Perspectives on quality mental health care from Brazilian and Cape Verdean outpatients: implications for effective patient-centered policies and models of care.
Mental health providers are increasingly coming into contact with large and growing multi-racial/ethnic and immigrant patient populations in the United States. Knowledge of patient perspectives on what constitutes quality mental health care is necessary for these providers. The aim of this study was to identify indicators of quality of mental health care that matter most to two underrepresented immigrant patient groups of Portuguese background: Brazilians and Cape Verdeans. A qualitative design was adopted using focus group discussions. Six focus groups of patients (n=24 Brazilians; n=24 Cape Verdeans) who received outpatient mental health treatment through public safety net clinics in the northeast region of the United States were conducted. The Consensual Qualitative Research analytic method allowed us to identify three quality of care domains: provider performance, aspects of mental health care environment, and effectiveness of mental health care treatment. Provider performance was associated with five categories: relational, communication, linguistic, cultural, and technical competencies. Aspects of mental health care environment were linked to two categories: psychosocial and physical environment. Effectiveness of mental health care treatment was related to two categories: therapeutic relationship and treatment outcomes. Study findings provide useful data for the development of more culturally appropriate and effective patient-centered models and policies in mental health care.
School of International Service, Center on Health, Risk, and Society, American University, Washington, DC, USA; Dejesus@american.edu.
Maria
M
De Jesus
ICF International, Inc., Division of Public Health and Survey Research, Atlanta, GA, USA; Cambridge Health Alliance, Center for Multicultural Mental Health Research, Harvard Medical School, MA, USA;
Tara R
TR
Earl
D000328:Adult; D001938:Brazil / Q000208:ethnology; D055726:Cabo Verde / Q000208:ethnology; D054521:Cultural Competency / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D009511:New England; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000379:methods; D036301:Qualitative Research; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Brazilian; Cape Verdean; Patient perspectives; mental health; patient-centered care; quality of care