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Mitrzyk BM, Marshall VD, Farris KB. Ethnic Determinants of Health and Medication Use for Depression Among US Latinx Adults. J Racial Ethn Health Disparities 2024; 11:834-845. [PMID: 37184813 PMCID: PMC10184621 DOI: 10.1007/s40615-023-01565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/28/2023] [Accepted: 03/08/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Medication use for depression among US Latinx adults is low (34%) and commonly associated with systems-related and individual-related cultural factors. Social determinants of health (SDH) include economic, environmental, educational, community, and healthcare systems factors. Ethnic determinants of health (EDH) are SDH factors specific to an ethnic group and described by an ethnic and disparities framework. OBJECTIVE To assess relationships between EDH factors and depression medication use among non-Latinx White (NLW) and Latinx adult populations using data from a weighted national sample for hypothesis building. METHODS Weighted responses to 2015-2018 National Survey on Drug Use and Health surveys from NLW, Latinx, and Latinx adult respondents from Puerto Rico, Mexico, and other Latinx countries were compared. Bivariate analyses were conducted using 2-way cross tabulation and a Wald chi-square test of association. EDH variables were characterized within the construct domains of systems-related geographic location, education, and economic stability, and individual-related cultural factors. RESULTS Prescription medication use for depressive symptoms is 16.6% (P < 0.05) lower among a national sample of Latinx compared with NLW adults with major depressive episode (MDE). Many differences among systems-level EDH variables between Latinx and NLW populations with MDE were also found between populations with depression medication use. Of note, seeing a primary care provider or psychologist or social worker was significantly different among populations with MDE but not for those with depression medication use. Individual-related cultural EDH variables of overall health and serious psychological distress were significantly worse for Latinx than NLW populations with depression medication use. However, stigma, healing beliefs, and religious beliefs were not different between populations with MDE or depression medication use. Differences between certain Latinx populations with depression medication use were found with limited English proficiency and living in poverty. EDH variables for environment-physical characteristics or community and interpersonal levels of analysis were not represented within the NSDUH survey. CONCLUSION Seeing a primary care provider or behavioral health specialist, depression severity, and overall health status appear to be important factors related to depression medication use among Latinx adults. Given the limitations of these analyses, multivariate analyses of EDH factors and other Latinx populations are warranted.
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Affiliation(s)
- Beatriz Manzor Mitrzyk
- University of Michigan College of Pharmacy, 1100 North University Building, Ann Arbor, MI, 48109, USA.
| | - Vincent D Marshall
- University of Michigan College of Pharmacy, 1100 North University Building, Ann Arbor, MI, 48109, USA
| | - Karen B Farris
- University of Michigan College of Pharmacy, 1100 North University Building, Ann Arbor, MI, 48109, USA
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Grieb SM, Platt R, Vazquez MG, Alvarez K, Polk S. Mental Health Stigma Among Spanish-Speaking Latinos in Baltimore, Maryland. J Immigr Minor Health 2023; 25:999-1007. [PMID: 37213041 PMCID: PMC10201042 DOI: 10.1007/s10903-023-01488-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 05/23/2023]
Abstract
To assess mental health-related stigma in an emerging Latino immigrant community and explore demographic characteristics associated with stigma. We surveyed 367 Spanish-speaking Latino adults recruited at community-based venues in Baltimore, Maryland. The survey included sociodemographic questions, the Depression Knowledge Measure, Personal Stigma Scale, and the Stigma Concerns about Mental Health Care (SCMHC) assessment. Multiple regression models examining associations between personal stigma and stigma concerns about mental health care, respectively, were constructed using variables that were statistically significant in bivariate analyses. Being male, having less than high school education, reporting high importance of religion, and having lower depression knowledge contributed to higher personal stigma. When controlling for other variables, only depression knowledge contributed unique variance to the prediction of higher SCMHC. Efforts to improve access to and quality of mental health care must be paralleled by ongoing efforts to reduce depression stigma within emergent immigrant Latino communities.
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Affiliation(s)
- Suzanne M Grieb
- Department of Pediatrics Center for Child and Community Health Research, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building - Center Tower Suite 4200, Baltimore, MD, 21205, USA.
| | - Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Monica Guerrero Vazquez
- Department of Pediatrics Center for Child and Community Health Research, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building - Center Tower Suite 4200, Baltimore, MD, 21205, USA
- Center for Salud/Health and Opportunities for Latinos, Johns Hopkins University, Baltimore, MD, USA
| | - Kiara Alvarez
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Sarah Polk
- Department of Pediatrics Center for Child and Community Health Research, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building - Center Tower Suite 4200, Baltimore, MD, 21205, USA
- Center for Salud/Health and Opportunities for Latinos, Johns Hopkins University, Baltimore, MD, USA
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Mallonee J, Escalante R, Robles EH, Tucker C. "Something very taboo": a qualitative exploration of beliefs, barriers, and recommendations for improving mental health care and access for Hispanic adults in the Paso del Norte U.S.-Mexico border region. Front Public Health 2023; 11:1134076. [PMID: 37325326 PMCID: PMC10267351 DOI: 10.3389/fpubh.2023.1134076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Background Hispanic adults with mental health conditions in the United States experience disproportionate access to and utilization of professional mental health treatment. This is believed to be in part due to systemic barriers and challenges, difficulty accessing care, cultural factors, and stigma. Studies to date have failed to examine these specific factors within the unique context of the Paso del Norte U.S.-Mexico border region. Methods For this study, 25 Hispanic adults identifying primarily of Mexican descent participated in four focus groups exploring these topics. Three groups were facilitated in Spanish and one group in both English and Spanish. Focus groups followed a semi-structured format eliciting perspectives on mental health and mental illness, help-seeking, barriers and facilitators of help-seeking and treatment access, and recommendations for mental health agencies and providers. Results Qualitative data analysis yielded the following themes: understanding of mental health and help-seeking; barriers to accessing care; mental health treatment facilitators; and recommendations for agencies, providers, and researchers. Conclusion Findings from this study support the need for innovative mental health engagement strategies to reduce stigma, increase understanding of mental health, foster support systems, reduce individual and systemic barriers to seeking and accessing care, and to continue to engage communities in mental health outreach and research.
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Affiliation(s)
- Jason Mallonee
- Department of Social Work, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, United States
| | - Rosa Escalante
- Department of Social Work, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, United States
| | - Eden Hernandez Robles
- Worden School of Social Service, Our Lady of the Lake University, San Antonio, TX, United States
| | - Christal Tucker
- The Kelly Center for Hunger Relief, El Paso, TX, United States
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Gearing RE, Washburn M, Brewer KB, Yu M, Bjugstad A, Torres LR. Predictors of Help-Seeking for Mental Health Treatment Among Latinos. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01370-y. [DOI: 10.1007/s40615-022-01370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
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Hernandez-Ramos R, Altszyler E, Figueroa CA, Avila-Garcia P, Aguilera A. Linguistic analysis of Latinx patients’ responses to a text messaging adjunct during cognitive behavioral therapy for depression. Behav Res Ther 2022; 150:104027. [DOI: 10.1016/j.brat.2021.104027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 11/29/2022]
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Lay beliefs about the causes and treatment of depression: Tests of measurement models and associations. J Affect Disord 2022; 299:93-101. [PMID: 34808135 DOI: 10.1016/j.jad.2021.11.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is reason to expect beliefs about depression's causes and treatment to influence use of psychotherapy, but the literature is marked by theoretical, methodological, and empirical inconsistencies. This study assessed the factorial validity of measures of beliefs about depression's causes and formal treatment versus self-management. It also tested the links of causal attributions to general treatment/self-management beliefs and endorsement of specific interventions. METHODS The revised Illness Perception Questionnaire (IPQ-R) adapted for depression was administered online to a non-patient, U.S. sample (N = 319). RESULTS Confirmatory factor analyses yielded three causal dimensions, Environmental Stressors, Biological Factors, and Personal Attributes, and two control dimensions, (Formal) Treatment and Personal. Both models fit irrespective of whether respondents believed they had ever experienced depression. A structural equation model (SEM) showed a positive relationship for Environmental and Biological attributions, and an inverse relationship for Personal attributions, in predicting general preferences for Formal Treatment. A second SEM, focusing on specific interventions, linked Environmental causation to endorsement of psychotherapy, dietary changes, and self-help, and Biological causation to endorsement of medication and exercise, with Personal causation inversely associated with endorsement of psychotherapy. LIMITATIONS A cross-sectional, correlational design precludes causal inferences. Potential sociocultural influences were not assessed. CONCLUSIONS Modifications to the IPQ-R suggested by this study improved its psychometric properties, validated its distinction between Treatment and Personal Control beliefs, and supported examination of both general and specific beliefs about ways to deal with depression. Relationships linking cause and treatment beliefs warrant further investigation as potential intervention targets to increase treatment utilization.
