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Telephone-Based Depression Care Management

Telephone-Based Depression Care Management Neighborhood Health Plan of Rhode Island
Greater Providence
Depression
Latino, 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.

Summary Results


This telephone-based depression care management program—delivered by linguistically and ethnically concordant care managers—could not be evaluated due to insufficient enrollment. The telephone recruitment method faced major barriers such as the proliferation of local telephone scams, the high cost of cell phone minutes, and the proposal of state legislation targeting undocumented immigrants. In a separate series of focus groups, Latino health plan members expressed a desire for having input over when and often they were called and a preference for being recruited by their provider or written communication instead.

Publications


Barriers to Depression Treatment among Low-income, Latino Emergency Department Patients
Community Mental Health Journal. Online September 2012.
Full Article (
subscription may be required)

Telephone Depression Care Management to Latino Medicaid Health Plan Members: A Pilot Study
Journal of Nervous and Mental Disease. 2011 Sept; 199(9): 678-683.
Full Article (
subscription may be required)

Barriers and Facilitators of Treatment for Depression in a Latino Community: A Focus Group Study
Community Mental Health Journal. 2011 Feb; 48(1): 114-126.
Full Article (subscription may be required)

Principal Investigators


  • Beth Marootian, MPH
  • Ivan Miller, PhD
  • Lisa Uebelacker, PhD