A community–academic partnership develops a more responsive model to providing depression care to disadvantaged adults in the US

• Published in: International journal of social psychiatry 2012-05, Vol.58 (3), p.295-305
• Main Authors: Dobransky-Fasiska, Deborah, Nowalk, Mary Patricia, Cruz, Mario, McMurray, Michelle L., Castillo, Enrico, Begley, Amy E., Pyle, Pamala, Pincus, Harold Alan, Reynolds, Charles F., Brown, Charlotte
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Community-Institutional Relations; Depression; Depression - drug therapy; Female; Focus Groups; Health Care Surveys; Health insurance; Health Services Accessibility - organization & administration; Homeless people; Housing; Humans; Interviews as Topic; Low income groups; Male; Mental depression; Mental health; Middle Aged; Models, Organizational; Partnerships; Poverty; Social psychiatry; Social support; U.S.A; Uninsured people; United States; Universities; Unmet needs
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/0020764010396406

Background: Socioeconomically disadvantaged adults experience greater healthcare disparities and increased risk of depression compared to higher-income groups. Aim: To create a depression care model for disadvantaged adults utilizing service agencies, through a community–academic partnership. Methods: Using participatory research methods, an organizational needs assessment was performed to ascertain depression care needs, identify barriers to clients receiving treatment, and marshal resources. Interviews and surveys were conducted with community organizational leaders. Focus groups were conducted with clients who used the service agencies. Results: Interviews and surveys identified barriers including discontinuity of care and unmet basic needs for food, housing, health insurance and transportation. Focus groups enriched the understanding of barriers including lack of motivation to seek depression care, lack of social support and needed resources for the uninsured, underinsured and homeless. The findings were used to develop a depression care model combining depression management with motivational interviewing to evaluate and meet needs, and peer education to motivate and provide support. Conclusions: This partnership facilitated the development of a community-driven intervention that academic researchers acting alone could not realize. To provide depression care to socioeconomically disadvantaged individuals, the intervention must include mitigating solutions to barriers.