Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2016

Open Access 01-12-2016 | Research

Utilization of a mental health collaborative care model among patients who require interpreter services

Authors: Jane W. Njeru, Ramona S. DeJesus, Jennifer St. Sauver, Lila J. Rutten, Debra J. Jacobson, Patrick Wilson, Mark L. Wieland

Published in: International Journal of Mental Health Systems | Issue 1/2016

Login to get access

Abstract

Background

Immigrants and refugees to the United States have a higher prevalence of depression compared to the general population and are less likely to receive adequate mental health services and treatment. Those with limited English proficiency (LEP) are at an even higher risk of inadequate mental health care. Collaborative care management (CCM) models for depression are effective in achieving treatment goals among a wide range of patient populations, including patients with LEP. The purpose of this study was to assess the utilization of a statewide initiative that uses CCM for depression management, among patients with LEP in a large primary care practice.

Methods

This was a retrospective cohort study of patients with depression in a large primary care practice in Minnesota. Patients who met criteria for enrollment into the CCM [with a provider-generated diagnosis of depression or dysthymia in the electronic medical records, and a Patient Health Questionnaire-9 (PHQ-9) score ≥10]. Patient-identified need for interpreter services was used as a proxy for LEP. Rates of enrollment into the DIAMOND (Depression Improvement Across Minnesota, Offering A New Direction) program, a statewide initiative that uses CCM for depression management were measured. These rates were compared between eligible patients who require interpreter services versus patients who do not.

Results

Of the 7561 patients who met criteria for enrollment into the DIAMOND program during the study interval, 3511 were enrolled. Only 18.2 % of the eligible patients with LEP were enrolled into DIAMOND compared with the 47.2 % of the eligible English proficient patients. This finding persisted after adjustment for differences in age, gender and depression severity scores (adjusted OR [95 % confidence interval] = 0.43 [0.23, 0.81]).

