Everyone Deserves Adequate Mental Health Care

By Mike Gaeta | Jul. 11, 2018


As a caretaker and advocate for my mom, it’s been daunting navigating both the cultural barriers in my Latino community and trying to access mental health services. Thus far, these challenges have proven too difficult to surmount in getting my mother adequate treatment for schizoaffective disorder.

Years before my mother got an official diagnosis, we viewed her “locura” (craziness) as just part of her personality. In hindsight, it was clear there were times when my mom was harboring extreme delusions and experiencing bouts of mania. At the time, though, it was our pride that probably led us to downplay my mom’s problems.

Pride is a common problem among Latino families—we don’t like people seeing our weaknesses. We don’t want to admit we even have any. Many of us also come from working class or impoverished backgrounds, which instills in us a deep-seated perseverance—an attitude encapsulated by the slogan “¡si se puede!”

Latino families are also very private, as problems are settled within the immediate family. This extends even to family gatherings. During these events, I would try to help my mom socially navigate, in the hopes of concealing any irrational behavior. But attending extended family functions began to occur less frequently as my mom’s mental health deteriorated.

She started to accuse the family of working for the FBI to spy on her and my dad of trying to kill her by putting poison in her food and drink. She’d wake up in the middle of the night and insist she heard people trying to get inside the house to kill her. Suggesting she see a psychiatrist made my mom angry and hostile, and everyone else miserable.

About three or four years into my mom showing symptoms, I began to take a more direct role in trying to get help and treatment for her. By then, my parents were divorced, but still living together. My mom was unemployed and uninsured, and her psychosis was constant. She had nowhere else to go and my dad was reluctant to kick his high school sweetheart out of the house.

Lack of health insurance was a significant barrier for us when I first tried to get her help. This is a problem experienced by too many Latinos. Additionally, my mom didn’t have an official diagnosis (which is proof of a disability) that we could use to apply for Medicaid.

I decided to move my mom in with me in San Francisco. The city was in its early years of offering health care services to impoverished, uninsured residents. I enrolled my mom, and we began accessing community medical and mental health services.

Fast forward nine years later. Despite my best efforts, my mom still remains untreated. In that time, my mom has been released from hospitals against my wishes and has developed various serious medical issues. Trying to access outpatient services, whether community centers or county services, has proven to be entirely useless. In one case, it was hard to even get in the door when we tried to access a county mental health program. My mom was denied services (“found not eligible”) because she didn’t admit to having a mental illness during her initial interview/evaluation. It took pressure and advocacy on my part to finally get her enrolled.

There are gross inadequacies and structural problems in the mental health system. More and better family education and outreach are essential in order to mitigate the cultural barriers that play a part in impeding Latino families from realizing and accepting they need help. Training and employing more culturally responsive and competent mental health staff and psychiatrists, and expanding community mental health centers/clinics are also important.

For example, the Latino mental health center we used in San Francisco was a blessing in helping us finally get an official diagnosis for my mom. With his cultural competence and skill, the psychiatrist my mom saw was able to build trust and a rapport with my mom relatively quickly, despite her deep reluctance in seeing him.

I will advocate for treatment centers like these for the rest of my life. My mom, my family and my community deserve quality care.


Mike was born in Fresno, CA, the grandchild of Mexican immigrants. He has been teaching at a community college in the Bay Area for ten years and is a caregiver for his mom who is diagnosed with Schizoaffective Disorder. Read his blog here.


Note: An earlier version of this blog appeared on NAMI.org in July 2017.


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Great experience. Really enjoyed this post. Thanks for your efforts! www.healthdose.org
7/17/2018 7:56:18 AM

Lizanne Corbit
Very important read. It's amazing how you choose to show up and be there for your mom. Everyone matters, and everyone who have access to the treatment they need and deserve to have.
7/14/2018 12:56:42 AM

Sarah Pederson
Thank you so much for sharing your story! While I am Caucasian, I can relate very much to what you are saying in regards to family stigma and trying to contain a problem. My son is 15 years old, and has anxiety and depression. My son's father thinks he just needs to get a job and that will cure him. Thinks it's all a problem that only my son can see. It's made it difficult to get ongoing support and behavior changes at dad's house when my son stays with him. It also perpetuates the shame of not having strong mental health.

My bigger concern is that the tighter we get with qualifying conditions for mental health care, and insurance creates increased costs (yes, my son's 50 minute session was billed at $326 with out of pocket at $86 to meet with an LPC.) This is ridiculous considering the provider we used to see was out of pocket only and cost $60 per visit. And we are blessed in that I have financial resources to pay for his biweekly visits. I cannot imagine what it would be like to not have insurance or the financial means to get needed help. Mental illness is not a character flaw. There are many biological and life experience impacts that rewire the brain and body chemistry. That's what I would want people to understand more than anything.

Thank you for being a champion for your mother and the Latino community.
7/13/2018 9:40:07 AM

God Bless you for what you are doing. If every mother had a son like you!
1/27/2018 9:17:13 PM

Maria Monhoff
You are a hero and a good son
It is hard to believe it was such a hardship to get the right help for your mom. Times have changed and hopefully no one has to go through so much medical neglect anymore
1/25/2018 11:31:23 PM

Kerry Gimbel
Thank you for sharing your story. My 23 year old son has the same diagnosis as your mother. While far from perfect, there are services available in New York. Trying to navigate the system with insurance is daunting-you can be proud of how you advocated for your mother.
1/25/2018 7:14:17 PM

Jodi Williams
Thank you for sharing your experiences Mike. I am having a hard time getting my 23 year old son help now. he is currently in jail for breaking a no contact order due to him being physically and verbally abusive and destructive at my house, the place he grew up.
12/18/2017 1:15:36 PM

Mira T. Lee
Unfortunately, we seem to hear this story over and over again, in every community. I wish you strength, and I hope your mom finds the treatment she needs. She is lucky to have you.
7/26/2017 9:06:11 PM

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