| Improving the Recognition and Treatment of Depression
Who is the intervention targeting?
Asian American and Latino American patients with depression
What intervention is being evaluated?
Once screening positive for depression using the PHQ-2, patients will receive a culturally focused psychiatric (CFP) consultation by a trained psychologist or psychiatrist to provide a culturally informed diagnosis, provide the patient with a toolkit for depression, and make recommendations for managing their disease. The diasgnostic and treatment recommendations will be communicated to the patient’s primary care provider. The depression toolkits will include self-rated depression questionnaires, psychoeducational booklets, worksheets and community resources.
Within two weeks of the initial consultation, patients will attend a follow-up visit with the consultants. At that time, consultants will review patients' use of and questions about the toolkit, including their use of the cognitive behavioral based handouts.
Additionally, a web-based system will assist providers in making referrals for the culturally focused consultations and improving the availability of the service.
Where is the intervention taking place?
Primary care practices affiliated with a large hospital that provides more than 1.5 million outpatient visit a year
Lead Organization
Massachusetts General Hospital
Why might this approach work?
Ethnic minorities with depression are much more likely to be cared for by primary care physicians than by specialists in mental health. The intervention is designed to improve primary care providers' ability to provide appropriate, culturally informed care and patients' knowledge of and resources for receiving treatment for depression. The initial screening form will be available in English, Spanish, Chinese, and Veitnamese. The consultation assessment will be used to make a culturally appropriate diagnosis, assess the patient’s psychiatric needs in a cultural context, conduct a culturally focused intervention, and consider culture within the diagnosis.
How will this intervention be evaluated?
Patients will be randomized by physician clusters within each practice site. Outcome measures include:
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Rates of depression diagnoses
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Rates of depression treatment
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Rates of prescription of pharmacotherapy
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Referrals/visits to mental health specialists
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Patient satisfaction
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Provider satisfaction
Principal Investigators:
Nhi-Ha T. Trinh, MD, MPH
Psychiatrist, Massachusetts General Hospital
C. Andres Bedoya, PhD
Staff Psychologist, Massachusetts General Hospital |
