Adapting a Fotonovela Intervention to Promote Latino Adolescent-Parent Mental Health Communication: Findings from Focus Groups with Adolescents and Adults

Background & Purpose: Latino adolescents are at greater risk for poor mental health outcomes such as anxiety and depression, which, when left untreated, can increase risk for suicidal behaviors, substance use, academic struggles, social isolation, and other negative long-term mental and physical health consequences. Despite these challenges, they often have low rates of mental health service utilization, largely due to low mental health literacy, limited access to community resources and culturally appropriate services, lack of health insurance, language barriers, deportation concerns, and mental health stigma. In addition, research with Latino parents and adolescents suggest that youth hesitate to discuss their mental health needs with their parents for fear of burdening them. This lack of communication, coupled with cultural stigma that generally regards mental health challenges as shameful and a sign of weakness, profoundly impacts Latino adolescents. Given this large unmet need, it is critical to develop and implement culturally relevant interventions that target mental health stigma and literacy of Latino adolescents and their families.

Methods: Our community-based participatory research was conceptualized in response to ongoing involvement with a community advisory board and previous interviews with Latino parents and adolescents where support for adolescents’ mental health through intervention development was identified as a community need. In an effort to create such an intervention, the current study conducted two focus groups (N = 20) with Latino immigrant parents (N = 10) and their adolescents, ages 14-17 (N = 10), living in Texas and Michigan. Participants were from South and Central American countries (e.g., Mexico, Dominican Republic, Venezuela). The focus group explored participants’ mental health literacy, perceived stigma, and their conversations about mental health. Additionally, participants provided feedback to adapt an existing fotonovela intervention for Latino adults with depression to use with adolescents.

Results: Structured thematic analysis revealed the adolescents’ and parents' views on the fotonovela included valuing the depiction of the main character overcoming hopelessness upon receiving mental health treatment. Noted limitations included a lack of representation of immigration-related stressors as well as the complexities and barriers of seeking care. Participants suggested that an ideal intervention should provide culturally responsive psychoeducational content, promote dialogue between adolescents and parents, and model positive family communication about mental health. It should also encourage adolescents to share their mental health struggles, highlight barriers like stigma and judgment, and realistically depict the Latino experience with structural and cultural challenges, including gendered experiences and increased stigma for boys' and men’s mental health.

Conclusions and Implications: These findings emphasize the importance of developing a culturally relevant intervention designed to promote mental health literacy, reduce stigma, and promote dialogue between parents and adolescents about mental health. Our findings demonstrate a critical gap in service offerings and a need for an intervention that provides resources for parents on supporting their child, while offering tangible tools to foster connection and communication on mental health within family systems. By targeting these needs, future interventions may be able to effectively reduce the service use gap among Latino adolescents and families and increase care-seeking behavior.