Follow-up to Depression Treatment among Latinos in Integrated Primary Care: A mixed methods analysis

Despite high lifetime risk for experiencing depressive disorder, Latinos disproportionately under-utilize mental health services as compared to non-Latino Whites, and are more likely to seek treatment for depression in primary care medical settings. Integrated behavioral health (IBH) in primary care is a promising service model for facilitating access to mental health care among Latinos. Yet, while IBH and the medical home are explicit mandates of the Affordable Care Act (ACA), research has not addressed whether IBH facilitates entry into needed behavioral health services for Latinos. The specific aims of this mixed methods study are: (1) To identify specific sociodemographic and contextual factors in the referral processes that predict psychotherapy initiation (treatment “uptake”) for depressed Latinos within an existing IBH setting; (2) To qualitatively explore why Latino patients decide to follow-up or not with behavioral health treatment upon referral. To achieve Aim 1, predictor analysis was performed from medical records data to identify psychosocial and contextual factors contributing to follow-up to behavioral health within the context of IBH. To achieve Aim 2, qualitative semi-structured interviews examining subjective reasons behind the decision of whether to follow-up were conducted with a sub-sample of depressed Latino patients referred for IBH services. Results will be presented and discussion will follow on implications for how findings can help guide best-practices for improving behavioral health utilization rates for depressed Latinos in the context of the IBH service model, and in the wake of ACA and health care reform.