Depression care management for Chinese Americans in primary care: a feasibility pilot study.
This study describes a culturally relevant intervention using a collaborative depression care model to integrate mental health and primary care services for depressed low income Chinese-Americans at a community health center. A total of 6,065 patients were screened for depression. Of the 341 who screened positive, 57 participated and were randomly assigned to receive either enhanced physician care with care management (32) or enhanced physician care only (25). All enrolled participants were assessed at baseline and 4 monthly follow-up visits for depression, physical and mental health functioning, and perceived stigma toward receiving depression care, to determine the impact, if any, of their mental health treatment. Both groups reported significant reduction of depressive symptoms and improved mental health functioning from baseline to follow-up assessments although there was no significant difference between the two groups. Although the study found no advantage to adding the care management component in the treatment of depression, screening and assertive treatment of immigrant Chinese Americans who tend to underutilize mental health services is important and consistent with the increased adoption of team based care models in patient centered medical homes. High refusal rates for enrollment in the study have implications for future study designs for this group.
Silberman School of Social Work at Hunter College, 2180 Third Avenue @119th Street, New York, NY 10035, USA. kkwong@hunter.cuny.edu
Kenny
K
Kwong
Henry
H
Chung
Karen
K
Cheal
Jolene C
JC
Chou
Teddy
T
Chen
D000328:Adult; D001213:Asian / Q000523:psychology*; D003299:Cooperative Behavior; D054521:Cultural Competency; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000706:statistics & numerical data; D003863:Depression / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D010348:Patient Care Team; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016896:Treatment Outcome