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Castilla-Puentes R, Dagar A, Villanueva D, Jimenez-Parrado L, Valleta LG, Falcone T. Digital conversations about depression among Hispanics and non-Hispanics in the US: a big-data, machine learning analysis identifies specific characteristics of depression narratives in Hispanics. Ann Gen Psychiatry 2021; 20:50. [PMID: 34844618 PMCID: PMC8630887 DOI: 10.1186/s12991-021-00372-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/15/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Digital conversations can offer unique information into the attitudes of Hispanics with depression outside of formal clinical settings and help generate useful information for medical treatment planning. Our study aimed to explore the big data from open-source digital conversations among Hispanics with regard to depression, specifically attitudes toward depression comparing Hispanics and non-Hispanics using machine learning technology. METHODS Advanced machine-learning empowered methodology was used to mine and structure open-source digital conversations of self-identifying Hispanics and non-Hispanics who endorsed suffering from depression and engaged in conversation about their tone, topics, and attitude towards depression. The search was limited to 12 months originating from US internet protocol (IP) addresses. In this cross-sectional study, only unique posts were included in the analysis and were primarily analyzed for their tone, topic, and attitude towards depression between the two groups using descriptive statistical tools. RESULTS A total of 441,000 unique conversations about depression, including 43,000 (9.8%) for Hispanics, were posted. Source analysis revealed that 48% of conversations originated from topical sites compared to 16% on social media. Several critical differences were noted between Hispanics and non-Hispanics. In a higher percentage of Hispanics, their conversations portray "negative tone" due to depression (66% vs 39% non-Hispanics), show a resigned/hopeless attitude (44% vs. 30%) and were about 'living with' depression (44% vs. 25%). There were important differences in the author's determined sentiments behind the conversations among Hispanics and non-Hispanics. CONCLUSION In this first of its kind big data analysis of nearly a half-million digital conversations about depression using machine learning, we found that Hispanics engage in an online conversation about negative, resigned, and hopeless attitude towards depression more often than non-Hispanic.
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Affiliation(s)
- Ruby Castilla-Puentes
- Center for Clinical and Translational Science and Training, University of Cincinnati Academic Health Center, Cincinnati, OH, USA. .,Neuroscience- Janssen Research & Development, LLC, Titusville, NJ, USA. .,Hispanic Organization of Leadership and Achievement, HOLA, Employee Resource Group of Johnson & Johnson, New Brunswick, NJ, USA.
| | - Anjali Dagar
- Department of Psychiatry/Epilepsy, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Dinorah Villanueva
- Neuroscience- Janssen Research & Development, LLC, Titusville, NJ, USA.,Hispanic Organization of Leadership and Achievement, HOLA, Employee Resource Group of Johnson & Johnson, New Brunswick, NJ, USA
| | - Laura Jimenez-Parrado
- Investigation Group - Sleep Disorders and Forensic Psychiatry, Universidad Nacional de Colombia, Bogota, Colombia
| | | | - Tatiana Falcone
- Department of Psychiatry/Epilepsy, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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Latinos' Conceptualization of Depression, Diabetes, and Mental Health-Related Stigma. J Racial Ethn Health Disparities 2021; 9:1912-1922. [PMID: 34508304 PMCID: PMC8432279 DOI: 10.1007/s40615-021-01129-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022]
Abstract
Depression and diabetes are two of the most common health conditions experienced by those from Latino backgrounds. However, community-based stigma toward these health conditions may discourage those experiencing symptoms of depression or diabetes from seeking professional assistance. To assess stigma in the Latino community toward these common health conditions, a community-based sample of 469 Latino participants in a major urban area in the [Southwestern United States — Houston, TX] completed a face-to-face survey using an experimental vignette methodology. Participants were asked to name the problem that the subject of the vignette was experiencing based on the symptoms described in the vignette. This survey also inquired about public stigma toward individuals experiencing symptoms of depression and/or diabetes. Results indicate that although the majority (60%) of the sample were able to correctly identify symptoms of depression, it was more difficult for them to identify symptoms of depression with co-occurring diabetes. Overall levels of public stigma toward those experiencing depression were moderate, and co-occurring symptoms of diabetes did not moderate stigma toward those experiencing depression. These findings indicate a need for intervention approaches within the Latino community to increase health literacy related to depression and type 2 diabetes, as well as an ongoing need to reduce stigma toward those experiencing symptoms of depression. Implications for future research, practice, and health promotion are discussed.
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den Hertog TN, Maassen E, de Jong JTVM, Reis R. Contextualized understanding of depression: A vignette study among the !Xun and Khwe of South Africa. Transcult Psychiatry 2021; 58:532-545. [PMID: 32281484 DOI: 10.1177/1363461520901888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Colonial misconceptions about the absence of depression and the lack of a psychologization of distress among Africans have long been refuted. However, cultural variation in depression in terms of symptomatic expression, conceptualization, explanatory models, and social responses is widely acknowledged. Insight into the cultural variation of depression is useful for providing appropriate care; however, few studies have explored cultural understandings of depression in African settings. In a depression vignette study of two displaced and marginalized San communities in South Africa, we conducted 20 semistructured interviews to explore causal interpretations and strategies for coping. Causal interpretations consisted of several dimensions, including life struggles and physical, psychological, and spiritual interpretations. Respondents primarily focused on life struggles in terms of socioeconomic and interpersonal problems. They described coping strategies as primarily addressing negative emotional and psychological affect through social support for relief, comfort, distraction, or advice on coping with the situation and emotions. In addition, religious coping and professional support from a social worker, psychologist, support group, or medications were mentioned. Findings illustrate that depression should be understood beyond individual suffering and be situated in its immediate social environment and larger sociopolitical setting. Interventions for depression therefore may benefit from a multilevel approach that addresses socioeconomic conditions, strengthens local resources, and fosters collaboration among locally appropriate informal and formal support structures.
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Affiliation(s)
- Thijs N den Hertog
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Eva Maassen
- Altrecht Institute for Mental Health Care, Utrecht, the Netherlands
| | - Joop T V M de Jong
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Ria Reis
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
- The Children's Institute, University of Cape Town, Cape Town, South Africa
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Psychometric Properties of Three Measures of Stigma Among Hispanics with Depression. J Immigr Minor Health 2021; 23:946-955. [PMID: 34152503 DOI: 10.1007/s10903-021-01234-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
While many measures of mental illness stigma have been developed, few have been validated in Hispanic populations. This study examined the psychometric properties of three stigma measures (Stigma Concerns about Mental Health Care [SCMHC], Social Distance Scale [SDS], and Latino Scale for Antidepressant Stigma [LSAS]) among a depressed, Hispanic sample. Data were collected during baseline assessments for two studies taking place in primary care settings (N = 500). Psychometric and factor validity were tested for each measure. Confirmatory factor analyses indicated adequate model fit, and adequate internal consistency reliability was found for all three measures. Stigma scores significantly differed by education level and gender. Findings from this analysis provide support for the use of the SCMHC, SDS, and LSAS in a depressed, Hispanic population. Assessing barriers to depression treatment, including stigma, are critical in engaging Hispanics in care and eliminating disparities for the population.
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Comparison of Patient Versus Trained Observer Assessments of Healthcare Providers' Use of Motivational Interviewing Techniques for Patients Experiencing Depression and Anxiety in the Dominican Republic. J Clin Psychol Med Settings 2021; 29:206-219. [PMID: 34143354 PMCID: PMC8211715 DOI: 10.1007/s10880-021-09781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
In settings with limited mental health system capacity, integrated care and the improvement of patient-provider communication surrounding common mental disorders is critical to advancing treatment outcomes. We trained primary care providers in the Dominican Republic in motivational interviewing (MI) to improve communication with patients experiencing depression and anxiety. Providers were randomized to an intervention group, which received MI training, or a control group. To evaluate the training’s effectiveness, patients assessed their clinical encounters using the Motivational Interviewing Measure of Staff Interaction (MIMSI). Trained research assistants (RAs) rated a sub-set of those interactions using an adapted MIMSI instrument. Overall, patients (n = 36) perceived their interactions with providers (n = 10) very positively; however, the RAs’ ratings strongly indicated that providers’ application of MI behaviors was insufficient. Patients generally could not distinguish between intervention and control providers. Findings underscore the need to carefully consider optimal training delivery and cultural influences surrounding the implementation of MI mental health interventions in settings where directive communication is highly valued.
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Abstract
Over the last decade, Baltimore has become a non-traditional sanctuary city, receiving an unprecedented influx of Latino immigrants, mostly from Central America’s Northern Triangle, who are often fleeing violence in their home countries. This study explored the nature and frequency of healthcare utilization for mental health problems among uninsured/uninsurable Latinos who received outpatient care between 2012 and 2015 through an academic hospital-affiliated program that covers primary and specialty services to uninsured patients without regard to documentation status. Encounters for mental health disorders were the most common category, accounting for 14.88% of all visits. Mood (78%) and anxiety disorders (16%) were the most prevalent mental health diagnoses. The most frequent reason to seek care was symptom, signs, and ill-defined conditions (37.47%), and within this subgroup, pain was the leading cause of seeking care (88%), which may indicate high rates of somatization of mental health distress. This study presents a unique opportunity to explore the burden and nature of mental health needs among a population for which healthcare information is rarely attainable and highlights the need for culturally competent screening mechanisms and interventions to address the stressors faced by emergent communities.
