Journal of Immigrant and Minority Health

, Volume 16, Issue 6, pp 1271–1277 | Cite as

Evaluating Patient Acceptability of a Culturally Focused Psychiatric Consultation Intervention for Latino Americans with Depression

  • Nhi-Ha T. TrinhEmail author
  • Patrick N. Hagan
  • Katherine Flaherty
  • Lara N. Traeger
  • Aya Inamori
  • Charlotte D. Brill
  • Katherine Hails
  • Trina E. Chang
  • C. Andres Bedoya
  • Maurizio Fava
  • Albert Yeung
Original Paper


Significant disparities exist in both access to and quality of mental health care for Latino Americans with depression compared to Caucasians, resulting in a greater burden of disability in this underserved population. Our aim is to evaluate participant acceptability of a Culturally Focused Psychiatric (CFP) consultation program for depressed Latino Americans. Latino American adult primary care patients endorsing depressive symptoms on a screening questionnaire were targeted in their primary care clinic. The intervention addressed participants’ depressive symptoms using culturally adapted clinical assessments and toolkits. Acceptability was evaluated using a treatment satisfaction scale and in-depth semi-structured interviews. Overall, 85 % of participants responded positively to all questions of the satisfaction scale. In in-depth interviews, the vast majority of participants reported the program met expectations, all stated providers were culturally sensitive, and most stated recommendations were culturally sensitive. The CFP program was found to be acceptable to a group of depressed Latino American primary care patients. Further research is needed to evaluate if the CFP intervention can improve depressive symptoms and outcomes.


Depression Latino Americans Primary care Culturally appropriate care 



The authors would like to thank the professional and support staff at the participating sites for their commitment and participation in the study: MGH Charlestown Healthcare Center, MGH Chelsea Healthcare Center, MGH Internal Medicine Associates, and MGH Revere Healthcare Center. The authors would also like to thank Drs. Joseph Betancourt and Alexander Green from the MGH Disparities Solutions Center for their contributions to the conception and design of the study, Jennifer Riconda and the MGH Development Office for their support of the grant, Dr. Jerrold Rosenbaum the chief of the MGH Department of Psychiatry for his support of the study, Dr. Susan Regan for her statistical support of the study, and Soo Jeong Yoon and Jenny Man for their technical assistance in the study. This manuscript was made possible through the support of the Robert Wood Johnson Foundation’s program, ‘Finding Answers: Disparities Research for Change’ (RWJF grant number 66709); Harvard Medical School’s Center of Excellence Health Disparities Post Graduate Fellowship (HDPG); Disparities Mentorship and Professional Support (D-MaPS) Enrichment Award from the Harvard Catalyst Health Disparities Research Program; and the MGH Department of Psychiatry.


