University of Arizona
Tucson
Depression
Latino

Project

Patients receive psychiatric care through real-time video connection.

Psychiatrists provide treatment for depression through Internet videoconferencing (webcam) to patients at their primary care medical home. The focus is on providing culturally appropriate care from a specialist, even in locations that do not have easy access to those resources. Latino patients who meet diagnostic criteria for depression receive monthly psychiatric care through a webcam link for six months. The psychiatrists providing services are linguistically and culturally competent bilingual Mexican-Americans. The intervention takes place at St. Elizabeth’s Health Center in Tucson, Arizona which serves uninsured and underinsured patients.

Rationale

The traditional health care system is typically ill-equipped to deliver adequate specialty care to patients experiencing socioeconomic challenges or to patients with linguistic and cultural backgrounds that differ from the majority. Population-specific socioeconomic, linguistic and cultural factors require cultural competence and flexibility when providing mental health care. Furthermore, patients requiring specialist care often do not follow up with referrals to off-site mental health services. This project aims to bridge both the cultural gap as well as the physical distance between mental health specialists and Latino patients by providing culturally-appropriate depression care to patients in a familiar health care setting.

Summary Results

The culturally-adapted depression treatment delivered by psychiatrists via webcam was well received by Latino patients and received high patient buy-in as the result of the high degree of linguistic and cultural congruence in care. This intervention led to improvements in depression severity, functional ability, and quality of life that are at least equivalent and potentially superior to improvements achieved by usual treatment delivered by primary care providers. This is a feasible intervention.

Publications

Use of Standard Webcam and Internet Equipment for Telepsychiatry Treatment of Depression Among Underserved Hispanics
Psychiatric Services 2012. Online October 2012.
Full Article (subscription may be required)

Feasibility and acceptability of clinic-based telepsychiatry for low-income Hispanic primary care patients
Telemedicine and e-Health. 2012 May; 18(4): 297-304.
Full Article (subscription may be required)

Additional Resources

• Read a case study of the University of Arizona’s intervention (part of a U.S. HHS Policy Report on Health IT and Disparities):

Principal Investigators

• Francisco A. Moreno, MD
• Jenny Chong, PhD