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Caplan S. Intersection of Cultural and Religious Beliefs About Mental Health: Latinos in the Faith-Based Setting. HISPANIC HEALTH CARE INTERNATIONAL 2020; 17:4-10. [PMID: 30799650 DOI: 10.1177/1540415319828265] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Hispanics/Latinos utilize mental health care at a rate that is about half that of non-Hispanic Whites. Stigma and cultural and religious values play a significant role in mental health care utilization disparities. The purpose of this study was to explore beliefs about mental illness among Latino faith-based communities. METHODS A qualitative approach was used to explore perceptions of mental illness that were elicited during "El Buen Consejo," a mental health literacy intervention delivered within three faith-based settings. RESULTS Participants were socialized to believe that persons with mental illness were dangerous, out of control, and suffering from an incurable illness that resulted in rejection and ostracism. Most families would deny the existence of depression and mental illness, unless symptoms greatly interfered with daily functioning or were life-threatening. Religious coping such as prayer, and faith in God, were believed to be protective factors. Causal attributions for depression were both biomedical and religious, such as lack of faith, not praying, demons, and sinful behaviors of parents. CONCLUSION Latinos rely upon churches as a major social, educational, and spiritual resource. The cultural values among Latinos can be a source of strength but also contribute to stigma. The faith-based community is an important target for mental health literacy and antistigma interventions.
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Affiliation(s)
- Susan Caplan
- 1 Rutgers University, The State University of New Jersey, Newark, NJ, USA
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Brandl EJ, Dietrich N, Mell N, Winkler JG, Gutwinski S, Bretz HJ, Schouler-Ocak M. Attitudes towards psychopharmacology and psychotherapy in psychiatric patients with and without migration background. BMC Psychiatry 2020; 20:176. [PMID: 32303265 PMCID: PMC7164188 DOI: 10.1186/s12888-020-02585-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/05/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Sociodemographic factors, attitude towards treatment and acculturation may be important factors influencing the decision of immigrants to seek and maintain psychiatric treatment. A better understanding of these factors may significantly improve treatment adherence and outcome in these patients. Therefore, we investigated factors associated the attitude towards psychotherapy and medication in a sample of psychiatric outpatients with and without migration background. METHODS N = 381 patients in a psychiatric outpatient unit offering specialized treatment for migrants were included in this study. Attitude towards psychotherapy was assessed using the Questionnaire on Attitudes Toward Psychotherapeutic Treatment, attitude towards medication with the Drug Attitude Inventory-10. Acculturation, symptom load and sociodemographic variables were assessed in a general questionnaire. Statistical analyses included analyses of covariance and hierarchical regression. RESULTS Patients of Turkish and Eastern European origin reported a significantly more positive attitude towards medication than patients without migration background. When controlling for sociodemographic and clinical variables, we did not observe any significant differences in attitude towards psychotherapy. Acculturation neither influenced the attitude towards psychotherapy nor towards medication. CONCLUSION Our study indicates that sociodemographic and clinical factors may be more relevant for patients´ attitudes towards treatment than acculturation. Considering these factors in psychiatric treatment of patients with migration background may improve treatment outcome and adherence.
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Affiliation(s)
- Eva J. Brandl
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Nora Dietrich
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Nicoleta Mell
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Johanna G. Winkler
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Stefan Gutwinski
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - H. Joachim Bretz
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Meryam Schouler-Ocak
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
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Borrayo EA, Scott KL, Drennen A, Bendriss TM, Kilbourn KM, Valverde P. Treatment challenges and support needs of underserved Hispanic patients diagnosed with lung cancer and head-and-neck cancer. J Psychosoc Oncol 2020; 38:449-462. [PMID: 31920170 DOI: 10.1080/07347332.2019.1705453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose: We explored the treatment challenges and support needs that Hispanic underserved lung cancer and head-and-neck cancer patients face while undergoing cancer treatment.Design: Qualitative design - ethnography.Sample: Using a sample of 29 participants, we conducted semi-structured interviews with nine lung cancer and head-and-neck cancer survivors and seven health care providers and focus group interviews with six caregivers and seven patient navigators.Method: Relevant themes were extracted with Ethnographic content analysis.Findings: Participants reported treatment challenges and support needs in four areas: medical, financial, socio-cultural, and mental health. Health care providers and navigators primarily identified medical and financial challenges that impact treatment adherence, while patients and caregivers expressed the need for support for mental health problems (i.e., depression, anxiety).Implications for psychosocial providers: Understanding the experiences of underserved Hispanic cancer survivors can aid in creating psychosocial interventions that successfully target treatment-related challenges and provide them with the support they need.
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Affiliation(s)
- Evelinn A Borrayo
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katie L Scott
- Department of Neurology, Spectrum Health Medical Group, Grand Rapids, MI, USA
| | - Ava Drennen
- Health Psychology Associates, P.C., Greeley, CO, USA
| | - Tiare M Bendriss
- Psychiatry, Fremont Medical Center, Kaiser Permanente, Fremont, CA, USA
| | - Kristin M Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Patricia Valverde
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Eghaneyan BH, Murphy ER. Mental Health Help-Seeking Experiences of Hispanic Women in the United States: Results from a Qualitative Interpretive Meta-Synthesis. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:505-518. [PMID: 31211663 DOI: 10.1080/19371918.2019.1629559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to conduct a qualitative interpretive meta-synthesis to examine the experiences and perceptions of mental health help-seeking behaviors by Hispanic women in the United States. Synthesis of five studies resulted in one major theme of determinants of mental health help-seeking organized into three subthemes: (1) societal determinants, (2) health services system, and (3) individual determinants. These results provide a more holistic understanding of the mental health help-seeking experiences of Hispanic women, an important consideration when developing interventions to address the disparities in access to and quality of mental health treatment experienced by this unique population.
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Menendez J, Franco M, Davari J, Gnilka PB, Ashby JS. Barriers and Facilitators to Latinx College Students Seeking Counseling. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2019. [DOI: 10.1080/87568225.2019.1600093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Collado A, Zvolensky M, Lejuez C, MacPherson L. Mental health stigma in depressed Latinos over the course of therapy: Results from a randomized controlled trial. J Clin Psychol 2019; 75:1179-1187. [PMID: 30951609 DOI: 10.1002/jclp.22777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/27/2018] [Accepted: 03/15/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current study examined the course, correlates, and predictors of mental health stigma among depressed, Spanish-speaking Latinos that were receiving treatment. This population faces significant disparities in mental health treatment and carries high levels of mental health stigma. METHOD The study utilized data generated from a randomized clinical trial (N = 46) that evaluated the efficacy of Behavioral Activation and Supportive Counseling for depression among Latinos. RESULTS Mental health stigma decreased over time; these decreases were more pronounced among individuals who were randomized to Supportive Counseling. Mental health stigma was positively associated with depressive symptoms and therapeutic alliance over time. Mental health stigma was not related to treatment attrition. CONCLUSIONS These preliminary findings indicate that mental health stigma continues to be relevant among individuals who are actively participating in treatment. Receiving mental health treatment may be sufficient to dispel some of the stigmatizing views endorsed by underserved clinical populations.
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Affiliation(s)
- Anahi Collado
- Department of Psychology, Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas
| | | | - Carl Lejuez
- Department of Psychology, University of Kansas, Lawrence, Kansas
| | - Laura MacPherson
- School of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
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Curtin AJ, Martins DC, Genere AA, Perez DM, Cabrera E, Viveiros N, Schwartz-Barcott D. Perceptions of Mental Health Among Hispanic Older Adults: Findings Among Immigrants from the Dominican Republic, Colombia, and Guatemala. J Gerontol Nurs 2018; 44:44-50. [PMID: 30358887 DOI: 10.3928/00989134-20181010-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/23/2018] [Indexed: 01/20/2023]
Abstract
Disparities exist in the recognition and treatment of mental health issues among Hispanic community-dwelling older adults. Previous researchers have focused on accessing mental health services, with limited attention to older Hispanic immigrants' perceptions of mental health issues. A qualitative descriptive research design was used to understand older Hispanic immigrants' perceptions of mental health issues, especially those related to stress, anxiety, and depression. Seventeen older adults from the Dominican Republic, Colombia, and Guatemala were interviewed. Despite having experienced significant personal tragedies, participants did not initially describe emotional distress or any mental health issues. When specifically questioned, depression was the most recognized illness. Depression was commonly described as sadness, whereas stress and anxiety had multiple definitions among participants. Understanding older Hispanic immigrants' perceptions of mental health issues and establishing a therapeutic relationship between the health care provider and patient may be helpful in recognizing and treating individuals who may be at high risk for emotional distress, anxiety, and depression. [Journal of Gerontological Nursing, 44(11), 44-50.].
