Family Support and Help Seeking for Depression Among Mexican-Americans

We have developed the Support System worksheet and Eco-map to serve as a culturally grounded tool to help counselors explore multiculturalism and help-seeking tendencies with Mexican-American clients. This resource seeks to address the current disparity in Hispanic communities in which less than 10% seeks help from mental health professionals for mental distress (Keeler et al., 2013). The worksheet and eco-map provided in this document aim to address this gap by encouraging active reflection on current support systems and cultural values. Central to this resource is the nuanced core value (familismo) in many Mexican-American families that emphasizes family obligations, shared responsibility, and prioritizing the family's needs over the individual. However, research shows that once depression severity increases, members of these communities are less comfortable turning to family in times of distress and have reduced belief in the effectiveness of help-seeking in general. The Support System worksheet and Eco-map were designed to explore these dynamics in a structured manner and engage discussions around one's own understanding of their support systems. It touches on the Mexican-American identity by gauging the client's values and experiences with their family, and using a strengths-based approach to work with the client to reframe and recognize cultural strengths. Clients will identify pillars of their current support network and reflect on any perceived barriers when reaching out for support. The aim through strengths-based exploration of the client's cultural identity is to recognize and re-engage potential sources of support, aligning with cultural values during depressive episodes.

Our resource is particularly helpful to counselors who aim to incorporate more multicultural competence and cultural humility in their practice. Centering Mexican-American cultural values encourages counselors to recognize family relationships as potential protective factors rather than silencing family dynamics to fit an individualistic, Western mindset. Using the worksheet and Eco-map allows the counselor and client to explore strengths and perceived barriers together within a client's day-to-day support systems. Depression and other mental stressors commonly influence how people will interpret relationships, and can lead to beliefs misaligned with reality. This worksheet maintains a perspective of cultural values while exploring how the client has experienced and expressed support in their life. Through this reflection, the client can begin to develop a stronger sense of their cultural strengths as well as possible perceived barriers that influence their willingness to seek support amongst depressive thinking and behavior. Overall, giving the client the chance to consider the strengths and challenges within their support network in an emotionally safe environment. In the early beginnings of a counselor's relationship with their client, the usage of the eco-map as a tool can help the counselor in visually understanding the client's support network and family relationships, allowing for easier identification of sources of support.