For Latinx families in this country, the Covid-19 pandemic came soon after what our expert calls “the forgotten pandemic,” one characterized by a rise in hate speech and anti-immigrant sentiment. Both pandemics, and the inability to heal from one before the other, have been devastating to the Latinx community. But now, as the country enters a period of healing, there are many reasons to feel hope.
In this Q&A, Edith Bracho-Sanchez, M.D., Assistant Professor of Pediatrics at Columbia University, interviews Maria Veronica Svetaz M.D, M.P.H., Assistant Professor of Family Medicine and Community Health at the University of Minnesota School of Medicine and Medical Director of the Aquí Para Tí/Here for You program. Dr. Svetaz cares for most of the families that consider themselves Latinx in Minneapolis and St. Paul, the “Twin Cities” of Minnesota. Minnesota has a large second and third generation of Latinx immigrants in St Paul, and mainly newly arrived First Generation Families in Minneapolis. Her work focuses on creating family-centered spaces where both teens and their parents can experience the importance of re-activating their voices. In addition, she has long worked to achieve health equity for generations of Latinx families and communities at large.
In this conversation, Dr. Bracho-Sanchez and Dr. Svetaz discuss what working with generations of Latinx families has taught her about the strength and power of the family unit, the importance of these strengths as we enter a period of healing and transition, and how and why parents should encourage Latinx teens to exert their control over their lives.
Edith Bracho-Sanchez: You are founder of the “Aquí Para Ti” or “Here for You” program. Tell us about this program and what it has represented in the community where you work?
Maria Veronica Svetaz: The program was born thanks to a grant from the Minnesota Department of Health to eliminate health disparities. “Aquí Para Ti” was born with the force of positive youth development and the force of health equity. And both of those things speak to helping create a strengths-based, community driven and community owned model that initially aimed to map out the barriers faced by the Latinx community, and then to use the strengths and values of this community to address them. We knew we had to include parents and families in our model of care because adolescence is a growth phase that affects the whole family, and because familism — the loyalty and expectations of emotional and social support one gives to family — is one of the most important values to Latinx communities.
EBS: What have you learned from bringing in the families and the parents in this community, what happened when you and your team did this?
MSV: It transformed everything. Latinx teens have a family-oriented lens. Sometimes they will tell you for example, I want to see what my mom has to say about this, and that to me is fascinating. For a long time as we tried to create a confidential space for teens in our offices, we pushed the parents away, and it was time to bring them back. When you do that and when you explain that you created this space to support them as parents too, it truly transformed the interactions.
EBS: What have these parents taught you about the community and about raising teens?
MVS: If I had the chance to give a small recognition to someone in the form of art, I would choose to create a sculpture of a mother, with her arms up, fighting for her children. Because I am their witness and I see what they go through. I see what they have to do to support their family. It’s unbelievable, the love they give while simultaneously carrying their own baggage and dealing with their own loss — the loss that leaving your country of origin sometimes puts on your shoulders, the stress of economic scarcity. So, if I were to summarize what I have learned from those parents, it’s a sense of humbleness and admiration.
EBS: How has your relationship with this community changed through time, now that your program has been operating there for 20 years?
MVS: When you’re in a community for 20 years, you have the honor to see what they were able to conquer and how the resilience in our youth is so strong. Now we are caring for the second generation, the children of my first generation of teens. It’s fascinating to support them now as parents of their own teens. In regard to parents in general, we learned how lack of access to healthcare denied parents the possibility to heal from past traumatic events that sometimes may be similar to what their teens are going through. There, they look you in the eye and say, “the same thing happened to me, and I never shared it with anyone.” And we are there, to provide that opportunity to heal from that event as a family. I’ve also learned that in our healthcare system we are quick to label a family as “dysfunctional,” but in reality, no one addressed their underlying needs. So, we have to do both — help parents get out of the protective shells they created around them as a first aid for their own traumatic event, to allow them to talk about their feelings and vulnerabilities and also meet their teens’ needs.
EBS: Thinking about the specific moment through which we are living, can you tell us about what you’re seeing when it comes to the mental health of Latinx teens?