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Curtin A, Martins DC, Schwartz-Barcott D. Coping with mental health issues among older Hispanic adults. Geriatr Nurs 2018; 40:123-128. [PMID: 30107949 DOI: 10.1016/j.gerinurse.2018.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
Access to mental health services for older Hispanic adults is limited and often older Hispanic adults must rely on their own resources in dealing with mental health issues. The aim of this study was to understand how older Hispanic immigrants cope mental health issues (e.g. stress, anxiety, and/or depression). A qualitative, descriptive approach was used to interview 17 older Hispanic immigrants from Guatemala, Dominican Republic and Colombia. Interviews were audio recorded, transcribed and translated verbatim by bilingual research assistants. Data were analyzed using content analysis with a combination of immersion/crystallization, editing and template organizing styles. Ways of coping included spiritual beliefs and religious practices, social support, distraction, medications and professional help. Primary care providers may be more effective if they build upon the cultural constructs that undergird older Hispanic immigrants' ways of coping in addressing emotional distress and mental health issues in this population.
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Affiliation(s)
- Alicia Curtin
- University of Rhode Island, College of Nursing, White Hall, 39 Butterfield Road, Kingston, RI 02881, USA.
| | - Diane C Martins
- University of Rhode Island, College of Nursing, RI NEC, Room 229, 350 Eddy Street, Providence, RI 02905, USA
| | - Donna Schwartz-Barcott
- University of Rhode Island, College of Nursing, White Hall, Room 249, 39 Butterfield Road, Kingston, RI 02881, USA
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Li Y, Cai X, Harrington C, Hasselberg M, Conwell Y, Cen X, Temkin-Greener H. Racial and Ethnic Differences in the Prevalence of Depressive Symptoms Among U.S. Nursing Home Residents. J Aging Soc Policy 2018; 31:30-48. [PMID: 29883281 DOI: 10.1080/08959420.2018.1485394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms (score ≥ 10 on the 9-item Patient Health Questionnaire [PHQ-9] scale) and whether associations were explained by resident and nursing home covariates. Stratified analyses further determined independent associations in subgroups of residents. We found that the prevalence rate of PHQ-9 scores ≥ 10 was 8.8% among non-Hispanic White residents (n = 653,031) and 7.4%, 6.9%, and 6.6% among Black (n = 97,629), Hispanic (n = 39,752), and Asian (n = 16,636) residents, respectively. The reduced likelihoods of significant depressive symptoms for minority residents compared to non-Hispanic Whites persisted after sequential adjustments for resident and nursing home covariates, as well as in stratified analyses. The persistently lower rate of significant depressive symptoms among racial and ethnic minority residents suggests that training of nursing home caregivers for culturally sensitive depression screening is needed for improved symptom recognition among minority residents.
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Affiliation(s)
- Yue Li
- Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA
| | - Charlene Harrington
- Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Michael Hasselberg
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Xi Cen
- Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Helena Temkin-Greener
- Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New York, USA
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Ezeobele IE, Ekwemalor CC, Ogunbor A. Depression and Perspectives of Nigerian Immigrant Men in the United States: An Applied Ethnographic Study. J Transcult Nurs 2018; 30:39-46. [PMID: 29962290 DOI: 10.1177/1043659618781707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Depression is among the most serious health problems experienced by immigrants. Research has not sufficiently explored the perspectives of immigrant men from male-dominant cultures on depression. The purpose of this study was to describe the perspectives of Nigerian immigrant men in the United States on depression and to determine whether their perceptions differ from those of their female counterparts of a previous study. METHOD Focused applied ethnography was used to explore the perspectives of a purposeful sample of 18 Nigerian immigrant men in Houston, Texas, and analyze the data using a thematic approach. RESULTS The overarching theme was, "Depression does not exist in the Nigerian culture." The participants denied the existence of depression. Gender differences were not noted in their perception of depression. DISCUSSION The participants perceived depression differently from the U.S. dominant culture and may not receive adequate screening or treatment for depression, supporting the extant call for recognition of cultural differences in health care.
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Affiliation(s)
- Ifeoma E Ezeobele
- 1 The University of Texas Health Science Center at Houston, TX, USA.,2 Texas Woman's University, Houston, TX, USA
| | | | - Anderson Ogunbor
- 1 The University of Texas Health Science Center at Houston, TX, USA
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Rogers AH, Short NA, Robles Z, Bakhshaie J, Viana A, Schmidt NB, Garza M, Ochoa-Perez M, Lemaire C, Bogiaizian D, Medvedeva A, Zvolensky MJ. Identifying the role of sociodemographic factors in major depressive disorder and suicidality among Spanish-speaking Latino patients in a federally qualified health center. Cogn Behav Ther 2018; 47:397-411. [PMID: 29508645 DOI: 10.1080/16506073.2018.1445123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Rates of suicide and major depressive disorder (MDD) are currently at the highest point in the history of the United States (US). However, these rates are not distributed evenly among the population and Latinos show disproportionately high rates of both suicide and MDD. Yet, past research has infrequently explored factors related to suicide and MDD in primary care settings that serve as the major community portal for mental health among the Latino population. Thus, the current study investigated sociodemographic variables (marital status, nativity, education, employment, primary language, age, and gender) in terms of their relations with suicidal ideation, suicide risk, MDD, and MDD symptom severity among Latino primary care patients in a Federally Qualified Health Center (N = 634, M age = 39.46, SD = 11.46, 87.1% female). Results indicated that gender and Nativity were associated with suicidal ideation, older age was associated with suicide risk, and higher education and having a partner were negatively associated with MDD and depressive symptom severity. These results provide novel insight into the role of sociodemographic factors predicting suicide and MDD among Latinos in primary care, and suggest greater scientific and clinical attention can be focused on certain sociodemographic factors to offset mental health disparities among this group.
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Affiliation(s)
- Andrew H Rogers
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Nicole A Short
- b Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Zuzuky Robles
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Jafar Bakhshaie
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Andres Viana
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Norman B Schmidt
- b Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Monica Garza
- c Legacy Community Health Services , Houston , TX , USA
| | | | - Chad Lemaire
- c Legacy Community Health Services , Houston , TX , USA
| | - Daniel Bogiaizian
- d Psychotherapeutic Area of "Asociación Ayuda" , Anxiety Disorders Clinic , Buenos Aires , Argentina
| | - Angela Medvedeva
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Michael J Zvolensky
- a Department of Psychology , University of Houston , Houston , TX , USA.,e Department of Behavioral Science , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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Grupp F, Moro MR, Nater UM, Skandrani SM, Mewes R. "It's That Route That Makes Us Sick": Exploring Lay Beliefs About Causes of Post-traumatic Stress Disorder Among Sub-saharan African Asylum Seekers in Germany. Front Psychiatry 2018; 9:628. [PMID: 30534091 PMCID: PMC6275318 DOI: 10.3389/fpsyt.2018.00628] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/06/2018] [Indexed: 11/26/2022] Open
Abstract
Many asylum seekers have been confronted with traumatizing events, leading to high prevalence rates of post-traumatic stress disorder (PTSD). Within the diagnostic context, clinicians should take into account patients' culturally shaped presentation of symptoms. Therefore, we sought to provide insights into beliefs about causes of PTSD held by Sub-Saharan African asylum seekers living in Germany. To this aim, we used a quantitative and qualitative methodological triangulation strategy based on a vignette describing symptoms of PTSD. In the first part of the study, asylum seekers (n = 119), predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a German comparison sample without a migration background (n = 120) completed the Revised Illness Perception Questionnaire (IPQ-R). In the second part, asylum seekers reviewed the results within eight focus group discussions (n = 26), sampled from groups of the three main countries of origin. Descriptive analyses of the first part demonstrated that asylum seekers predominantly attributed PTSD symptoms to psychological and religious causes, and rather disagreed with supernatural causes. In comparison to the German sample without a migration background, asylum seekers attributed symptoms less strongly to terrible experiences, but more strongly to religious and supernatural causes. Within the focus group discussions, six attribution categories of participants' causal beliefs were identified: (a) traumatic life experiences, (b) psychological causes, (c) social causes, (d) post-migration stressors, (e) religious causes, and (f) supernatural causes. Our findings suggest that the current Western understanding of PTSD is as relevant to migrants as to non-migrants in terms of psychological causation, but might differ regarding the religious and supernatural realm. While awareness of culture-specific belief systems of asylum seekers from Sub-Saharan Africa regarding PTSD is important, our findings do underline, at the same time, that cultural differences should not be overstated.
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Affiliation(s)
- Freyja Grupp
- Division of Clinical Biopsychology, Department of Psychology, University of Marburg, Hesse, Germany
| | - Marie Rose Moro
- University of Paris Descartes, Hospital Cochin Paris, Paris, France
| | - Urs M Nater
- Division of Clinical Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sara M Skandrani
- University of Paris Nanterre, Hospital Cochin Paris, Paris, France
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
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Green BL, Watson MR, Kaltman SI, Serrano A, Talisman N, Kirkpatrick L, Campoli M. Knowledge and Preferences Regarding Antidepressant Medication Among Depressed Latino Patients in Primary Care. J Nerv Ment Dis 2017; 205:952-959. [PMID: 29076955 PMCID: PMC5718964 DOI: 10.1097/nmd.0000000000000754] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
US Latinos are less likely to utilize mental health services than non-Latino whites and to take antidepressant medications. This mixed-method study followed a subset (N = 28) of a research sample of depressed Latino immigrant primary care patients, who took depression medication, with a telephone interview to study their knowledge about and experiences with antidepressant medications. Most (82%) reported taking medication for 2 months or more, and 75% reported feeling better, whereas more than half reported side effects. Most (61%) agreed that antidepressants are generally safe and helpful in treating depression (68%); however, many believed they could be addictive (39%). Fifty percent of patients who discontinued their medication did not inform their providers. Twelve of the 28 patients also participated in focus groups about interactions with providers and made suggestions for conveying information about antidepressants. Patients suggested videos as a format to disseminate medication information because they do not require written comprehension. Other patient recommendations are presented.
