The unmet needs of depressed adolescent patients: how race, gender, and age relate to evidence-based depression care in rural areas

Abstract

Background: Studies have established that many depressed adolescent patients do not receive optimal mental health care. Specifically, depression in primary-care settings is underrecognized, undertreated, and stigmatized. Although the seriousness and prevalence of adolescent depression is well known to primary-care physicians, its assessment, diagnosis, and treatment remains a significant problem in general and in rural communities in particular. Aims and discussion: In this article, the author accomplishes three aims: (1) summarizes the most current evidence-based guidelines for depression care for adolescents in primary-care settings, (2) reviews the empirical literature on how key patient demographic variables (race, gender, and age) may be correlated with and predictive of variations in evidence-based depression care (assessment, diagnosis, and treatment) for adolescent patients, particularly in rural areas, and (3) provides implications for translating empirical research findings to evidence-based depression care in rural primary-care settings.

Effective Psychotherapy With Low-income Clients: The Importance of Attending to Social Class

“…As many scholars have argued, the intersections of race, ethnicity, class, gender, and other social identities have both separate and interconnected impacts on a person’s development, everyday life, and relations to people and institutions (Amott & Matthaei, 1996; Constantine, 2001; Hooper, 2010). Furthermore, these identities are continuously in flux and can be transformed subtly or dramatically by changes in social systems.…”

“…Furthermore, disparities in terms of access to mental health care are also divided across intersecting social locations. For example, underprivileged populations who reside in rural settings face greater barriers for obtaining adequate and timely care (Hooper, 2010; Petterson, et al, 2009). Hence, researchers and practitioners must also remain aware of how various social variables interact to perpetuate a system of oppression and inequality.…”

Relations Among Suicidality, Recent/Frequent Alcohol Use, and Gender in a Black American Adolescent Sample: A Longitudinal Investigation

“…Finally, we did not assess for psychiatric disorders. Given the substantial literature that supports the link between select mental health disorders and suicide behavior (Shaffer et al.,), future studies should also include assessment of both present and lifetime history of mental health and comorbid medical conditions (Hooper, ). It is well known that the presence of a mental health disorder often increases the odds of suicide attempts and completions (CDC, 2007; Shaffer et al., ).…”

“…Toward this end, several scholars have noted that the clarification of demographic factors uniquely relevant to adolescent suicide also merits attention (Hutch‐Bocks, Kerr, Ivey, Kramer, & King, 2007; Joe, ,b; Joe & Marcus, ; Nock, ; Wadsworth, Kurbin, & Herting, ). Although demographic factors are not modifiable, population‐specific information can help direct the formation of developmentally and culturally responsive preventions and interventions (Cash & Bridge, ; Hooper, ; Wadsworth et al., ). In addition to the possible importance of demographic factors, most adolescents who engage in suicide behaviors are more likely to have persistent mental health concerns (e.g., substance use; Garlow, Purselle, & Heninger, ; Jones, ) as well.…”

Exploring the Relations Between Parent Depressive Symptoms, Family Religious Involvement, and Adolescent Depressive Symptoms: A Test of Moderation

“…The current study examined the relations between religion, parent depressive symptoms, and adolescent depressive symptoms. Specifically, and as shown in Figure 1, we tested three hypotheses: (1) There will be a linear relation between parent depressive symptoms and adolescent depressive symptoms (Hooper, 2010;Rice, 2009; Hypothesis 1), (2) family religious involvement will be inversely associated with adolescent depressive symptoms (higher scores on the Family Environment-Religious Involvement Scale will be associated with lower scores on the Beck Depression Inventory; Cotton et al, 2005;Horowitz & Garber, 2003; Hypothesis 2), and (3) family religious involvement will moderate the association between parent depressive symptoms and adolescent depressive symptoms (Cotton et al, 2005;Fabricatore, Handal, Rubio, & Gilner, 2004;Holmbeck, 1997;Wink, Dillon, & Larsen, 2005; Hypothesis 3). We also explored the association between family conflict and the study variables (Campbell & Moyers, 1988;Davis & Epkins, 2009;Hooper & DePuy, 2010;Hudson et al, 2005;Mabe & Josephson, 2004).…”