Mind and Body/Mente y Cuerpo – An effective model for the integration of mental health and primary care of Latinas in community health centers

Latinas have high rates of depression and are less likely to receive appropriate mental health treatment than their non-Latina counterparts. With funding from the Office of Minority Health, the Boston Public Health Commission and 2 community health centers developed a model of care that integrates mental health screening into primary care, using case managers (CMs) trained in an expanded role. (Mind and Body/Mente y Cuerpo)In the project's first 2 years we screened 1800 women, of whom 50.6% screened positive for depression. In addition to assistance with concrete needs, referrals to traditional mental health providers, tracking and standard CM services, CMs also provide universal patient education regarding mental health and behavioral concerns, brief interventions, and conduct support and stress management groups. The project also provides non-traditional services such as yoga, acupuncture and massage. Of the total number of women with positive screens, 87% received further services, of whom 47% attended support groups and/or received non-traditional services, and 53% received traditional mental health services, with or without non-traditional services and support groups. Follow-up screens demonstrate improved mental health among participants. Focus groups and key informant interviews with participants and providers confirm the key role of CMs for providing an initial link to mental health services; effective mental health services themselves, and preparation of women for optimal participation in traditional mental health services. Our model integrates mental health and primary care, expands mental health capacity and improves the mental well-being of Latinas patients. We are investigating its impact on patients' chronic disease outcomes.