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Affiliation(s)
- Bonnie L. Green
- Department of Psychiatry, Georgetown University Medical School, 2115 Wisconsin Avenue NW, Washington DC, 20007
| | - Maria Rosa Watson
- Primary Care Coalition of Montgomery County, 8757 Georgia Avenue, Silver Spring MD 20910 (currently independent consultant)
| | - Stacey I. Kaltman
- Department of Psychiatry, Georgetown University Medical School, 2115 Wisconsin Avenue NW, Washington DC, 20007
| | - Adriana Serrano
- Department of Psychiatry, Georgetown University Medical School, 2115 Wisconsin Avenue NW, Washington DC, 20007
| | - Nicolas Talisman
- Department of Psychiatry, Georgetown University Medical School, 2115 Wisconsin Avenue NW, Washington DC, 20007
| | - Laura Kirkpatrick
- Georgetown University Medical School, 4000 Reservoir Road NW, Washington DC, 20057
| | - Marcela Campoli
- Department of Psychiatry, Georgetown University Medical School, 2115 Wisconsin Avenue NW, Washington DC, 20007
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Rodrigues M. Do Hispanic Girls Develop Eating Disorders? A Critical Review of the Literature. HISPANIC HEALTH CARE INTERNATIONAL 2017; 15:189-196. [PMID: 29185363 DOI: 10.1177/1540415317744500] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Eating disorders have become increasingly prevalent in North America. Anorexia nervosa, bulimia nervosa, and binge eating disorder were previously thought to solely affect Caucasian women. However, contemporary research has studied the occurrence of this phenomenon in ethnic minority women, such as Latinas. METHODS This article presents a critical review of 12 quantitative, prospective psychological research studies from the past 17 years. RESULTS The authors in the reviewed literature identified bodily dissatisfaction, environmental influences, and acculturation as significant risk factors in the development of eating disorders in Hispanic girls and women. CONCLUSION The methodology and empirical findings from these studies are discussed, and suggestions for future research and culturally sensitive clinical treatment are considered.
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Antoniades J, Mazza D, Brijnath B. Becoming a patient-illness representations of depression of Anglo-Australian and Sri Lankan patients through the lens of Leventhal's illness representational model. Int J Soc Psychiatry 2017; 63:569-579. [PMID: 28786331 DOI: 10.1177/0020764017723669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Depression is prevalent globally. While the uptake of mental health services is poor in the general community, the lack of service engagement is particularly profound in migrant and refugee communities. To understand why there is under-utilisation cross-cultural comparisons of how people make sense of mental illnesses such as depression are essential. AIMS To verify how differing cultural aetiologies about depression influence mental health service use, this study investigated illness representational models of depression held by Sri Lankan migrants and Anglo-Australians living with depression. METHODS In-depth interviews ( n = 48) were conducted with Sri Lankan migrants and Anglo-Australians living with depression to explore their illness beliefs. Data were analysed using Leventhal's illness representational model. RESULTS Significant overlaps in illness representational models were noted but distinctive differences were found between causal and chronicity beliefs; Sri Lankan migrants more frequently endorsed depression as a time-limited condition underpinned by situational factors, whereas Anglo-Australians endorsed a chronic, biopsychosocial model of depression. DISCUSSION AND CONCLUSION Findings highlight the importance of forging a shared understanding of patient beliefs in the clinical encounter to ensure that interventions are coherent with illness beliefs or at least work towards improving mental health literacy. Differences in illness beliefs also provide insights into possible interventions. For example, psychosocial interventions that align with their illness beliefs may be more suited to Sri Lankan migrants than pharmaceutical or psychological ones.
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Affiliation(s)
- Josefine Antoniades
- 1 Department of General Practice, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia
| | - Danielle Mazza
- 1 Department of General Practice, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia
| | - Bianca Brijnath
- 2 School of Occupational Therapy and Social Work, Curtin University, Bentley, WA, Australia
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Pineros-Leano M, Liechty JM, Piedra LM. Latino immigrants, depressive symptoms, and cognitive behavioral therapy: A systematic review. J Affect Disord 2017; 208:567-576. [PMID: 27810273 DOI: 10.1016/j.jad.2016.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/14/2016] [Accepted: 10/22/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND In order to address the needs of the growing Latino immigrant population, this study aimed to systematically review peer-reviewed articles of intervention studies that used cognitive behavioral therapy to treat depressive symptoms among Latino immigrants in the U.S. METHODS We searched PsycINFO, PubMed, and Medline databases from January 1995 through July 2016 as part of a registered review protocol (PROSPERO) following PRISMA guidelines. Inclusion criteria were intervention studies that used cognitive behavioral techniques to treat depressive symptoms among a predominantly U.S. Latino immigrant sample -- or subsample with disaggregated results, and the use of standardized measures of depression. We used the National Heart, Lung, and Blood Institute quality assessment tools for systematic reviews to assess risk of bias. RESULTS We identified 11 studies that met inclusion criteria. Nine of the included studies reported a reduction of depressive symptoms. Each study used a least one cultural adaptation to deliver the intervention. Using an existing content model, cultural adaptations were categorized as (a) cognitive-informational adaptations, (b) affective-motivational adaptations, and (c) environmental adaptations. LIMITATIONS Heterogeneity of articles in terms of sample size, cultural adaptations, methodological rigor, and setting limited comparability of effectiveness across studies. CONCLUSIONS Culturally adapted CBT to address depressive symptoms among Latino immigrants appears promising but further research is needed. The most commonly used cultural adaptations included language, inclusion of migration experience, and adjusting for literacy level. Study design elements and adaptations were often responsive to geographic characteristics and available resources.
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Affiliation(s)
| | - Janet M Liechty
- School of Social Work, University of Illinois at Urbana-Champaign, USA; College of Medicine, University of Illinois at Urbana-Champaign, USA
| | - Lissette M Piedra
- School of Social Work, University of Illinois at Urbana-Champaign, USA
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Merianos AL, Vidourek RA, King KA. Effective Prevention Strategies for Increasing Health Services Utilization Among Hispanic Youth. Community Ment Health J 2017; 53:79-91. [PMID: 27250843 DOI: 10.1007/s10597-016-0022-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
Abstract
The study purpose is to address the underutilization of mental health services among Hispanic youth. This article provides professionals with strategies to increase health services utilization by utilizing a framework of the levels of prevention model, with an emphasis on primary prevention. The following questions were explored: (1) What are primary prevention strategies that can assist school professionals? (2) What are secondary prevention strategies and tertiary prevention strategies school professionals can employ to increase the utilization of health services? Implementing primary, secondary, and tertiary prevention strategies may improve Hispanic youth's overall mental health, academic achievement, and quality of life.
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Affiliation(s)
- Ashley L Merianos
- Health Promotion and Education Program, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA.
| | - Rebecca A Vidourek
- Health Promotion and Education Program, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Keith A King
- Health Promotion and Education Program, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
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Park J, Newman D, Engstrom G, Hammar LM, Swall A. The moderating and covarying effects of social support and pain intensity on depressive symptomology among racially and ethnically diverse older adults. Pain Manag 2017; 7:19-32. [DOI: 10.2217/pmt-2016-0027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To examine the interplay of social support, pain intensity and ethnicity as moderators and covariates of relationship on depressive symptomatology. Methods: Racially and ethnically diverse elders responded to measures of depressive symptomatology and social support. Results: Hispanics reported significantly higher prevalence of moderate pain intensity and depressive symptomology, and lower prevalence of high social support compared with other ethnic groups. Although social support showed reduced depressive symptomatology among those with high pain intensity, it did not play a significant role in decreasing depressive symptomatology among those with low/moderate pain intensity. Conclusion: Social support in decreasing depressive symptomatology is more effective in older adults with high pain intensity than those with moderate or low levels of pain intensity.
