Barriers to depression treatment among low-income, Latino emergency department patients.
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.
Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130-4899, USA. awells@gwbmail.wustl.edu
Anjanette
A
Wells
Isabel T
IT
Lagomasino
Lawrence A
LA
Palinkas
Jennifer M
JM
Green
Diana
D
Gonzalez
D000293:Adolescent; D000328:Adult; D002140:California; D003863:Depression / Q000188:drug therapy*; D004636:Emergency Service, Hospital; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D036301:Qualitative Research; D055815:Young Adult