Why Latinx Communities Are Left Out of the OCD Conversation

by Mayra Diaz, LMFT

While much progress has been made to educate and increase access to mental health care, there is still a stigma within many cultures of color about mental health issues. The intrusive thoughts and repetitive behaviors that characterize Obsessive Compulsive Disorder (OCD) are often misunderstood in various communities, such as the Latinx community. Many Latinx individuals are struggling with OCD without even knowing it. And even if they have gotten a diagnosis, members of the Latinx community may not feel comfortable or safe seeking out treatment for OCD. This article will touch on reasons that Latinx people are left out, what therapists can do, what clients can do and resources.

Exposure and Response Prevention (ERP) is the most effective form of treatment for OCD. And yet, many people in the Latinx community may not have heard of it. ERP is a form of Cognitive Behavioral Therapy (CBT) used to treat disorders such as OCD by targeting fears and thoughts through exposure to help reduce compulsive behaviors. 

ERP Kaleidoscope (ERP-K) was developed to create a safe space for BIPOC individuals to engage in conversations about OCD. ERP-K develops educational material based on the various experiences of BIPOC therapists and OCD sufferers. It also includes events and activities where members of the Latinx community can get involved and feel included. 

Reasons for the Disconnect Between Latinx Communities and OCD

• Care-seeking behaviors: Latinx Americans are more likely to go to a medical doctor than a therapist for their physical symptoms. Due to a lack of awareness of OCD and widespread education and conversations about anxiety, Latinx Americans likely attribute their physical symptoms to a medical cause instead of a mental health issue. Religion is important to many in the Latinx community. Latinx Americans are also more likely to seek out help from their religious community over a mental health provider.² 
• Lack of resources: Latinx Americans are less likely to be insured than White Americans. The “typical” Latinx American earns 72% of the “typical” non-Latinx American White individual.⁵ A lack of resources through insurance or personal wealth stands as a barrier to Latinx Americans receiving the care they need.⁴  
• Language barriers: There are fewer educational resources for OCD in Spanish. And only 5.5% of psychologists report being able to provide services in Spanish.¹ This makes it difficult for Spanish speakers to educate themselves about the OCD diagnosis and receive appropriate treatment.³  
• The importance of the group: Latinx Americans value families and groups, often above the individual. This can make prioritizing personal needs feel wrong or disrespectful if it might negatively impact the group. A Latinx American may feel afraid of disrupting the peace of the group if they call attention to a mental health issue or fear judgment or rejection. 
• Shame and stigma: There are cultural values within the Latinx community that may make individuals feel shame if they reach out for help. Machismo is a prevalent cultural value that promotes hypermasculine behaviors such as aggression, male dominance, and intimidation. Being a strong provider is a core trait of machismo. Acknowledging vulnerable emotions such as anxiety or shame, often associated with OCD, can be viewed as a weakness or personal flaw. Marianismo is the corresponding cultural value for women, emphasizing a woman’s role as caretaker and source of strength for the family.⁶ Similarly, women admitting to mental health issues can be viewed as failing in their duty to be strong caretakers. 
• Cultural norms: Caring for loved ones and keeping a tidy home are common values within the Latinx American community. Worrying over the safety of family members as a sign of love or fastidious cleanliness can be normalized in this community. When these behaviors become excessive and harmful, it can be hard to recognize as possible symptoms of OCD. 

What Can Therapists Do to Address These Issues?

