Hispanic communities, as well as the issue of Hispanic women in psychiatric treatment. This section is useful in providing an understanding of the cultural factors involved in domestic violence and the role played by social and financial stressors in the clinical presentations of individual patients. The discussions of domestic violence and Hispanic women are well written, although the emphasis is more descriptive than practical. The chapter dedicated to substance abuse is comprehensive, provides staggering statistics on substance abuse in the Latino population, and offers some caveats to be considered in treatment.
I found The Latino Psychiatric Patient to be a comprehensive source of information for mental health professionals who are involved in the treatment of Hispanic patients. The authors were able to introduce the relevant issues with clarity and brevity. At the time of this review, the book is available to be read online free of charge on the Web site of American Psychiatric Publishing Inc. (www.appi.org)—it doesn't get any better than that.
Dr. Miozzo is affiliated with Community Healthlink in Worcester, Massachusetts.
