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

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Abstract

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.

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Acknowledgments

This project was supported by Robert Wood Johnson Finding Answers Grant, Grant #59743 (PI: Isabel Lagomasino, PhD, MSHS). We would like to thank Sarita Mohonty, PhD, MPH, Alina Molina, MSW, Maria Pallares, Lisa Perez, BA, and Silvia Simenthal, MSW for assistance with data collection and valuable contributions to this work.

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Authors and Affiliations

  1. Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130-4899, USA

    Anjanette Wells

  2. Department of Psychiatry & Behavioral Sciences, Keck School of Medicine at USC, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA

    Isabel T. Lagomasino & Jennifer M. Green

  3. School of Social Work, University of Southern California, MRF 339, Los Angeles, CA, 90089-0411, USA

    Lawrence A. Palinkas

  4. Special Service for Groups, Weber Community Center, 5849 Crocker St., Los Angeles, CA, 90003, USA

    Diana Gonzalez

Authors
  1. Anjanette Wells
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  2. Isabel T. Lagomasino
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  3. Lawrence A. Palinkas
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  4. Jennifer M. Green
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  5. Diana Gonzalez
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Correspondence to Anjanette Wells.

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Wells, A., Lagomasino, I.T., Palinkas, L.A. et al. Barriers to Depression Treatment Among Low-Income, Latino Emergency Department Patients. Community Ment Health J 49, 412–418 (2013). https://doi.org/10.1007/s10597-012-9547-5

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  • DOI: https://doi.org/10.1007/s10597-012-9547-5

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