title: Burden of common mental disorders in a community health centre sample.
abstract: OBJECTIVE
  To examine the rates of common mental disorders (CMDs) such as depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol use in an urban community health care centre (CHC) serving vulnerable immigrant and ethnoracial communities in order to improve knowledge on the rates of CMDs specific to these groups accessing primary care settings.
  
  
  METHODS
  English or Spanish, self-administered, tablet-based survey known as the Interactive Computer-Assisted Client Assessment Survey (iCCAS).
  
  
  METHODS
  Access Alliance Multicultural Health and Community Services CHC in Toronto, Ont.
  
  
  METHODS
  Adult patients waiting to see a clinician.
  
  
  METHODS
  The iCCAS screened for depression (using the PHQ-9 [Patient Health Questionnaire]), anxiety (using the GAD-7 [Generalized Anxiety Disorder 7-item scale]), PTSD (using the PC-PTSD [Primary Care PTSD Screen]), and alcohol dependency (using the CAGE questionnaire); those with an existing diagnosis and active treatment for one of these conditions were not asked to complete that condition-specific screening scale. An exit survey measured demographic characteristics and relevant indicators.
  
  
  RESULTS
  A response rate of 78.6% was achieved. The iCCAS survey was completed by 75 patients (26 men and 49 women) with a mean age of 36.5 years. Almost all were first-generation immigrants: 32.0% originated from Latin America, 28.0% from South Asia, and 17.3% from Africa or the Middle East. Major depression was found among 44.0% of participants (11 with diagnosis and treatment, 22 with a score of 10 or greater on the PHQ-9). Generalized anxiety disorder was present in 26.7% of participants (7 with diagnosis and treatment, 13 with a score of 10 or greater on the GAD-7 scale). Posttraumatic stress disorder was detected in 37.3% of participants (7 with diagnosis and treatment, 21 with a score of 3 or greater on the PC-PTSD tool). Alcohol dependency was found among 10.7% of participants (1 with diagnosis and treatment, 7 with a score of 2 or greater on the CAGE questionnaire).
  
  
  CONCLUSIONS
  The high rates of probable depression, generalized anxiety, and PTSD that were found in the studied population suggest a need for systematic assessment of CMDs in CHCs, as well as training and resources to increase readiness to handle identified cases.
authors.affiliation: Associate Professor in the School of Health Policy and Management at York University in Toronto, Ont, and Research Scientist at the North York General Hospital. farahmad@yorku.ca.
authors.forename: Farah
authors.initials: F
authors.lastname: Ahmad
authors.affiliation: Senior Research Scientist at Access Alliance Multicultural Health and Community Services and Assistant Professor in the Dalla Lana School of Public Health at the University of Toronto.
authors.forename: Yogendra
authors.initials: Y
authors.lastname: Shakya
authors.affiliation: Associate Professor in the School of Health Policy and Management at York University.
authors.forename: Liane
authors.initials: L
authors.lastname: Ginsburg
authors.affiliation: Professor and Head of the Biostatistics Division of the Dalla Lana School of Public Health at the University of Toronto.
authors.forename: Wendy
authors.initials: W
authors.lastname: Lou
authors.affiliation: Professor in the School of Administrative Studies at York University.
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Ng
authors.affiliation: Director of Cross Roads Clinic at Women's College Hospital and Assistant Professor at the Department of Family and Community Medicine at the University of Toronto.
authors.forename: Meb
authors.initials: M
authors.lastname: Rashid
authors.affiliation: Postdoctoral fellow in the School of Health Policy and Management at York University.
authors.forename: Manuela
authors.initials: M
authors.lastname: Ferrari
authors.affiliation: Director of Primary Health Care and Special Initiatives at Access Alliance Multicultural Health and Community Services.
authors.forename: Cliff
authors.initials: C
authors.lastname: Ledwos
authors.affiliation: Psychiatrist and Medical Director of Underserved Populations at the Centre for Addiction and Mental Health in Toronto, Ont, and Chief Executive Officer of The Wellesley Institute.
authors.forename: Kwame
authors.initials: K
authors.lastname: McKenzie
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000453:epidemiology*; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003865:Major Depressive Disorder / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008603:Mental Health; D008875:Middle Aged; D009864:Ontario; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult