Research has identified numerous mechanisms through which perceived social isolation and lack of social support negatively impact health. Little research attention has been dedicated to factors that influence the development of social networks, which have the potential to decrease perceptions of social isolation and provide social support. There is mixed evidence concerning the availability of supportive social networks for Latinos in the US. This study explores trauma-exposed Latina immigrants' experiences of social isolation in the US and its perceived causes. Twenty-eight Latina immigrant women participated in an interview about traumatic experiences. Informal help seeking and the availability of friendships in the US were also queried. Frequent comparisons between experiences in their home countries and in the US shaped the emerging themes of social isolation and lack of social support. Women reported feeling lonely, isolated, closed-in, and less free in the US due to family separation and various obstacles to developing and maintaining relationships. Socioeconomic, environmental, and psychosocial barriers were offered as explanations for their limited social networks in the US. Understanding experiences of social isolation as well as barriers to forging social networks can help inform the development of social support interventions that can contribute to improved health among Latinos.
Trauma has been understudied among Latina immigrants from Central and South America. This study examined the types and context of trauma exposure experienced by immigrant women from Central America, South America, and Mexico living in the United States. Twenty-eight women seeking care in primary care or social service settings completed life history interviews. The majority of the women reported some type of trauma exposure in their countries of origin, during immigration, and/or in the United States. In the interviews, we identified types of trauma important to the experience of these immigrants that are not queried by trauma assessments typically used in the United States. We also identified factors that are likely to amplify the impact of trauma exposure. The study highlights the importance of utilizing a contextualized approach when assessing trauma exposure among immigrant women.
Latinos in the United States (U.S.) experience disparities in the detection and treatment of mental disorders. Although previous research has found that Latinos prefer individual psychotherapy and treatment in a primary care setting for common trauma-related mental disorders (e.g., depression, posttraumatic stress disorder), reasons for these treatment preferences are not fully understood and preferences regarding other mental health treatment characteristics are not known. Using a mixed-methods approach, the current study sought to identify preferences for treatment modality, type of psychotherapy, type of provider, and setting, as well as the influences of logistical factors and potential barriers on the help-seeking behaviors of trauma-exposed Latina immigrants who met screening criteria for PTSD and/or depression and were receiving health care in a primary care clinic. Consistent with previous research, participants expressed a preference for individual therapy, particularly supportive psychotherapy and cognitive–behavioral therapy. Participants preferred receiving mental health care in a primary care clinic by a mental health specialist. Cost emerged as the most important logistical consideration when determining whether to seek services. Unfamiliarity with mental health services and confidentiality concerns, particularly regarding immigration status, were identified as additional barriers that may decrease the likelihood of seeking treatment for depression or PTSD. Providers will need to be creative in incorporating the treatment preferences of Latinos in cost-efficient interventions. Efforts to decrease the mental health disparities faced by the growing Latino population may include psychoeducation, hybrid treatments, and systems-level interventions to integrate mental health treatment into primary care settings.
Latinos in the United States face significant mental health disparities related to access to care, quality of care, and outcomes. Prior research suggests that Latinos prefer to receive care for common mental health problems (e.g., depression and anxiety disorders) in primary care settings, suggesting a need for evidence-based mental health services designed for delivery in these settings. This study sought to develop and preliminarily evaluate a mental health intervention for trauma-exposed Latina immigrants with depression and/or PTSD for primary care clinics that serve the uninsured. The intervention was designed to be simultaneously responsive to patients’ preferences for individual psychotherapy, to the needs of safety-net primary care clinics for efficient services, and to address the social isolation that is common to the Latina immigrant experience. Developed based on findings from the research team’s formative research, the resulting intervention incorporated individual and group sessions and combined evidence-based interventions to reduce depression and PTSD symptoms, increase group readiness, and improve perceived social support. Twenty-eight trauma-exposed low-income Latina immigrant women who screened positive for depression and/or PTSD participated in an open pilot trial of the intervention at a community primary care clinic. Results indicated that the intervention was feasible, acceptable, and safe. A randomized controlled trial of the intervention is warranted.
US Latinos are less likely to utilize mental health services than non-Latino Whites, and to take antidepressant medication. This mixed-method study followed a subset (N=28) of a research sample of depressed Latino immigrant primary care patients with a telephone interview to study their knowledge about and experiences with antidepressant medications. Most (82%) reported taking medication for two months or more, and 75% reported feeling better, while over half reported side effects. Most (61%) agreed that antidepressants are generally safe, and helpful in treating depression (68%); however, many believed they could be addictive (39%). Fifty percent of patients who discontinued their medication did not inform their providers. Twelve of the 28 patients also participated in focus groups about interactions with providers and made suggestions for conveying information about antidepressants. Patients suggested videos as a format to disseminate medication information since they do not require written comprehension. Other patient recommendations are presented.
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