title: Using participatory methods to enhance patient-centred mental health care in a federally qualified community health center serving a Mexican American farmworker community.
abstract: BACKGROUND
  Mexican American farmworkers experience high rates of mental health conditions; however, it is difficult for them to access care. Patient-centred care is a systems-wide approach to improving the delivery of services for diverse populations in the primary care setting.
  
  
  OBJECTIVE
  We describe the application of community-based participatory research methods to assess and address gaps in perceptions of mental health care between providers and migrant workers living in a US-Mexico Border community.
  
  
  METHODS
  A federally qualified health centre (FQHC) serving a community of approximately 60 000 agricultural workers who live in Yuma County and harvest vegetables during the winter season.
  
  
  METHODS
  We conducted patient focus groups (n = 64) and FQHC staff interviews (n = 16) to explore attributes and dimensions of patient-centred mental health care.
  
  
  RESULTS
  Patients and staff both prioritized increased access to mental health care and patient-centred care, while patients were more concerned with interpersonal care and providers with coordination of care. All participants stressed the relationship between life events and mental health and the centrality of family in care. Patients also emphasized the importance of a good attitude, the ability to solve problems, positive family relationships and reliance on faith. Patients suggested that the FQHC inform patients about mental health resources, provide community informational talks to address stigma, and offer support groups.
  
  
  CONCLUSIONS
  The participatory approach of this qualitative study resulted in a wealth of data regarding patient preferences that will enable the FQHC to develop protocols and training to provide patient-centred mental health-care services for their community.
authors.affiliation: University of Arizona College of Public Health, Tucson, AZ, USA.
authors.forename: Maia
authors.initials: M
authors.lastname: Ingram
authors.affiliation: University of Arizona College of Public Health, Tucson, AZ, USA.
authors.forename: Ken A
authors.initials: KA
authors.lastname: Schachter
authors.affiliation: University of Arizona College of Public Health, Tucson, AZ, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Guernsey de Zapien
authors.affiliation: Rand Corporation, Santa Monica, CA, USA.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Herman
authors.affiliation: University of Arizona College of Public Health, Tucson, AZ, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Carvajal
mesh_terms: D001130:Arizona; D003155:Community Mental Health Centers; D003156:Community Mental Health Services / Q000379:methods*; D055812:Community-Based Participatory Research / Q000379:methods; D000067565:Farmers; D017144:Focus Groups; D006801:Humans; D017058:Mexican Americans; D018802:Patient-Centered Care / Q000379:methods*
keywords: community health workers; community-based participatory research; mental health; patient centred care; primary care