Navigating mental health care: latine perceptions, barriers, and pathways to engagement

Vollständiger Abstract

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Abstract Background Latine individuals in the U.S. experience similar or higher rates of depression compared to non-Hispanic Whites but remain less likely to receive timely or effective mental health care. While structural and cultural barriers have been well-documented, limited research has examined how Latine primary care patients conceptualize depression and depression care. This study explores the factors shaping engagement in mental health discussions and subsequent depression care among Latine primary care patients. Methods We conducted a qualitative study with semi-structured interviews of 10 Latine patients (13 interviews). Eligible participants included those who: (1) were ≥ 18 years old, (2) had received care in a primary care clinic in the 5 months prior to the first interview, (3) self-identified as Latine and spoke English or Spanish, and (4) had depressive symptoms (defined as a PHQ-2 score ≥3 and/or PHQ-9 (score ≥10)) or had a recent diagnosis of depression on their problem list or an ICD-10 code for depression (F32.0 - F33.3). Semi-structured interviews were conducted in English or Spanish and analyzed using consensual qualitative research methods. Follow-up interviews (N=3) were conducted after a year to explore longitudinal perspectives on engagement in depression care. Results In addition to structural barriers like limited language concordant care, four themes emerged from our data; 1) importance of trust in primary care physicians (PCPs) and creating a safe space for discussing mental health; (2) reliance on culturally informed coping strategies to promote mental health; (3) variable understanding of depression diagnosis impacts care; and (4) beliefs about the etiology of depression may influence willingness to engage in care. Conclusions Our findings show that trust, cultural values, and illness beliefs shape how Latine patients engage in mental health discussions and subsequent depression care. Interventions that validate patient perspectives, address language barriers, and build longitudinal trust may promote more equitable, culturally responsive depression care. These findings offer guidance for health systems and PCPs aiming to improve depression care engagement and outcomes among Latine populations.