MVS: I think we have to think back to the few years before the current COVID-19 pandemic, back to what I call the ‘forgotten pandemic.’ Most of us in the Latinx community were tired, there was an increase in hate crimes, hate speech and anti-immigrant sentiment that was condoned and even encouraged. We in Aqui Para Ti were dealing with increases in fear, anxiety and depression when the COVID-19 pandemic hit. It didn’t take a genius to realize that any situation in which kids were forced to be isolated was going to be worse for their mental health. So we decided not to stop the care, and continued working to stay in contact with families in the community.
EBS: How did you stay connected with the community through the COVID-19 pandemic?
MVS: First over the phone and later through telemedicine, and even when we never stopped seeing patients, we saw our waitlist grow due to the mental health needs that our Latinx teens were enduring. We had to start to triage, especially the mental health conditions; we had to ask ourselves who needs to be seen immediately because they’re in crisis, who needs to be started on medications, etc.
EBS: What do you think going from one pandemic of hate to a COVID-19 pandemic, without any time to recover in between, will mean for Latinx teens and parents long term?
MVS: Now is the time to truly believe in and support the resiliency of our children and our teens. We as parents need to allow them to have and to own their narrative. We want them to see that we’re still working to conquer something seemingly unconquerable (the pandemic, and the social needs that it created). In thinking about their mental health, we can ask them to think about what helped them, what was the most important thing that they were missing, and see how this could give them a new lens: a lens where we value the present and what we have, not so much what it is missing; where we value the connections and the communal support. I’ve seen it in my own child- she now has this need, this thirst for relationships, and this generation is so aware of our social and political issues. As we enter this new phase of recovery, I am really hopeful that they will use these lessons moving forward.
EBS: What do you think parents can do to foster resilience in their kids in this recovery period?
MVS: The first thing is to make sure we are paying attention to ourselves as human beings, pay attention to our own health first. Nothing helps a child with anxiety more than the parent dealing with their own anxiety. As we reflect about our own needs, we may find some gratitude for the things we took for granted before, and this can re-center you and put you in the right frame of mind. I also think it’s more important than ever to create those spaces for reflection with our teens, and if you are drained and you can’t be that adult for your child, then make sure there is someone else in their lives who can fill that role. This time for reflection by the way is familiar to many in the Latinx community because we used to have that in Latin America. We’d go to the café and we’d talk with friends and reflect, reflect, reflect for hours. We’d get dinner and it would take hours because we’d sit and talk. So, I keep telling people- get rid of the agenda. Or if you have one and you don’t get through it because you were reflecting, who cares? Create those spaces to talk and model vulnerability by saying things like, “I feel the same way,” because that shows children they’re not alone. It normalizes the fact that we are all limping out of this.
EBS: I also want to ask you about how parents can foster a sense of control in their teens in this period. We know that culturally this can be hard for some Latinx parents and in the past year families have largely been inside without many places to go or things to do.
MVS: This has been hard for Latinx teens, exerting their own sense of control, or agency, can sometimes come as a clash of cultures. There’s of course a beauty and a value in familismo, the concept of defining yourself through your family and respecting your elders in Latinx culture; but sometimes if we take that to the extreme it may mean that if an adult is talking, youth don’t talk, or they cannot share what they think because youth need to hear what the elders are going to infuse, the wisdom that they’re giving to you. That can be problematic because in schools across this country for example, teens are rewarded for speaking up, participating and having opinions. So, what we do in Aquí Para Ti is help parents to remember that most of them came to this country to give their kids a better future and in order to do that, they have to do well in school. It’s all about explaining the codes of each culture. This culture values activism and speaking up, and not allowing kids to speak up can actually harm them. When you frame it that way, parents can understand the importance of this. It doesn’t mean they’re leaving their culture behind. It means you honor and respect your own culture and identity while at the same time making them aware that their young people are navigating and trying to be successful in two cultures.
EBS: What do you think communities can learn from Latinx teens and their families?
MVS: Some of the most important psychological strengths of the Latinx community are the connections, what I call the “togetherness” and the gratitude. When you come from Latin America you know that nothing is guaranteed. You may wake up one day and the bank took away all your money or the inflation rates mean that you can’t afford the things you used to with your same salary. You learn to be grateful, to get creative and to rely on your community and your creativity as the only way to move forward. I think this country needs an infusion of togetherness. And then, like we do in Latinx culture, we can celebrate being together with food and with music and without an agenda.