Abstract
This article contributes to the literature on mental health in Puerto Rico based on a focus group study with bilingual mental health service providers. The study explored perceptions of mental health and mental health services and the factors that influenced utilization of mental health services. According to participants, having a mental health condition in Puerto Rico is associated with "being crazy," a concept that carries the attitude that something wrong is going on inside the person. Stigma was identified as a powerful force influencing the perceptions of mental illness, the support of the family and community to people with mental health conditions as well as the use of mental health services. Findings suggested that the structural changes in mental health services delivery from a public to a mostly privatized system has limited quality, access and utilization of mental health services. A trend highlighted by participants was that some people seek mental health services because of socioeconomic factors. They create a factitious disorder based on economic insecurity. Mental health remains a public health concern. Suggestions included advocacy to change stigmatized perceptions, a reform that included mental health as a human right and an educational campaign that addresses prevention, early detection and treatment.
