Telephone-Based Depression Care Management
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Neighborhood Health Plan of Rhode Island
Greater Providence
Depression
Not-for-profit HMO
Latino or Spanish-speaking patients |
PROJECT
Patients receive a 12-week telephone-based depression care management program.
Linguistically and ethnically congruent depression care managers are recruited and hired to deliver this program. The care managers are trained to call patients diagnosed with depression eight times over the course of 12 weeks: once within two weeks of their starting antidepressant medication; weekly for four weeks; and biweekly for the next eight weeks. During each call, the depression care manager assesses depression symptoms; assesses medication use/adherence, side effects and other concerns; discusses the need for a follow-up appointment with the primary care provider; and sets depression treatment goals. Written feedback to the patient’s primary care provider is generated at least once per month. The program and patient materials are made available in both English and Spanish.
RATIONALE
In comparison to non-Latino Whites, Latinos receive less treatment and have poorer treatment outcomes for depression. Telephone-based depression care management, in which a “physician extender” tracks and monitors patients with newly diagnosed depression, is designed to improve depression treatment outcomes in the primary care setting and has shown promise in improving care for a general patient population.
This project incorporates additional features into a general telephone-based depression care management program to address the language and cultural needs of the local Latino population. In the program, Bilingual and Latino depression care managers are employed; the program is available and delivered in Spanish as needed; and cultural norms are incorporated into practice such as offering to talk with other family members, using formal titles, and being warm and personable. Lastly, care managers are able to assist with finding a bicultural, bilingual psychotherapist if desired.
EVALUATION PLAN
Funded by Finding Answers in 2006.
A qualitative study is being planned to learn, in depth about the community members’ perceptions of the barriers to adequate depression care, as well as their ideas about how health plans and other organizations might work with the community to overcome those barriers. English- and Spanish-speaking Latinos are participating in a series of focus groups. Due to the stigma associated with mental illness in the Latino community, it is not required that focus group participants be diagnosed with depression. However, they are allowed to participate if they or someone who they are close to currently or recently has had problems with depression, high stress, or “nervios.”
Information about the acceptability and feasibility of a telephone-based depression care management program is being gathered.
Principal Investigators:
- Beth Marootian, MPH
- Ivan Miller, PhD
- Lisa Uebelacker, PhD
In the News
Focus groups that were conducted as part of the program evaluation were highlighted in a story on the local Rhode Island NPR affiliate, WRNI. This story is part on an ongoing series, One Square Mile, that devotes an entire week of programming to one square mile of Rhode Island. This segment focuses on the availability of mental health services for the Latino immigrants in Central Falls (a city near Providence, Rhode Island).
Listen to the Story
For More Information
Please Contact:
Beth Ann Marootian, MPH
bmarootian@nhpri.org
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