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Affiliation(s)
- Juyoung Park
- Florida Atlantic University School of Social Work, 777 Glades Road, Boca Raton, FL 33431, USA
| | - David Newman
- Florida Atlantic University Christine E Lynn College of Nursing, 777 Glades Road, Boca Raton, FL 33431, USA
| | - Gabriella Engstrom
- Florida Atlantic University Charles E Schmidt College of Medicine, 777 Glades Rd, Boca Raton, FL 33431, USA
| | - Lena M Hammar
- Dalarna University, School of Education, Health & Social Studies, Högskolegatan 2, Sweden
| | - Anna Swall
- Dalarna University, School of Education, Health & Social Studies, Högskolegatan 2, Sweden
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31
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Hernandez MY, Mejia Y, Mayer D, Lopez SR. Using a Narrative Film to Increase Knowledge and Interpersonal Communication About Psychosis Among Latinos. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1236-1243. [PMID: 27858525 PMCID: PMC5508716 DOI: 10.1080/10810730.2016.1242670] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Narrative communication is effective in increasing public awareness while generating dialogue about varied health topics. The current study utilized narrative communication in the form of a 15-minute motivational film titled La CLAve to help Latinos recognize symptoms of psychosis and begin a discussion about serious mental illness. The study aimed to explore the participants' response to the film and whether the film led to further dialogue about psychosis. Four focus groups were conducted with 40 Spanish-speaking participants, mostly foreign-born Latinas, with a mean age of 49 years. Results indicate that participants engaged with the film as reflected in their ability to recall the storyline in detail. Reports of psychosis knowledge gains included recognition of key symptoms, such as hallucinations and disorganized speech. Participants attributed symptoms of psychosis, observed in a film character, to social stressors and other previously constructed views of mental illness. Many participants discussed the content of the film within their immediate social networks. Other findings include discussions of key barriers and facilitators to seeking mental health treatment among Latino families, such as denial and family support. Results suggest that narrative films offer a promising strategy to stimulate dialogue about serious mental illness among Latinos.
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Affiliation(s)
- Maria Y. Hernandez
- School of Social Work, California State University, Los Angeles, Los Angeles, California, USA
| | - Yesenia Mejia
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Doe Mayer
- School of Cinematic Arts, Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, California, USA
| | - Steven R. Lopez
- Department of Psychology, University of Southern California, Los Angeles, California, USA
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Alemi Q, James S, Montgomery S. Contextualizing Afghan refugee views of depression through narratives of trauma, resettlement stress, and coping. Transcult Psychiatry 2016; 53:630-53. [PMID: 27507761 DOI: 10.1177/1363461516660937] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative study explored how Afghan refugees conceptualize frames of mind that may reflect depression in general and as it relates to trauma they experienced. We performed in-depth interviews with 18 Afghans residing in the San Diego area. Views regarding the causes, symptoms, and perceived treatments of depression were gathered through free-listing techniques, and supplemented with narratives relating to pre- and post-resettlement stressors and coping mechanisms. Data were analyzed with standard qualitative content analysis methods. Items endorsed with relation to depression causality included pre-migration war traumas, notably separation from family, and post-migration stressors including status dissonance and cultural conflicts that ranged from linguistic challenges to intergenerational problems. Depressive symptoms were viewed as highly debilitating, and included changes in temperament, altered cognitions, avoidance and dissociative behaviors, and somatic complaints. Relief was sought through family reunification and community support, reliance on prayer, and the academic success of their children in the US. The findings underscore the need for practitioners to take into account situational stressors, cultural aspects of mourning and symptomatology, and existing coping mechanisms in developing interventions that are based on refugees' articulated needs.
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Abstract
The scarcity of accessible culturally competent service providers and a general sense of mistrust in Eurocentric-based mental health settings exacerbate the lack of help seeking and effective therapeutic engagement for Latinos. Thus, clinical interventions that account for diverse values and worldviews may be an important step in the helpful treatment of U.S. Latino populations. Behavioral activation (BA), an evidence-based intervention for the treatment of depression, was recently evaluated through a preliminary clinical trial study in a community clinic primarily serving Spanish-speaking Latinos, and the results were promising. A culturally adapted version of BA was developed for Latinos, which took into consideration the cultural value of familismo (a collectivist worldview and preference for maintaining close connections to family); however, BA has not been previously applied to Latino families. The current case study presents the clinical treatment of a Mexican American family living in the southwest of the United States experiencing numerous stressors resulting in depressive symptoms. Specifically, this family sought therapy having experienced many negative life events, including stressors associated with institutionalized racism, their financial situation, and acculturation process. This led to a disruption of the family hierarchy, anger, unhappiness, fear, and isolation among family members. Outcomes of the intervention include a decrease in depressive symptoms and improved family communication and relationships by their involvement in activities such as attending cultural events in their community, family outings, and the children’s participation in extracurricular activities.
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Primary care professional's perspectives on treatment decision making for depression with African Americans and Latinos in primary care practice. J Immigr Minor Health 2016; 16:1262-70. [PMID: 24104206 DOI: 10.1007/s10903-013-9903-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Increasing interest has been shown in shared decision making (SDM) to improve mental health care communication between underserved immigrant minorities and their providers. Nonetheless, very little is known about this process. The following is a qualitative study of fifteen primary care providers at two Federally Qualified Health Centers in New York and their experience during depression treatment decision making. Respondents described a process characterized in between shared and paternalistic models of treatment decision making. Barriers to SDM included discordant models of illness, stigma, varying role expectations and decision readiness. Respondents reported strategies used to overcome barriers including understanding illness perceptions and the role of the community in the treatment process, dispelling stigma using cultural terms, orienting patients to treatment and remaining available regarding the treatment decision. Findings from this study have implications for planning SDM interventions to guide primary care providers through treatment engagement for depression.
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Muñoz-Laboy M, Worthington N, Perry A, Guilamo-Ramos V, Cabassa L, Lee J, Severson N. Socio-environmental risks for untreated depression among formerly incarcerated Latino men. J Immigr Minor Health 2016; 16:1183-92. [PMID: 23508876 DOI: 10.1007/s10903-013-9814-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To identify the levels of untreated depression and the socio-environmental factors associated with it among formerly incarcerated Latino men (FILM). Cross-sectional survey with 259 FILM ages 18-49 who were released from prison/jail within the prior 5 years. Depression was measured by the brief symptom inventory (BSI). Backward elimination was used to determine the best regression models. 26.9 % of the study sample reported depression. Low familism, residing farther away from family members, low utilization of health and social services, high levels of loneliness and high lifetime and current frequency of alcohol use were also associated with depression. Depression is a major problem among FILM. Addressing untreated depression among FILM must be a public health priority.
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Affiliation(s)
- Miguel Muñoz-Laboy
- School of Social Work, Temple University, Ritter Annex 5th floor, 1301 W. Cecil B. Moore Avenue, Philadelphia, PA, 19122-6091, USA,
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Caplan S. A Pilot Study of a Novel Method of Measuring Stigma about Depression Developed for Latinos in the Faith-Based Setting. Community Ment Health J 2016; 52:701-9. [PMID: 27085546 DOI: 10.1007/s10597-016-0005-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 04/07/2016] [Indexed: 10/21/2022]
Abstract
In order to understand the effects of interventions designed to reduce stigma about mental illness, we need valid measures. However, the validity of commonly used measures is compromised by social desirability bias. The purpose of this pilot study was to test an anonymous method of measuring stigma in the community setting. The method of data collection, Preguntas con Cartas (Questions with Cards) used numbered playing cards to conduct anonymous group polling about stigmatizing beliefs during a mental health literacy intervention. An analysis of the difference between Preguntas con Cartas stigma votes and corresponding face-to-face individual survey results for the same seven stigma questions indicated that there was a statistically significant differences in the distributions between the two methods of data collection (χ(2) = 8.27, p = 0.016). This exploratory study has shown the potential effectiveness of Preguntas con Cartas as a novel method of measuring stigma in the community-based setting.
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Affiliation(s)
- Susan Caplan
- School of Nursing, Rutgers University, The State University of New Jersey, 228 Ackerson Hall, 180 University Avenue, Newark, NJ, 07102, USA.
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Martinez Tyson D, Arriola NB, Corvin J. Perceptions of Depression and Access to Mental Health Care Among Latino Immigrants: Looking Beyond One Size Fits All. QUALITATIVE HEALTH RESEARCH 2016; 26:1289-1302. [PMID: 26035855 DOI: 10.1177/1049732315588499] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Compared with non-Latino Whites, Latino immigrants have a lower prevalence of depression. However, they are also less likely to seek professional mental health services. Our objective was to compare and contrast perceptions of depression and access to mental health care among four of the largest Latino immigrant subgroups in Florida (Puerto Rican, Cuban, Mexican, and Colombian). We conducted a total of 120 interviews (30 men and women from each subgroup). Thematic analysis of qualitative data revealed that participants across the four groups were aware of the signs and symptoms of depression and had similar perceptions of depression. However, notable differences by subgroup emerged with regard to perceptions of access to mental health care. We suggest that the variation stems from differences in life experiences and the immigration context. Understanding the variances and nuances of Latino immigrants' cultural construction of depression and immigration experience will enable practitioners to better serve this community.
