Session: Depression and Stigma Measurement for Clinical Research with Hispanics in Primary Care (Society for Social Work and Research 23rd Annual Conference - Ending Gender Based, Family and Community Violence)

Significant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Low use of anti-depressant medication, poor provider-patient communication, and persistent stigma around depression are key barriers to treatment in Hispanic populations. Common concerns about depression treatment among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. Primary care settings often are the gateway to identifying undiagnosed or untreated mental health disorders, particularly for people with comorbid physical health conditions. Hispanics, in particular, are more likely to receive mental health care in primary care settings.

In 2014, the Center for Medicare and Medicaid Services Grants to Support the Hispanic Health Services Research Grant Program funded the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) project, and in 2015 The NIH National Institute on Minority Health and Health Disparities (NIMHD) funded METRIC: Measurement, Education and Tracking in Integrated Care. The purpose of both studies was to understand the role of culturally appropriate, patient-centered education in improving engagement in treatment, with an additional goal of eliminating health disparities through a culturally and linguistically centered integrated care approach. Both studies sought to establish the feasibility of universal screening for depression in an adult primary care safety net setting, and measure the effectiveness of a culturally appropriate depression education intervention to reduce stigma and increase uptake in depression treatment.

This symposium will report on measurement of depression and related stigma in a baseline sample (N=500) of Hispanic patients in a primary care setting, implications for research and measures for use in clinical practice. Two of the symposium presentations describe the performance of the Patient Health Questionnaire-9 (PHQ-9), a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. The first describes the measure's performance and the second describes the manifestation of depressive symptoms in a primary care sample of Hispanics. The third presentation reports on the psychometric qualities of three stigma measures. The discussant is an expert on the topic of mental health among Hispanics, and will explore measurement challenges presented in the three presentations, and will detail implications for future research.