FEATURE — Fall 2008

(Photo by Joe Angeles)

Improving Lives of Latinos Is Front and Center

Through clinical practice and ground-breaking research, Professor Luis H. Zayas works to enhance the lives of Latino children, adolescents, and adults. This dedication has led to his recent formation of the Center for Latino Family Research at the School of Social Work.

By Judy H. Watts

Luis H. Zayas has five post-secondary degrees, plus highly regarded certification in psychoanalysis and psychotherapy—yet his eighth-grade teacher had to argue with a guidance counselor to secure his place in a college-preparatory curriculum. (His family lived on a military base at the time.) A few years later, despite a successful academic record in high school, another advisor tried to dissuade him from applying to college. “It was against those odds—discrimination, racism, or perhaps people’s lack of energy to help young people succeed—that I applied to Manhattan College and won a full scholarship. And when I told my counselor I’d been accepted, she wouldn’t believe me until I brought her my admissions letter and financial-aid information.”

Today, Zayas stands at the top of his profession: He is the Shanti K. Khinduka Distinguished Professor of Social Work in the nationally top-ranked George Warren Brown School of Social Work and professor of psychiatry at the similarly rated School of Medicine. To date, Zayas has published or has in press 77 scholarly articles and chapters for peer-reviewed journals on a broad range of topics related to his core research agendas. Five others are under review. Three major, multiple-year grants are in progress at the innovative Center for Latino Family Research, which he founded and directs.

Zayas’ research focuses on children, adolescents, and parents—and the cultural influences that support or torment families. He is determined to improve Latino families’ lives, driven in large part by his proclivity for helping others—“a spirit I got from my parents,” he says.

“Children and adolescents have a tremendous vitality that too often is squashed through circumstances in their lives,” he continues. “Those years are so foundational that helping them is very important to me.”

The need for culture-inclusive research

The U.S. Census Bureau calls Hispanics the fastest-growing group in the United States. Within that population, 15 percent of teenaged girls [henceforth, Latinas] say they have tried to kill themselves—a rate 1.5 times what white or black females between ages 12 and 17 report and nearly twice the rate of Hispanic adolescent males.

Zayas has been conducting the complex, primarily qualitative work required to understand Latina teens’ suicide attempts since the late ’70s, when he was a medical social worker in New York City. He encountered the phenomenon in hospitals and clinics—only to discover that very little research about the problem existed. During this period, Zayas also attended a seminar psychoanalysts presented at a well-known New York medical school. The discussion centered on child-rearing in Hispanic and primarily Puerto Rican families.

Professor Zayas, through his clinical and advocacy work, is getting to know Hispanic families in St. Louis. He also is continuing research in New York, Puerto Rico, and the Dominican Republic, where he is working with Albert and Deedee Pujols and their foundation on medical missions. Zayas is hoping soon to have University students in social work, public health, education, engineering, and medicine do internships in the country, possibly as part of the Pujols Family Foundation. (Photo by Joe Angeles)

“Basically, the presenters were saying that the mothers’ behavior toward their children was part of a pathological sequence.” Zayas recalls his response: “No, you are incorrect! The pathways under discussion are healthy—but differently defined within a separate culture.” He realized then the urgent need for intercultural explanations of child-rearing and family interaction that could result in healthy as well as maladaptive functioning, such as suicide attempts. “So I took my ideas and have been running with them for the past 25 years.” In addition to studying Latina teens who attempted suicide, Zayas is keenly interested in cultural psychology and human development.

In line with his interest in mental health and how people are diagnosed and treated, he and his team “plan to follow up on our findings that psychiatric clinicians seldom agree on the diagnoses assigned to Hispanic adults. We need to know about the impact of ethnicity and cultural differences and the interpersonal ‘dance’ that clinician and patient do when they meet,” he says. Zayas describes his own psychotherapeutic orientation as “interpersonal,” a working relationship in which he and his patient “are partners in a journey of self-discovery.”

Insight into agony

To understand what might prompt a Hispanic child of 13 or 14 to take pills or cut herself in an attempt to end her life, Zayas is working with a five-year grant from the National Institute of Mental Health (NIMH). During this time, he will study approximately 100 Hispanic girls who have never attempted suicide and about 80 young women who have, in order to determine the sociocultural processes involved. The data and knowledge he is amassing were partially obtained through his clinical work.

Unearthing and scientifically culling meaning from the diverse source material is painstaking. “The differences between those who did and did not attempt suicide, and the nature of the experiences that push some to try, are all embedded in the inscrutable black box of family and culture,” Zayas says. “But now we’re teasing them apart.”

One early finding suggests that troubled Latina teens suffer from conflicting pressures of their parents’ values and the pervasive cultural practices of American adolescents. Many Latinas born in the United States are completely unfamiliar with the culture their parents want to preserve; others are immigrants themselves and subject to added social and psychological stresses. Circumstances such as absent fathers, a series of men in the home, abuse, or drugs sometimes cloud the picture even further.