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Affiliation(s)
| | | | - Jaime Corvin
- University of South Florida, Tampa, Florida, USA
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Collado A, Calderón M, MacPherson L, Lejuez C. The efficacy of behavioral activation treatment among depressed Spanish-speaking Latinos. J Consult Clin Psychol 2016; 84:651-7. [PMID: 27054826 DOI: 10.1037/ccp0000103] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is highly prevalent among U.S. Spanish-speaking Latinos, but the lack of empirically supported treatments precludes this population's access to quality mental health care. METHOD Following the promising results of an open-label trial of the Behavioral Activation Treatment for Depression (BATD) among Spanish-speaking Latinos, the authors conducted a randomized control trial (RCT; N = 46) that compared BATD to supportive counseling. Study outcomes included depression, BATD proposed mechanisms of change, and nonspecific psychotherapy factors. RESULTS Relative to supportive counseling, BATD led to greater decreases in depressive symptoms over time (p = .04) and greater MDD remission at the end of treatment (p = .01). Activity level (p = .01) and environmental reward (p = .05) showed greater increases over time among those who received BATD compared to supportive counseling. Treatment adherence, therapeutic alliance, and treatment satisfaction did not differ between the groups over time (ps > 0.17). The 1-month follow-up suggested sustained clinical gains across therapies. CONCLUSIONS The current study adds to a growing treatment literature and provides support that BATD is efficacious in reducing depression and increasing activity level and environmental reward in the largest, yet historically underserved U.S. ethnic minority population. This trial sets the stage for a larger RCT that evaluates the transportability and generalizability of BATD in an effectiveness trial. (PsycINFO Database Record
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Affiliation(s)
| | - Marilyn Calderón
- Latin American Youth Center/Maryland Multicultural Youth Centers
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Ruiz E, Praetorius RT. Deciphering the Lived Experience of Latinos with Diabetes and Depression: A Qualitative Interpretive Meta-Synthesis. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:70-82. [PMID: 26799580 DOI: 10.1080/19371918.2015.1087912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to understand Latinos' experiences with diabetes and depression. The authors conducted a qualitative interpretive meta-synthesis of studies describing Latinos' experiences with diabetes and depression. Themes included (a) perceptions of diabetes, (b) bidirectional relationship between emotions and diabetes, (c) perceptions of depression, (d) perceptions of depression treatment, and (e) religion as strength. Additionally, a negative case was identified and is discussed. Practice implications are that Latinos are in need of psychoeducation to improve diabetes literacy, understand the comorbidity of depression and diabetes, and understand depression and diabetes treatment. Also, there is a need for policies removing barriers to health care and promoting depression assessment among Latinos who have a high prevalence of diabetes. Finally, there is a need for further research on spirituality and health.
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Affiliation(s)
- Erika Ruiz
- a The University of Texas at Arlington , Arlington , Texas , USA
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Savage B, Foli KJ, Edwards NE, Abrahamson K. Familism and Health Care Provision to Hispanic Older Adults. J Gerontol Nurs 2016; 42:21-9; quiz 30-1. [DOI: 10.3928/00989134-20151124-03] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 10/27/2015] [Indexed: 11/20/2022]
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Shao Z, Richie WD, Bailey RK. Racial and Ethnic Disparity in Major Depressive Disorder. J Racial Ethn Health Disparities 2015; 3:692-705. [DOI: 10.1007/s40615-015-0188-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/08/2015] [Accepted: 11/12/2015] [Indexed: 12/15/2022]
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Wei Y, McGrath PJ, Hayden J, Kutcher S. Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review. BMC Psychiatry 2015; 15:291. [PMID: 26576680 PMCID: PMC4650294 DOI: 10.1186/s12888-015-0681-9] [Citation(s) in RCA: 177] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 11/09/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental health literacy has received increasing attention as a useful strategy to promote early identification of mental disorders, reduce stigma and enhance help-seeking behaviors. However, despite the abundance of research on mental health literacy interventions, there is the absence of evaluations of current available mental health literacy measures and related psychometrics. We conducted a scoping review to bridge the gap. METHODS We searched PubMed, PsycINFO, Embase, CINAHL, Cochrane Library, and ERIC for relevant studies. We only focused on quantitative studies and English publications, however, we didn't limit study participants, locations, or publication dates. We excluded non-English studies, and did not check the grey literature (non peer-reviewed publications or documents of any type) and therefore may have missed some eligible measures. RESULTS We located 401 studies that include 69 knowledge measures (14 validated), 111 stigma measures (65 validated), and 35 help-seeking related measures (10 validated). Knowledge measures mainly investigated the ability of illness identification, and factual knowledge of mental disorders such as terminology, etiology, diagnosis, prognosis, and consequences. Stigma measures include those focused on stigma against mental illness or the mentally ill; self-stigma ; experienced stigma; and stigma against mental health treatment and help-seeking. Help-seeking measures included those of help-seeking attitudes, intentions to seek help, and actual help-seeking behaviors. CONCLUSIONS Our review provides a compendium of available mental health literacy measures to facilitate applying existing measures or developing new measures. It also provides a solid database for future research on systematically assessing the quality of the included measures.
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Affiliation(s)
- Yifeng Wei
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada.
| | - Patrick J McGrath
- IWK Health Centre, Nova Scotia Health Authority and Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada.
| | - Jill Hayden
- Centre for Clinical Research, Dalhousie University, Room 403, 5790 University Avenue, Halifax, Nova Scotia, B3H IV7, Canada.
| | - Stan Kutcher
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada.
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Depression, Help-Seeking and Self-Recognition of Depression among Dominican, Ecuadorian and Colombian Immigrant Primary Care Patients in the Northeastern United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10450-74. [PMID: 26343691 PMCID: PMC4586621 DOI: 10.3390/ijerph120910450] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/07/2015] [Accepted: 08/19/2015] [Indexed: 12/31/2022]
Abstract
Latinos, the largest minority group in the United States, experience mental health disparities, which include decreased access to care, lower quality of care and diminished treatment engagement. The purpose of this cross-sectional study of 177 Latino immigrants in primary care is to identify demographic factors, attitudes and beliefs, such as stigma, perceived stress, and ethnic identity that are associated with depression, help-seeking and self-recognition of depression. Results indicated that 45 participants (25%) had depression by Patient Health Questionnaire (PHQ-9) criteria. Factors most likely to be associated with depression were: poverty; difficulty in functioning; greater somatic symptoms, perceived stress and stigma; number of chronic illnesses; and poor or fair self-rated mental health. Fifty-four people endorsed help-seeking. Factors associated with help-seeking were: female gender, difficulty in functioning, greater somatic symptoms, severity of depression, having someone else tell you that you have an emotional problem, and poor or fair self-rated mental health. Factors most likely to be associated with self-recognition were the same, but also included greater perceived stress. This manuscript contributes to the literature by examining attitudinal factors that may be associated with depression, help-seeking and self-recognition among subethnic groups of Latinos that are underrepresented in research studies.
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Withers M, Moran R, Nicassio P, Weisman MH, Karpouzas GA. Perspectives of vulnerable U.S Hispanics with rheumatoid arthritis on depression: awareness, barriers to disclosure, and treatment options. Arthritis Care Res (Hoboken) 2015; 67:484-92. [PMID: 25187020 DOI: 10.1002/acr.22462] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 08/26/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Despite the high prevalence of depression among vulnerable Hispanics with rheumatoid arthritis (RA), many do not disclose it or seek treatment. This study explored patient perceptions of depression, its association with their primary disease, barriers to disclosure, reasons for low utilization of mental health care resources, and culturally acceptable intervention approaches. METHODS Semistructured interviews were conducted with 46 participants with RA. Depression was evaluated using Patient Health Questionnaire 9 (PHQ-9). RESULTS Thirty-three percent of participants were moderately depressed at the time of the interview, based on PHQ-9 score ≥10; 12 of 46 patients (26%) stated they were depressed regardless of PHQ-9 score. Depression was perceived as a long-term, severe problem leading to suicide. It was associated with weakness and character flaws, contributing to stigma and reduced likelihood of disclosure. Antidepressants were not acceptable; self-reliance and interventions incorporating interpersonal connections were preferred. Systems-related barriers to disclosure included lack of verbal screening, language barriers, limited clinic visit time, and lack of continuity of care, restricting trust with providers. CONCLUSION Rectifying misconceptions, as well as providing education regarding the association between RA and depression, the continuum of symptoms, and the range of experiences incurred are needed to facilitate earlier recognition and reduce stigma. Use, duration, and goals of antidepressant therapy should be clarified. Providers should strive to establish trust and conduct in-person depression screening to facilitate disclosure. Interventions with an interpersonal component, such as support groups or patient navigators, were preferred. Themes emphasizing coping strategies, stress reduction, positive thinking, self-efficacy, and resiliency are likely to be most acceptable.
