Incorporating Community Groups into Depression Care Can Improve Coping among Low-Income Patients

Improving care for depression in low-income communities — places where such help is frequently unavailable or hard to find — provides greater benefits to those in need when community groups such as churches and even barber shops help lead the planning process, according to a study published online by the Journal of General Internal Medicine.

When compared to efforts that provided only technical support to improve depression care, a planning effort co-led by community members from diverse services programs further improved clients’ mental health, increased physical activity, lowered their risk of becoming homeless and decreased hospitalizations for behavioral problems.

Researchers say the findings demonstrate that incorporating an array of community groups in planning efforts to treat depression, and then providing trainings to address depression jointly across health care and community agencies, can provide a more-complete support system and help depressed people make broader improvements in health and social outcomes.

The study team, including researchers and community leaders, worked together for a decade to determine how to address depression in communities with few resources. The latest project compared two models.

One approach involved providing technical support and culturally-sensitive outreach to individual programs, including health, mental health, substance abuse and an array of other community programs. The second was a community engagement approach. In this effort, programs across the same broad array of health, mental health, substance abuse and other community programs worked together with shared authority to make decisions and collaborate as a network in providing depression services.

The study took place in South Los Angeles and Hollywood-Metropolitan Los Angeles, and involved nearly 100 programs across the range of primary care, mental health, substance abuse and social services providers. Participating programs included those who provide homeless services, prisoner re-entry help, family preservation programs, and faith-based and other community-based programs like senior centers, barber shops and exercise clubs. All programs were randomly assigned to one of the two approaches (technical assistance or community engagement), but only in the community engagement approach did agencies work together to decide how best to provide training for providers and collaborate to deliver depression services.

Population of focus: People enrolled in the study were primarily African American and Latino, most had earnings below the federal poverty level, and nearly half were both uninsured and at high risk for becoming homeless. The majority also had multiple chronic medical conditions, while many had multiple psychiatric conditions and substance abuse problems.

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Date: 2013

Organization: RAND Corporation and University of California Los Angeles