Treatment of depression and PTSD in primary care clinics serving uninsured low-income mostly Latina/o immigrants: A naturalistic prospective evaluation.

Treatment of depression and PTSD in primary care clinics serving uninsured low-income mostly Latina/o immigrants: A naturalistic prospective evaluation. - 2019

CONCLUSIONS: Results suggest that both models were effective for depression and PTSD; however, the collaborative care model had added benefits for those patients with PTSD. (PsycINFO Database Record (c) 2019 APA, all rights reserved). METHOD: One hundred thirty-eight patients with presumptive depression were interviewed at baseline. Follow-up data were collected 8 months later. Care received between the two assessments was ascertained by chart review. OBJECTIVES: Uninsured immigrants to the United States are psychologically vulnerable due to limited access to mental health services. Latina/o immigrants from Central and South America are further at risk due to high levels of trauma exposure, both in their country of origin and their adopted country. Effective behavioral interventions in primary care are needed to address this services gap for common trauma-related mental disorders, including depression and posttraumatic stress disorder (PTSD). A naturalistic prospective study compared depression and PTSD outcomes for uninsured primary care patients, mostly Latina/o immigrants, in clinics with distinct models for integrating behavioral health services. One clinic had a collaborative care program, that is, a multicomponent, system-level intervention with the goals of facilitating increased screening, improving diagnostic accuracy, increasing uptake of evidence-based treatment, and utilizing measurement-based treatment to target. The other had colocated services, with an on-site therapist. RESULTS: There was a significant decrease in depression symptoms regardless of clinic. Factors associated with improved depression outcomes included absence of comorbid PTSD and lack of additional trauma exposures. Although there was overall improvement in PTSD, there was significantly more improvement in the collaborative care clinic.


English

1077-341X

10.1037/cdp0000251 [doi] 2019-10292-001 [pii]


*Depression/th [Therapy]
*Emigrants and Immigrants/px [Psychology]
*Hispanic Americans/px [Psychology]
*Medically Uninsured/eh [Ethnology]
*Stress Disorders, Post-Traumatic/th [Therapy]
Adult
Depression/eh [Ethnology]
Depression/px [Psychology]
Female
Humans
Male
Mental Health Services
Middle Aged
Poverty
Primary Health Care
Prospective Studies
Stress Disorders, Post-Traumatic/eh [Ethnology]
Stress Disorders, Post-Traumatic/px [Psychology]
United States


MedStar Health Research Institute


Journal Article

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