Center Happenings - December 2014
CMMHR Researchers Author Report on Behavioral Health Disparities in Massachusetts
Center Director Dr. Margarita Alegria, along with co-authors Dr. Benjamin Cook, Stephen Loder and Dr. Michael Doonan, released a report this month entitled The Time is Now: Tackling Racial and Ethnic Disparities in Mental and Behavioral Health Services in Massachusetts. Drs. Alegria and Cook presented the results of their analysis at the Massachusetts Health Policy Forum in Boston on Thursday, December 11.
One of the most striking findings included in the report is that Latinos in Massachusetts are much less likely to access behavioral health care than whites. Among Latino adults with mental illness in Massachusetts, only 29.2% received treatment compared to 51.5% of whites. The authors also found that among Massachusetts high school students, Hispanic and Native American youth were significantly more likely than whites to report feelings of sadness and hopelessness, suicidal ideation and suicide attempts. In contrast, higher rates of drug and alcohol use were reported among white youth and adults.
In her presentation, Dr. Alegria speculated that large disparities for Latinos may reflect difficulty in accessing care for undocumented immigrants and the challenge of finding Spanish-speaking behavioral health providers. Solutions recommended in the report include increasing Medicaid payments for behavioral health services, expanding provision of services regardless of documentation status or ability to pay and focusing resources on community-based research and prevention programs.
The report was commissioned by the Massachusetts Health Policy Forum with support from the Blue Cross Blue Shield of MA Foundation and the Harvard Pilgrim Health Care Foundation. A PDF of the full document can be found here.
News coverage of the report:
The results of the Center's Engagement and Counseling for Latinos (ECLA) clinical trial are now published in Medical Care.
The Engagement and Counseling for Latinos (ECLA) Intervention was tested in Boston, MA and San Juan, PR in 8 community health clinics serving the Latino population. This 6–8 session cognitive behavioral therapy and care management intervention was offered both in person and by phone to Latino patients recruited from primary care, and compared to usual care for depression. Both telephone and face-to-face versions of the intervention were found to be more effective than usual care. The intervention appears to help Latino patients reduce depressive symptoms and improve functioning. The higher treatment initiation for the telephone versus face-to-face intervention (89.7% vs. 78.8%) suggests that telephone-based care may improve access and quality of care. This study was funded by the National Institute on Minority Health and Health Disparities (NIMHD), as part of its Comparative Effectiveness Research for Eliminating Disparities (CERED) projects.
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Current CMMHR Projects:
- EXPORT II - UPR/CHA Research Center
- Effects of Social Context, Culture and Minority Status on Depression and Anxiety
- International Latino Research Partnership
- PCORI: Effectiveness of DECIDE in Patient-Provider Communication, Therapeutic Alliance & Care Continuation
- Building Community Capacity for Disability Prevention for Minority Elders
- Understanding Mechanisms of Mental Health Care Disparities
- RWJF Mentoring and Training