Barriers and Facilitators of Treatment for Depression in a Latino Community: A Focus Group Study

Abstract

We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.

Mental illness stigma and engagement in an implementation trial for Cognitive Processing Therapy at a diverse community health center: a qualitative investigation

“…Clients unilaterally discussed the role of family as central to help-seeking. This observed familial orientation is consistent with previous research on traditional Latino values, where a collective or family orientation is pre-ferred over the individualistic orientation, mainstream American values (Goldston et al, 2008; Organista, 2006; Uebelacker et al, 2012). Our data are consistent with previous studies that promote the importance of exploring the role of family in the treatment process when treating clients who endorse a familial orientation (Rossello, Bernal, & Rivera-Medina, 2012; Uebelacker et al, 2012).…”

Sociodemographic Barriers to Early Detection of Autism: Screening and Evaluation Using the M-CHAT, M-CHAT-R, and Follow-Up

“…For families with economic challenges, difficulties making bill payments or having short-term phone plans that are intermittently out of service may be a possible barrier. For example, Uebelacker and colleagues (2012) investigated barriers to providing care for depression to Latinos in a community setting by conducting focus groups. Participants commented in particular about difficulties with telephone contact, including how phones were often disconnected or changed when they were having financial difficulties.…”

Mejorando Matrimonios

“…Moreover, the literature suggests that establishing confianza helps participants and clients feel more at ease and comfortable with discussing sensitive issues such as marital stress or depression (Uebelacker et al, 2012). In sum, consideration of cultural values is imperative to successfully engage Hispanic couples in services.…”