• Educate the community. Offer to give talks or create informational materials such as handouts to share with the Latinx community. 
• Learn. Consult with Latinx therapists or read relevant material about OCD and how it impacts the Latinx community.² Approach your clients with an openness to learning from their perspectives and a willingness to admit what you don’t know. 
• Lower financial barriers. Offer pro bono or sliding scale services to increase access to underserved Latinx Americans. 
• Get the family involved. Consider the family’s importance to a Latinx American client. Include family members in treatment to increase buy-in and show respect for their cultural values. 
• Assess for and respect religious beliefs. Explore the role religion may play in your client’s life. Be considerate of their values while also exploring any areas where OCD may be negatively impacting their religious beliefs. Consider consulting with a religious leader to help clients discern between the doctrine of their faith and compulsive behavior. 
• Talk about gender roles. Explore the client’s experience of gender roles and engage in dialogue about alternatives to harmful behaviors such as intimidation or suppression of emotions. Validate the client’s values while exploring which behaviors serve the client and possible changes the client may be open to. 
• Run a support group for Latinx American OCD sufferers. Create the much-needed space the community needs to share and receive support from people who have similar experiences. 

What Can Latinx OCD Sufferers Do?

• Talk about these issues. Let people around you know that it’s okay to struggle with mental health issues. Open up about your challenges if you feel a sense of trust in a relationship. The more we talk about these things, the more we can normalize and destigmatize OCD. 
• Share evidence-based information. If you have encountered a reliable educational resource, pass it along. Make sure to confirm the information comes from a reputable source. 
• Communicate with your therapist. If you feel safe with your provider, be honest about your cultural beliefs and values. Give your therapist feedback so they can understand how best to serve you. 
• Join a support group. Being able to witness other people going through similar experiences can be powerful. Search for a general OCD support group or a support group specifically for Latinx OCD sufferers. Ask your mental health or medical providers for suggestions. 
• Get involved in advocacy. Many local mental health organizations have peer-led opportunities. You may be able to speak on a panel of OCD sufferers or provide peer-level assistance. Organizations like NAMI, IOCDF, or local organizations like OCD SoCal have peer advocacy opportunities. 

OCD no longer has to be a stigmatizing and isolating experience. Latinx communities can and should be a part of the growing conversation around OCD. Providers have a real opportunity to bring their clients the most effective treatment, ERP, and provide it with cultural humility. ERP Kaleidoscope (ERP-K) is a safe space for BIPOC individuals to engage in conversations about OCD. ERP-K offers educational material, events, and activities that allow members of the Latinx community to get involved and feel included.

About the Author: Mayra Diaz is a licensed marriage and family therapist based in Glendale, CA. She specializes in working with adult individuals who are navigating OCD and related anxiety disorders, offering compassionate, evidence-based treatment. In addition to her clinical practice, Mayra is actively involved in the BIPOC community, where she advocates for increased mental health awareness and access to culturally responsive care.

1. American Psychological Association. (2016, September). 2015 APA Survey of Psychology Health Service Providers. American Psychological Association. Retrieved September 22, 2022, from https://www.apa.org/workforce/publications/15-health-service-providers/ 

2. Altarriba, J., & Bauer, L. M. (1998). Counseling the Hispanic Client: Cuban Americans, Mexican Americans, and Puerto Ricans. Journal of Counseling & Development, 76(4), 389).

3. IOCDF. (n.d.). Tips for clinicians when working with Hispanic/latinx americans with … IOCDF. Retrieved September 17, 2022, from https://iocdf.org/wp-content/uploads/2013/12/Tips-for-clinicians-when-working-with-Hispanic_Latinx-Americans.pdf 

4. Joint Economic Committee. (n.d.). The Economic State of the Latino Community in America. Retrieved September 20, 2022, from https://www.jec.senate.gov/public/_cache/files/2d162187-e1cc-4629-a39e-7f0853194280/jec-hispanic-report-final.pdf 

5. U.S Department of Labor. (2011). Labor force characteristics by race and ethnicity, 2011. Retrieved from http://www.bls.gov/cps/cpsrace2011.pdf 13. Vega, W., Karno, M., Alegria, M., Alvidrez, J., Bernal, G., Escami
6. Viana, A. G., Trent, E. S., & Silva, K. (2022). Anxiety and depression in Latino populations: Socio-cultural considerations and best practices. Comprehensive Clinical Psychology, 52–65. https://doi.org/10.1016/b978-0-12-818697-8.00185-0