Zayas says the Hispanic community in St. Louis is growing, although it’s still under the radar and therefore hard to penetrate as a researcher. Yet there is a great need for services.

When Zayas’ work on teen suicide attempts appeared in the national media, he received e-mails and letters from well-adjusted Latina women, many of them happily married mothers, who had once tried suicide. “A number said they made it through college but felt they were swimming upstream,” Zayas says. “What determines different life courses? We need to investigate all this.” Zayas is at work on a book from this research.

Focusing on cultural context

Zayas teaches monthly Outpatient Management Rounds at the School of Medicine and famously rigorous courses at the Brown School on human behavior and development and on applied social practice. His pedagogy is predicated on his convictions about the importance of understanding individuals within their own ecological niche. During rounds with third-year psychiatric residents, for example, he emphasizes that medicating people is not enough. “Young psychiatrists have got to know the family, the social supports, the family history, in order to take a leadership role in patient care.”

A research center of a critical kind

Complementing Zayas’ acutely important research and teaching contributions is the Center for Latino Family Research—the first such center whose ideas involve applied social research to discover what interventions can be done to enhance Latino communities. The center supports research on topics that influence both services and community development, develops young scholars, and produces programs to effectively address some of the most pressing issues Latinos face in the United States and in Latin America.

“Luis is inspirational,” says Margarita Alegria, a professor of psychology at Harvard Medical School, who collaborates with Zayas under a grant to develop interventions for Latino families and youth. “He takes on very serious, complicated, and challenging big-picture tasks, such as asking a group of Latino researchers to conceptualize the role of culture in adapting interventions for children.”

School of Social Work Dean Eddie Lawlor commends Zayas for providing international, national, and local leadership in Latino family studies: “What’s unique about Luis’ work is that he’s informing local policy and practice from international cultural observations.” Zayas obtained a prestigious NIMH grant for what proved to be a resoundingly successful three-meeting international conference—at which emerging scholars worked alongside senior investigators. The researchers examined cultural adaptations of social services and social practices to Latino populations, tackling the critical problem of how clinicians could best approach individuals from different ethnic minorities to engage them in treatments, retain them, and obtain the best therapeutic outcomes. They also collaborated on ways to make the strategies much more accessible to researchers and clinicians toiling in urban communities.

“We talk a lot at Washington University about the interplay of our international work and our local work, and nobody does it better than Luis Zayas,” Lawlor adds. “It’s a privilege to have him here.”

Whereupon the inevitable question arises. How does Zayas, a distinguished scientific researcher long-established in New York City, assess being based in St. Louis with a smaller population of Hispanics?

“Being part of a truly great university, where I benefit from colleagues who are the leading scholars in their fields and enjoy incredible institutional support, has made this transition much smoother than one might imagine,” he says. “Coming to St. Louis has reminded me that when it comes to community-based research, reputations burnished elsewhere don’t transfer easily; I have to re-earn my credibility and that’s what I’m trying to do.”

Zayas says the Hispanic community in St. Louis is growing, although it’s still under the radar and therefore hard to penetrate as a researcher. Yet there is a great need for services. “Through my clinical and advocacy work locally—and the rising visibility of the Center for Latino Family Research—Hispanic folks here are getting to know and trust me,” he says. “Meanwhile, I continue my research in New York, Puerto Rico, the Dominican Republic, and other places—straddling the local, national, and international, and learning from all.”

Judy H. Watts is a freelance writer based in St. Louis and a former editor of this magazine.

(Photo by Joe Angeles)

Family Matters

Born in small-town Coamo, Puerto Rico, and raised during the racial and ethnic upheaval of the ’60s, Zayas was a military child whose family lived on U.S. Army bases around the world and was part of a tiny minority—at best—of Hispanic families at the posts. The Zayas household provided a psychological buffer, an island of warmth and support, for its six children. “My parents kept our family very tight-knit, which was impressive,” Zayas says.

In addition, his father, a compassionate man who Zayas says “was always there for other people—and who was my inspiration” often brought home “homesick 19- and 20-year-old soldiers who were away from the island for the first time. Our mother would cook them a Puerto Rican meal—roast pork, yellow rice with pigeon peas, fried green plantains, octopus salad, and coconut candy. For those sweet moments, those young men were back home.”

Today, Zayas has a thriving family of his own. “My wonderful wife, Stephanie, is a special-education teacher who has a master’s degree from Columbia University. We have three great children: Marissa, 26; Amanda, 24 [the sisters, a nonprofit fundraiser and a fashion designer, respectively, live in the family’s home in New York, where their parents return in the summertime]; and Luis-Michael, who is a junior here at Washington U. and a budding ethnomusicologist.”