Barriers and Facilitators of Treatment for Depression in a Latino Community: A Focus Group Study

We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators
of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone
care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for
their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager
educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician,
and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family
member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes:
vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and
family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments,
healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators
of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead
to interventions better able to meet the needs of this particular group.