Conclusions

Within primary care practices, tailored interventions are needed, including those that address cultural competence and language navigation, to improve the utilization of this effective model among patients with LEP.
Literature
1.
Pumariega AJ, Rothe E, Pumariega JB. Mental health of immigrants and refugees. Community Ment Health J. 2005;41:581–97.CrossRefPubMed
2.
Office of the Surgeon General (US), Center for Mental Health Services (US), National Institute of Mental Health (US). Mental health: culture, race, and ethnicity: a supplement to mental health: a report of the surgeon general. Rockville: Substance Abuse and Mental Health Services Administration (US); 2001.
3.
Falah-Hassani K, Shiri R, Vigod S, Dennis CL. Prevalence of postpartum depression among immigrant women: a systematic review and meta-analysis. J Psychiatr Res. 2015;70:67–82.CrossRefPubMed
4.
Wilmoth JM, Chen PC. Immigrant status, living arrangements, and depressive symptoms among middle-aged and older adults. J Gerontol B Psychol Sci Soc Sci. 2003;58:S305–13.CrossRefPubMed
5.
Hollander AC, Bruce D, Burstrom B, Ekblad S. The association between immigrant subgroup and poor mental health: a population-based register study. J Nerv Ment Dis. 2013;201:645–52.CrossRefPubMed
6.
Kirmayer LJ, Narasiah L, Munoz M, et al. Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ. 2011;183:E959–67.CrossRefPubMedPubMedCentral
7.
Stockdale SE, Lagomasino IT, Siddique J, McGuire T, Miranda J. Racial and ethnic disparities in detection and treatment of depression and anxiety among psychiatric and primary health care visits, 1995-2005. Med Care. 2008;46:668–77.CrossRefPubMedPubMedCentral
8.
Cabassa LJ, Zayas LH, Hansen MC. Latino adults’ access to mental health care: a review of epidemiological studies. Adm Policy Ment Health. 2006;33:316–30.CrossRefPubMedPubMedCentral
9.
Bridges AJ, Andrews AR 3rd, Deen TL. Mental health needs and service utilization by Hispanic immigrants residing in mid-southern United States. J Transcult Nurs. 2012;23:359–68.CrossRefPubMedPubMedCentral
10.
Blanco C, Patel SR, Liu L, et al. National trends in ethnic disparities in mental health care. Med Care. 2007;45:1012–9.CrossRefPubMed
11.
Cook BL, McGuire T, Miranda J. Measuring trends in mental health care disparities, 2000 2004. Psychiatr Serv. 2007;58:1533–40.CrossRefPubMed
12.
13.
Ryan C. Language Use in the United States: 2011 American Community Survey Reports. In; 2013.
14.
Fiscella K, Franks P, Doescher MP, Saver BG. Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Med Care. 2002;40:52–9.CrossRefPubMed
15.
DuBard CA, Gizlice Z. Language spoken and differences in health status, access to care, and receipt of preventive services among US Hispanics. Am J Public Health. 2008;98:2021–8.CrossRefPubMedPubMedCentral
16.
Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev. 2005;62:255–99.CrossRefPubMed
17.
Sentell T, Shumway M, Snowden L. Access to mental health treatment by English language proficiency and race/ethnicity. J Gen Intern Med. 2007;22(Suppl 2):289–93.CrossRefPubMedPubMedCentral
18.
Takach M. About half of the states are implementing patient-centered medical homes for their Medicaid populations. Health Aff (Millwood). 2012;31:2432–40.CrossRef
19.
Sprague L. Disease management to population-based health: steps in the right direction? NHPF Issue Brief. 2003:1–16.
20.
Faber M, Voerman G, Erler A, et al. Survey of 5 European countries suggests that more elements of patient-centered medical homes could improve primary care. Health Aff (Millwood). 2013;32:797–806.CrossRef
21.
Thota AB, Sipe TA, Byard GJ, et al. Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis. Am J Prev Med. 2012;42:525–38.CrossRefPubMed
22.
Dejesus RS, Angstman KB, Cha SS, Williams MD. Antidepressant medication use among patients with depression: comparison between usual care and collaborative care using care managers. Clin Pract Epidemiol Ment Health. 2013;9:84–7.CrossRefPubMedPubMedCentral
23.
Angstman KB, Dejesus RS, Williams MD. Collaborative care management for depression: comparison of cost metrics and clinical response to usual care. J Prim Care Community Health. 2010;1:73–7.CrossRefPubMed
24.
Chang-Quan H, Bi-Rong D, Zhen-Chan L, Yuan Z, Yu-Sheng P, Qing-Xiu L. Collaborative care interventions for depression in the elderly: a systematic review of randomized controlled trials. J Investig Med. 2009;57:446–55.PubMed
25.
Angstman KB, Phelan S, Myszkowski MR, et al. Minority primary care patients with depression: outcome disparities improve with collaborative care management. Med Care. 2015;53:32–7.CrossRefPubMed
26.
Davis TD, Deen T, Bryant-Bedell K, Tate V, Fortney J. Does minority racial-ethnic status moderate outcomes of collaborative care for depression? Psychiatr Serv. 2011;62:1282–8.CrossRefPubMed
27.
Ohtani A, Suzuki T, Takeuchi H, Uchida H. Language barriers and access to psychiatric care: a systematic review. Psychiatr Serv. 2015;66:798–805.CrossRefPubMed
28.
Sanchez K, Watt TT. Collaborative care for the treatment of depression in primary care with a low-income, spanish-speaking population: outcomes from a community-based program evaluation. Prim Care Companion CNS Disord. 2012;14.
29.
30.
A new direction in depression treatment in Minnesota: DIAMOND program, Institute for Clinical Systems Improvement, Bloomington, Minnesota. Psychiatr Serv 2010;61:1042–4.
