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Background

Latino youth and other minority youth experience substantial treatment disparities, with stigma and discrimination highlighted as key contributors in qualitative work with Black and Latinx youth. Nationally representative survey evidence also indicates persistent gaps in treatment for adolescents with co-occurring major depressive episodes (MDE) and substance use disorder (SUD), with unmet treatment needs significantly higher among Hispanic adolescents and among uninsured adolescents.

Methods

This literature review synthesizes evidence from recent peer-reviewed studies and national surveys that directly measure help-seeking, treatment receipt, stigma, and structural barriers relevant to Latino/Hispanic youth populations, including school-based climate surveys, qualitative youth interviews about stigma and barriers to care, qualitative interviews with Latino mental health stakeholders about access and cultural tailoring, nationally representative NSDUH analyses of depression/SUD treatment, NHIS analyses of healthcare access barriers among Hispanic children and adolescents, and a systematic review of culturally adapted RCTs for adolescent substance use treatment.

Results

Across study designs, barriers clustered into (1) cultural and interpersonal processes, including self-stigma that dampened the translation of internalizing symptoms into formal or peer help-seeking among Latinx youth at higher stigma levels and community narratives linking mental illness to poor work ethic or religiosity-related roles; (2) family-related barriers and facilitators, including parental/immigrant stigma in youths’ care-seeking pathways and the need to engage Latino caregivers as partners from stakeholders’ perspectives; (3) immigration-related worry and problems, which functioned as a barrier to seeking trusted adult support among Latinx youth in immigrant families; and (4) systemic constraints, including workforce shortages (e.g., most U.S. counties lacking a child psychiatrist) and the need for improved service coordination for SUD care.

Conclusions

The reviewed evidence suggests that effective strategies to reduce unmet need for Latino youth should combine stigma reduction that is culturally representative, caregiver partnership and cultural humility approaches in clinical systems, policy and infrastructure investments to address workforce shortfalls, and culturally adapted SUD interventions that outperform comparison conditions in RCTs.