  1. 1.
    Mental Health: Culture, Race, and Ethnicity. US Department of Health and Human Services. 2001. Available at
  2. 2.
    Smedley BD, Stith AY, Nelson AR. Unequal treatment: confronting racial and ethical disparities in health care. Washington, DC: Institute of Medicine; 2002.Google Scholar
  3. 3.
    Atdjian S, Vega WA. Disparities in mental health treatment in US racial and ethnic minority groups: implications for psychiatrists. Psychiatr Serv. 2005;56(12):1600–2.PubMedCrossRefGoogle Scholar
  4. 4.
    Alegria M, Chatterji P, Wells K, et al. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatr Serv. 2008;59(11):1264–72.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Gonzalez HM, Vega WA, Williams DR, et al. Depression care in the United States: too little for too few. Arch Gen Psychiatry. 2010;2010(67):37–46.CrossRefGoogle Scholar
  6. 6.
    Cooper LA, Gonzales JJ, Gallo JJ, et al. The acceptability of treatment for depression among African-American, hispanic, and white primary care patient. Med Care. 2003;41(2):479–89.PubMedGoogle Scholar
  7. 7.
    Alegria M, McGuire T. Rethinking a universal framework in the psychiatric symptom-disorder relationship. J Health Soc Behav. 2003;44:257–74.PubMedCrossRefGoogle Scholar
  8. 8.
    Hansen MC, Cabassa LJ. Pathways to depression care: help-seeking experiences of low-income Latinos with diabetes and depression. J Immigr Minor Health. 2012. Available at
  9. 9.
    Hails K, Brill CD, Chang TE, et al. Cross-cultural aspects of depression management in primary care. Curr Psychiatry Rep. 2012;14(4):336–44.PubMedCrossRefGoogle Scholar
  10. 10.
    Pingitore D, Snowden L, Sansone RA, et al. Persons with depressive symptoms and the treatments they receive: a comparison of primary care physicians and psychiatrists. Int J Psychiatry Med. 2001;31(1):41–60.PubMedCrossRefGoogle Scholar
  11. 11.
    Trinh NH, Bedoya CA, Chang TE, et al. A Study of a culturally focused psychiatric consultation service for Asian American and Latino American primary care patients with depression. BMC Psychiatry. 2011;11:166.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–92.PubMedCrossRefGoogle Scholar
  13. 13.
    Yeung A, Trinh NH, Chang TE, et al. The Engagement Interview Protocol (EIP): improving the acceptance of mental health treatment among Chinese immigrants. Int J Cult Ment Health. 2011;4(2):91–105.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Barrett JE, Dietrich AJ, Eisenberg L, et al. Depression management toolkit. The MacArthur initiative on depression and primary care. 2009. Available at
  15. 15.
    Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep. 2003;118(4):293–302.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    SPSS Inc. SPSS statistics for windows, version 17.0. Chicago: SPSS Inc.; 2008.Google Scholar
  17. 17.
    Neuendorf KA. The content analysis guidebook. Thousand Oaks: Sage Publications; 2002.Google Scholar
  18. 18.
    Ayanian JZ, Zaslavsky AM, Guadagnoli E, et al. Patients’ perceptions of quality of care for colorectal cancer by race, ethnicity, and language. J Clin Oncol. 2005;23(7):6576–86.PubMedCrossRefGoogle Scholar
  19. 19.
    Bartels SJ, Coakley EH, Zubritsky C, et al. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. Am J Psychiatry. 2004;161:1455–62.PubMedCrossRefGoogle Scholar
  20. 20.
    Gallo JJ, Zubritsky C, Maxwell J, et al. Primary care clinicians evaluate integrated and referral models of behavioral health care for older adults: results from a multisite effectiveness trial (PRISM-E). Ann Fam Med. 2004;2:305–9.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Bryan CJ, Morrow C, Appolonio KK. Impact of behavioral health consultant interventions on patient symptoms and functioning in an integrated family medicine clinic. J Clin Psychol. 2009;65:281–93.PubMedCrossRefGoogle Scholar
  22. 22.
    Flaskerud JH. The effects of culture-compatible intervention on the utilization of mental health services by minority clients. Community Ment Health J. 1986;22(2):127–41.PubMedCrossRefGoogle Scholar
  23. 23.
    Dwight-Johnson M, Lagomasino IT, Aisenberg E, et al. Using conjoint analysis to assess depression treatment preferences among low-income Latinos. Psychiatr Serv. 2004;55:934–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Griner D, Smith TB. Culturally adapted mental health intervention: a meta-analytic review. Psychotherapy (Chic). 2006;43(4):531–48.CrossRefGoogle Scholar
  25. 25.
    Sue S, Zane N, Nagayama Hall GC, et al. The case for cultural competency in psychotherapeutic interventions. Annu Rev Psychol. 2009;60:525–48.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Serrano N, Monden K. The effect of behavioral health consultation on the care of depression by primary care clinicians. WMJ. 2011;10(3):113–8.Google Scholar
  27. 27.
    Lewin SA, Dick J, Pond P, et al. Lay health workers in primary and community healthcare. Cochrane Database Syst Rev. 2005;(1):CD004015. Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Nhi-Ha T. Trinh
    • 1
    Email author
  • Patrick N. Hagan
    • 2
  • Katherine Flaherty
    • 3
  • Lara N. Traeger
    • 4
  • Aya Inamori
    • 1
  • Charlotte D. Brill
    • 1
  • Katherine Hails
    • 1
  • Trina E. Chang
    • 1
  • C. Andres Bedoya
    • 4
  • Maurizio Fava
    • 1
  • Albert Yeung
    • 1
  1. 1.Depression Clinical and Research ProgramMassachusetts General HospitalBostonUSA
  2. 2.Center for Community Health ImprovementMassachusetts General HospitalBostonUSA
  3. 3.Abt Associates, Inc.CambridgeUSA
  4. 4.Behavioral Medicine ServiceMassachusetts General HospitalBostonUSA

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