Barriers to Depression Treatment Among Low-Income, Latino Emergency Department Patients

• Published in: Community mental health journal Vol. 49; no. 4; pp. 412 - 418
• Main Authors: Wells, Anjanette, Lagomasino, Isabel T., Palinkas, Lawrence A., Green, Jennifer M., Gonzalez, Diana
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.08.2013; Springer Nature B.V
• Subjects: Accident and emergency departments; Adolescent; Adult; Brief Report; California; Community and Environmental Psychology; Constraints; Depression; Depression (Psychology); Depression - drug therapy; Emergency medical care; Emergency Medical Services; Emergency Service, Hospital; Facilitators; Female; Health care; Health Services Accessibility; Hispanic Americans; Hispanic Americans - psychology; Humans; Immigrants; Intervention; Interviews; Latin American people; Low Income Groups; Low income people; Male; Medical screening; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Mental health; Mental health care; Middle Aged; Minority & ethnic groups; Patients; Perceptions; Poverty; Psychiatry; Qualitative Research; Social workers; Transportation; Young Adult; California; Depression; Emergency department; Low-income; Minority; Latino
• ISSN: 0010-3853; 1573-2789
• DOI: 10.1007/s10597-012-9547-5

Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. We conducted telephone interviews with 24 ED patients (18–62 years of age, 79 % female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Although most patients acknowledged signs of depression, there was a lack of readiness to seek help. Patients reported negative perceptions about anti-depressant medication, even if they had no previous use. Barriers to treatment included transportation concerns, employment/unemployment, patient-provider issues, and immigrant documentation. Identified facilitators included consistent provider advice and “talking.” This study introduced new misunderstanding and miscommunication barriers.