For one Latina resident of East L.A., trudging through the day with a plastic smile became an exhausting routine that was unbearably difficult. The recent loss of her son to a violent beating by gang members shattered her façade of complacency. She lost interest in day-to-day activities, withdrew from social interaction and curled into a cocoon of sadness and guilt.

Realizing that she needed help, this Spanish-speaking Angelena crossed the cultural divide and sought professional counsel from a local physician. The doctor soon diagnosed her with clinical depression and she was referred to a La Puente clinician named Alfred Sanchez who treated her for three months. Sanchez noted marked improvement in her emotional and psychological well being and her depressive symptoms began to wane.

"It was the first time she had gone to see a doctor," Sanchez said. "But I saw this case as an anecdote of someone whose condition improved with treatment and whose future now looks hopeful."

In spite of the many treatment options now available, Latinos continue to treat mental illness as a non-issue. Others seek resources but are unable to receive proper care due to poorly funded mental health programs.

The underutilization of mental health resources by Hispanics and the taboos surrounding mental illness remain the "elephants in the room," according to mental health expert Bob Martinez. Mental illness remains "one of the most important issues out there" that no one is talking about, he says.

Latinos use mental health services at markedly lower rates than other group, according to two recent studies led by Sergio A. Aguilar-Gaxiola and William A. Vega. Given that Hispanics are the fastest-growing ethnic group in the country, this generates concern among mental health experts nationwide.

"Disparities in mental health care for Latinos will result in an increasing burden to the United States," said Lopez. "A failure to address the mental health needs of Latinos results in considerable social and economic loss."

Where does this problem stem from? Ironically, the answer lies in some of the richest facets of Latino culture, including its beautiful language, deep family ties and close-knit communities.

According to Lopez, members of the Latino community often misunderstand the gravity of mental health and label the mentally ill as "crazy or loca." Applying these labels marginalizes and discourages people from seeking treatment.

Other Latinos are encouraged by family members to practice spiritual rituals or to try traditional treatment methods in lieu of seeking costly medical care.

Ana Lazu, founder of Latinos Unidos Siempre, encountered cultural barriers to obtaining the mental health services she needed while suffering from depression. Lazu was made to feel as though her "depression was a result of witchcraft," according to a statement released by Join Together Online.

"As a Latina, I didn't believe in mental illness," Lazu said. "I faced a double stigma—the stigma of mental illness and the shame that I felt from my culture."

Linguistic barriers pose an even more fundamental problem for Latinos, according to Martinez, a consultant for the California Institute for Mental Health.

"Language is a huge issue because many Latino immigrants are monolingual," Martinez said. "When a Latino goes to a hospital, for instance, and asks the front desk for treatment, [health workers] often can't understand [this patient] because they don't speak Spanish."

Cultural and linguistic outreach to Latinos remains sorely insufficient—a trend that several local and statewide programs intend to reverse.

Academics such as Aguilar-Gaxiola and Lopez are spearheading a movement to improve outreach efforts and the quality of services that Latinos receive. Separate studies conducted by these two researchers highlight a recurring theme: a culturally and linguistically sensitive, multi-pronged strategy is needed to address the burgeoning needs of the Hispanic population.

"Mental health facilities need to do a better job in training and hiring folks who speak the language," said Lopez. "Society as a whole needs to do more to address mental health legislation that reduces stigma."

Lopez lauds the efforts made by a slew of organizations to heighten linguistic and cultural sensitivity as well as outreach to members of the Latino community. The National Alliance on Mental Illness offers Hispanics a family-to-family self-help group program to support family members caring for their ill relatives. The Los Angeles Department of Mental Health's Training and Cultural Competency Bureau actively reaches out to communities, while the Latino Behavior Health Institute hosts an annual conference to educate mental health practitioners about the latest advances in care for Latinos.

Another organization leading the fight to diversify service outreach is the California Institute for Mental Health, which formed the "Center of Multicultural Development" six years ago, according to executive director Sandra Goodwin. The center is led by a panel of mental health experts and conducts exploratory studies to research the efficacy of mental health policy affecting multicultural populations.

"One of the major issues we tackle is, of course, language," Goodwin said. "We developed a series of brochures and interactive CDs that describe 12 different mental health issues in seven languages, including Spanish. These information pieces address the issues not just in the language, but also in the cultural context."

Despite all of these efforts, Lopez agrees that more needs to be done on a national scale to reduce cultural stigma and to facilitate mental health use–not just by Latinos but also by everyone who needs care.

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