Barriers to depression treatment among low-income, Latino emergency department patients

Community Ment Health J. 2013 Aug;49(4):412-8. doi: 10.1007/s10597-012-9547-5. Epub 2012 Sep 30.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • California
  • Depression / drug therapy*
  • Emergency Service, Hospital
  • Female
  • Health Services Accessibility*
  • Hispanic Americans / psychology*
  • Humans
  • Male
  • Middle Aged
  • Poverty*
  • Qualitative Research
  • Young Adult