Racial differences in the utilization of public mental health services in Washington State

Maynard, Charles; Ehreth, Jenifer; Cox, Gary B.; Peterson, Paul D.; McGann, Mary

doi:10.1007/bf02042723

Cited by 37 publications

(14 citation statements)

References 7 publications

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“…The literature points towards specific barriers endemic to individuals residing in low-income urban areas, such as high treatment costs, lack of insurance, limited time and competing priorities, loss of pay from missing work, inconvenient or inaccessible clinic locations, limited clinic hours, transportation problems, and child care difficulties (Armstrong, Ishiki, Heiman, Mundt & Womack, 1984; Maynard, Ehreth, Cox., Peterson & McGann, 1997). For those caregivers with significant economic difficulties, seeking treatment may be seen as an additional financial burden (Hall, 2001).…”

Section: Discussionmentioning

confidence: 99%

Caregiver Depression and Youth Disruptive Behavior Difficulties

Gopalan

Dean-Assael

Klingenstein

et al. 2010

Social Work in Mental Health

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This study examines the rates of depressive symptoms and service use among caregivers whose children receive treatment for disruptive behavior disorders. Descriptive analyses examined preliminary baseline data from the Family Groups for Urban Youth with Disruptive Behaviors study for 212 caregivers to determine rates of caregiver depressive symptoms and lifetime mental health service use. Findings indicate that caregivers manifest substantially higher rates of depressive symptoms compared to national norms. Of those caregivers with clinically significant depressive symptoms, less than half reported ever receiving mental health services. Findings suggest that greater attention should be paid to identifying and treating caregiver depression among children receiving treatment for disruptive behavior disorders.

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Section: Discussionmentioning

confidence: 99%

Caregiver Depression and Youth Disruptive Behavior Difficulties

Gopalan

Dean-Assael

Klingenstein

et al. 2010

Social Work in Mental Health

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“…Epidemiologic and qualitative studies (Armstrong et al 1984;Maynard et al 1997) have identified a number of practical barriers to service use by populations living on low incomes: cost; not being insured; limited time and competing priorities; loss of pay from missing work; inconvenient or inaccessible clinic locations; limited clinic hours; transportation problems; and child care difficulties. Psychological barriers to care may include the stigma of depression (Corrigan et al 2000), previous negative treatment experiences on the part of the woman with depression or members of her family and social network (McKay and Bannon 2004), and the burden of depression itself.…”

Section: Adding a Pre-treatment Engagement Session To Brief Iptmentioning

confidence: 99%

Enhancing Interpersonal Psychotherapy for Mothers and Expectant Mothers on Low Incomes: Adaptations and Additions

Grote

Swartz

Zuckoff

2007

J Contemp Psychother

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Intervening with depressed women during their childbearing years, especially with those on low incomes, is critically important. Not only do mothers and expectant mothers suffer unnecessarily, but their untreated depression has critical negative consequences for their families. Despite this, these women have proven especially difficult to engage in psychotherapy. In this paper we describe several adaptations and additions we have made to a brief form of Interpersonal Psychotherapy (IPT) to meet the needs of mothers and expectant mothers living on low incomes in the community who suffer from depression, but face significant practical, psychological, and cultural barriers to engaging in and staying in treatment. In addition, we present some preliminary data on the extent to which our enhanced, brief IPT approach promotes improvements in treatment engagement and retention relative to usual care for expectant mothers on low incomes.

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“…Potential patient barriers include: 1) practical barriers (e.g.,economic problems; lack of medical insurance, transportation, or childcare; competing priorities and limited time; inaccessible clinic locations); 20,21,22 2) cultural barriers (e.g.,clinician insensitivity to cultural values, preferred ways of coping, and beliefs about depression); 15,23,24 and 3) psychological barriers (e.g.,previous negative experiences with service use; 25 stigma of depression 26 ). Another barrier appears to be an avoidant or fearful attachment style, often resulting from exposure to childhood or domestic trauma 27,28 and characterized by strong self-reliance and/or distrust of others, potentially making it difficult to engagement in treatment.…”

Section: Introductionmentioning

confidence: 99%

Culturally relevant treatment services for perinatal depression in socio-economically disadvantaged women: The design of the MOMCare study

Grote

Katon

Lohr

et al. 2014

Contemporary Clinical Trials

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Background Depression during pregnancy has been demonstrated to be predictive of low birthweight, prematurity, and postpartum depression. These adverse outcomes potentially have lasting effects on maternal and child well-being. Socio-economically disadvantaged women are twice as likely as middle-class women to meet diagnostic criteria for antenatal major depression (MDD), but have proven difficult to engage and retain in treatment. Collaborative care treatment models for depression have not been evaluated for racially/ethnically diverse, pregnant women on Medicaid receiving care in a public health system. This paper describes the design, methodology, culturally relevant enhancements, and implementation of a randomized controlled trial of depression care management compared to public health Maternity Support Services(MSS). Methods Pregnant, public health patients, ≥18 years with a likely diagnosis of MDD or dysthymia, measured respectively by the Patient Health Questionnaire-9(PHQ-9) or the Mini-International Neuropsychiatric Interview(MINI), were randomized to the intervention or to public health MSS. The primary outcome was reduction in depression severity from baseline during pregnancy to 18-months post-baseline(one-year postpartum). Baseline Results 168 women with likely MDD (96.4%) and/or dysthymia (24.4%) were randomized. Average age was 27.6 years and gestational age was 22.4 weeks; 58.3% racial/ethnic minority; 71.4% unmarried; 22% no high school degree/GED; 65.3% unemployed; 42.1% making ≤$10,000 annually; 80.4% having recurrent depression; 64.6% PTSD, and 72% an unplanned pregnancy. Conclusions A collaborative care team, including a psychiatrist, psychologist, project manager, and 3 social workers, met weekly, collaborated with the patients' obstetrics providers, and monitored depression severity using an electronic tracking system. Potential sustainability of the intervention within a public health system requires further study.

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Racial differences in the utilization of public mental health services in Washington State

Cited by 37 publications

References 7 publications

Caregiver Depression and Youth Disruptive Behavior Difficulties

Caregiver Depression and Youth Disruptive Behavior Difficulties

Enhancing Interpersonal Psychotherapy for Mothers and Expectant Mothers on Low Incomes: Adaptations and Additions

Culturally relevant treatment services for perinatal depression in socio-economically disadvantaged women: The design of the MOMCare study

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