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Affiliation(s)
- Mellissa Withers
- Harbor-University of California Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California
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Caplan S, Cordero C. Development of a Faith-Based Mental Health Literacy Program to Improve Treatment Engagement Among Caribbean Latinos in the Northeastern United States of America. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2015; 35:199-214. [DOI: 10.1177/0272684x15581347] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Depression is one of the leading causes of years lived with disability (YLDs) worldwide. Although depression can be successfully treated, 75% of Americans do not receive care. Treatment rates among Latinos immigrants are significantly lower than non-immigrant Latinos and non-Hispanic Whites. Known factors for mental health-care disparities such as poverty, insurance coverage, language barriers, and access to specialty mental health services in Latino neighborhoods do not fully explain the differences in treatment rates. Significant, but poorly understood factors influencing depression treatment among Latinos in the United States are lack of culturally congruent care, low mental health literacy, and stigma. Even though churches are a major source of health information, social and spiritual support for Latinos, the conceptualization of culturally congruent care rarely addresses religious beliefs. Therefore, one strategy to reduce disparities in depression treatment is to partner with churches to address faith-based stigma. Community-based participatory research is recognized as a methodology particularly well suited for creating successful culturally targeted interventions. The purpose of this article is to describe the process of creating a faith-based mental health literacy intervention in the Caribbean Latino community using the principles of community-based participatory research.
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Affiliation(s)
- Susan Caplan
- College of Nursing, Rutgers University, Newark, NJ, USA
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Rundberg-Rivera EV, Townsend LD, Schneider J, Farmer CA, Molina BB, Findling RL, Gadow KD, Bukstein OG, Arnold LE, Kolko DJ, Buchan-Page KA, McNamara NK, Michel C, Austin A, Kipp H, Rice RR, Aman MG. Participant satisfaction in a study of stimulant, parent training, and risperidone in children with severe physical aggression. J Child Adolesc Psychopharmacol 2015; 25:225-33. [PMID: 25885012 PMCID: PMC4403019 DOI: 10.1089/cap.2014.0097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the satisfaction of families who participated in the Treatment of Severe Childhood Aggression (TOSCA) study. METHODS TOSCA was a randomized clinical trial of psychostimulant plus parent training plus placebo (basic treatment) versus psychostimulant plus parent training plus risperidone (augmented treatment) for children with severe physical aggression, disruptive behavior disorder, and attention-deficit/hyperactivity disorder. Parents completed a standardized Parent Satisfaction Questionnaire (PSQ). RESULTS Of the 168 families randomized, 150 (89.3%) provided consumer satisfaction data. When they were asked if they would join the study again if they had the option to repeat, 136 (91%) said "yes," 11 (7%) said "maybe," and one (<1%) said "no." When asked if they would recommend the study to other parents with children having similar problems, 147 (98%) said "yes" and 3 (2%) said "maybe." Between 71% (rating one aspect of the Parent Training) and 96% (regarding the diagnostic interview) endorsed study procedures using the most positive response option. Asked if there were certain aspects of the study that they especially liked, 64 (43%) spontaneously reported parent training. Treatment assignment (basic vs. augmented) and responder status were not associated with reported satisfaction. However, responder status was strongly associated with parent confidence in managing present (p<0.001) and future (p<0.005) problem behaviors. CONCLUSIONS These findings indicate high levels of satisfaction with TOSCA study involvement and, taken together with previous pediatric psychopharmacology social validity studies, suggest high levels of support for the research experience. These findings may inform research bioethics and may have implications for deliberations of institutional review boards. TRIAL REGISTRY Treatment of Severe Childhood Aggression (The TOSCA Study), NCT00796302, clinicaltrials.gov .
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Affiliation(s)
| | - Lisa D. Townsend
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Psychiatry Kennedy Krieger Institute, Baltimore, Maryland
| | - Jayne Schneider
- Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, Nevada
| | | | - Brooke B.S.G. Molina
- Departments of Psychiatry and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert L. Findling
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kenneth D. Gadow
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
| | | | - L. Eugene Arnold
- The Nisonger Center (UCEDD), Ohio State University, Columbus, Ohio.,Department of Psychiatry, Ohio State University School of Medicine, Columbus, Ohio
| | - David J. Kolko
- Departments of Psychiatry and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Nora K. McNamara
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio
| | - Chenel Michel
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
| | - Adrienne Austin
- The Nisonger Center (UCEDD), Ohio State University, Columbus, Ohio
| | - Heidi Kipp
- Departments of Psychiatry and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert R. Rice
- Center for Clinical and Translational Science, Ohio State University Medical Center, Columbus, Ohio
| | - Michael G. Aman
- The Nisonger Center (UCEDD), Ohio State University, Columbus, Ohio
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Kanter JW, Santiago-Rivera AL, Santos MM, Nagy G, López M, Hurtado GD, West P. A randomized hybrid efficacy and effectiveness trial of behavioral activation for Latinos with depression. Behav Ther 2015; 46:177-92. [PMID: 25645167 DOI: 10.1016/j.beth.2014.09.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 11/30/2022]
Abstract
Depression presents a significant public health burden for Latinos, the largest and fastest-growing minority group in the United States. The current study performed a randomized controlled trial of Behavioral Activation (BA) for Latinos (BAL, n=21), with relatively minor modifications, compared to treatment as usual (TAU, n=22) in a community mental health clinic setting with a sample of depressed, Spanish-speaking Latinos. TAU was a strong comparison condition, taking place at the same clinic, under the same guidelines and clinic protocols, with similar levels of ongoing consultation, and using the same pool of therapists as BAL. Results indicated that BAL performed well with respect to treatment engagement and retention. Regarding acute treatment outcomes, an interaction emerged between number of sessions attended and condition. Specifically, only BAL clients who were engaged in treatment and attended more sessions demonstrated significant reductions in depression and improvements in quality of life and mental health functioning. Results are discussed in terms of the balance of efficacy and effectiveness issues addressed in this trial.
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Affiliation(s)
| | | | | | | | | | | | - Paul West
- Sixteenth Street Community Health Centers, Milwaukee
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48
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Bekteshi V, Xu Q, Van Tran T. Psychological distress among low-income U.S.- and foreign-born women of Mexican descent: impact of acculturation. Womens Health Issues 2015; 25:185-92. [PMID: 25636382 DOI: 10.1016/j.whi.2014.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 10/28/2014] [Accepted: 11/03/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE After testing the capacity of Kessler's psychological distress (K6) scale to measure equally across low-income Mexican-born women (n=881) and U.S.-born women of Mexican descent (n=317), this study assesses the impact of acculturation on this group's psychological distress. METHODS We employ descriptive and confirmatory factor analyses to test the cross-cultural equivalence of K6. Multivariate and logistic regression is used to test the association between acculturation and psychological distress among low-income, Mexican-American women. RESULTS The cross-cultural equivalence analysis shows that some of the scale's items have the capacity to measure psychological distress equally among participants. Regression results indicate that the more acculturated these women become, the greater their psychological distress is. CONCLUSION The study recommends that researchers emphasize the cross-cultural equivalence of their measures and suggests a heightened awareness among practitioners of the multidimensional impact of acculturation on clients of Mexican descent.
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Affiliation(s)
- Venera Bekteshi
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois.
| | - Qingwen Xu
- School of Social Work, Tulane University, New Orleans, Louisiana
| | - Thanh Van Tran
- Graduate School of Social Work, Boston College, Chestnut Hill, Massachusetts
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Sadule-Rios N, Tappen R, Williams CL, Rosselli M. Older Hispanics' explanatory model of depression. Arch Psychiatr Nurs 2014; 28:242-9. [PMID: 25017557 DOI: 10.1016/j.apnu.2014.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/08/2014] [Indexed: 11/18/2022]
Abstract
Cultural variations in the perception of depression make it difficult to recognize the disorder resulting in older Hispanics not being diagnosed and not receiving appropriate treatment. This study used a mixed-method design to explore older Hispanics' explanatory model of depression. Depression was recognized as the result of life stressors and personal weaknesses. Terms used for depressed people included "crazy, worry, bored, and nerves." These culturally coded terms may confound diagnosis among many Hispanics who find depression a shameful condition. Findings can be used to inform the adaptation of culturally relevant approaches to better serve the Hispanic community in this country.
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Villatoro AP, Morales ES, Mays VM. Family culture in mental health help-seeking and utilization in a nationally representative sample of Latinos in the United States: The NLAAS. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2014; 84:353-63. [PMID: 24999521 PMCID: PMC4194077 DOI: 10.1037/h0099844] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Considering the central role of familismo in Latino culture, it is important to assess the extent to which familismo affects mental health help-seeking. This study examined the role of behavioral familismo, the level of perceived family support, in the use of mental health services of Latinos in the United States. Data come from the National Latino and Asian American Study (NLAAS), a representative household survey examining the prevalence of mental disorders and services utilization among Latinos and Asian Americans. Analyses were limited to Latino adults with a clinical need for mental health services, indexed by meeting DSM-IV diagnostic criteria for any mood, anxiety, or substance use disorder during the past 12 months (N = 527). One-third of Latinos with a clinical need used any type of service in the past year, including specialty mental health, general medical, and informal or religious services. High behavioral familismo was significantly associated with increased odds of using informal or religious services, but not specialty or medical services. Self-perceived need and social perceptions of need for care within close networks (i.e., told by family/friends to seek professional help) also were significant predictors of service use. These results carry important implications toward expansions of the mental health workforce in the informal and religious services settings.
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Affiliation(s)
- Alice P Villatoro
- Department of Health Policy and Management, University of California
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