ORCID Identifier(s)

0000-0001-5358-2962

Graduation Semester and Year

2020

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Social Work

Department

Social Work

First Advisor

Katherine Sanchez

Abstract

Disparities in the underutilization of mental health services remain prominent among Hispanics in the United States. While integrated health care models can contribute to the elimination of mental health care disparities experienced by Hispanics, more research on how patient-level factors impact engagement and retention within these models is needed. The current study was a secondary data analysis informed by an integrative framework based on Andersen’s Behavioral Model of Health Service Use (1968) to examine what factors are associated with Hispanics’ depression treatment engagement and retention in an integrated health care intervention that took place in a community clinic. Utilizing a convergent mixed methods design, quantitative (N = 150) and qualitative (n = 22) data were collected and analyzed separately with a merging of results to provide a more in-depth and holistic understanding of treatment participation with the Depression Care Manager (DCM) among study participants. Participants were highly engaged in treatment with an average number of sessions of 11.90 (SD = 6.97) and 76% completing treatment. Results of the quantitative analysis demonstrated that greater mental health literacy and having a comorbid physical health condition were associated with a higher number of sessions with the DCM. Qualitative results revealed several themes related to treatment engagement (recognizing the need for treatment, perceptions of depression, and treatment, values, and access) and retention (satisfaction with treatment, support systems, and barriers to treatment). Taken together, these results highlight the importance of screening patients for depression, educating patients throughout treatment, and providing culturally and linguistically competent services to improve access and satisfaction with treatment. Future research should continue to examine patient level-factors and experiences to understand how integrated health care models can be developed and implemented to address barriers to care, leading to increased participation, improved outcomes, and the elimination of mental health disparities experienced by Hispanics.

Keywords

Depression, Hispanics, Integrated Health care, Treatment engagement

Disciplines

Social and Behavioral Sciences | Social Work

Comments

Degree granted by The University of Texas at Arlington

Included in

Social Work Commons

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