31.
Angstman KB, Williams MD. Patients in a depression collaborative care model of care: comparison of 6-month cost utilization data with usual care. J Prim Care Community Health. 2010;1:12–6.CrossRefPubMed
32.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. (text revision). Washington; 2000.
33.
34.
Karliner LS, Napoles-Springer AM, Schillinger D, Bibbins-Domingo K, Perez-Stable EJ. Identification of limited English proficient patients in clinical care. J Gen Intern Med. 2008;23:1555–60.CrossRefPubMedPubMedCentral
35.
Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–9.CrossRefPubMed
36.
Lesser I, Rosales A, Zisook S, et al. Depression outcomes of Spanish- and english-speaking Hispanic outpatients in STAR*D. Psychiatr Serv. 2008;59:1273–84.CrossRefPubMed
37.
Vega W, Kolody B, Aguilar-Gaxiola S. Help Seeking for Mental Health Problems Among Mexican Americans. J Immigr Health. 2001;3:133–40.CrossRefPubMed
38.
Pandya C, McHugh M, Batalova J. Limited english proficient individuals in the United States: number, share, growth and linguistic diversity. In: Integration NCoI, ed. Washington: Migration Policy Institute; 2011.
39.
He Y, Zhang M, Lin EH, et al. Mental disorders among persons with arthritis: results from the World Mental Health Surveys. Psychol Med. 2008;38:1639–50.CrossRefPubMedPubMedCentral
40.
Hudson CG. Socioeconomic status and mental illness: tests of the social causation and selection hypotheses. Am J Orthopsychiatry. 2005;75:3–18.CrossRefPubMed
41.
Yu Y, Williams D. Socioeconomic status and mental health. In: Aneshensel C, Phelan J, editors. Handbook of the sociology of mental health. New York: Springer; 1999. p. 151–66.
42.
Miech RA, Caspi A, Moffitt TE, Entner-Wright BR, Silva PA. Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. Am J Sociol. 1999;104:1096–131.CrossRef
43.
44.
Muggah E, Dahrouge S, Hogg W. Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada. BMC Fam Pract. 2012;13:128.CrossRefPubMedPubMedCentral
45.
Flores G, Abreu M, Olivar MA, Kastner B. Access barriers to health care for Latino children. Arch Pediatr Adolesc Med. 1998;152:1119–25.CrossRefPubMed
46.
Whitley R, Kirmayer LJ, Groleau D. Understanding immigrants’ reluctance to use mental health services: a qualitative study from Montreal. Can J Psychiatry. 2006;51:205–9.PubMed
47.
Martinez Tyson D, Arriola NB, Corvin J. Perceptions of depression and access to mental health care among latino immigrants: looking beyond one size fits all. Qual Health Res. 2015.
48.
Jimenez DE, Bartels SJ, Cardenas V, Dhaliwal SS, Alegria M. Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care. Am J Geriatr Psychiatry. 2012;20:533–42.CrossRefPubMedPubMedCentral
49.
Scuglik DL, Alarcon RD, Lapeyre AC 3rd, Williams MD, Logan KM. When the poetry no longer rhymes: mental health issues among Somali immigrants in the USA. Transcult Psychiatry. 2007;44:581–95.CrossRefPubMed
50.
Henning-Smith C, Shippee TP, McAlpine D, Hardeman R, Farah F. Stigma, discrimination, or symptomatology differences in self-reported mental health between US-born and Somalia-born Black Americans. Am J Public Health. 2013;103:861–7.CrossRefPubMedPubMedCentral
51.
Horevitz E, Organista KC, Arean PA. Depression treatment uptake in integrated primary care: how a “Warm Handoff” and other factors affect decision making by Latinos. Psychiatr Serv. 2015;66:824–30.CrossRefPubMed
52.
Miranda J, Azocar F, Organista KC, Dwyer E, Areane P. Treatment of depression among impoverished primary care patients from ethnic minority groups. Psychiatr Serv. 2003;54:219–25.CrossRefPubMed
53.
Manoleas P. Integrated primary care and behavioral health services for Latinos: a blueprint and research agenda. Soc Work Health Care. 2008;47:438–54.CrossRefPubMed
54.
Miranda J, Bernal G, Lau A, Kohn L, Hwang W-C, LaFromboise T. State of the Science on Psychosocial Interventions for Ethnic Minorities. Annu Rev Clin Psychol. 2005;1:113–42.CrossRefPubMedPubMedCentral
55.
Horvat L, Horey D, Romios P, KisRigo J. Cultural competence education for health professionals. Cochrane Database Syst Rev. 2014;5:CD009405.PubMed
Metadata
Title
Utilization of a mental health collaborative care model among patients who require interpreter services
Authors
Jane W. Njeru
Ramona S. DeJesus
Jennifer St. Sauver
Lila J. Rutten
Debra J. Jacobson
Patrick Wilson
Mark L. Wieland
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2016
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-016-0044-z

Other articles of this Issue 1/2016

International Journal of Mental Health Systems 1/2016 Go to the issue

Research

Comprehensive psychometric examination of the attitudes towards suicide (ATTS) in South Korea

Research

Consumers and their supporters’ perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups

Research

Gender differences in the association between cognitive social capital, self-rated health, and depressive symptoms: a comparative analysis of Sweden and Ukraine

Research

Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights

Research

Psychological distress is influenced by length of stay in resettled Iraqi refugees in Australia

Research

Violent events, ward climate and ideas for violence prevention among nurses in psychiatric wards: a focus group study