Depressed people in lower-income communities — areas where help is frequently unavailable or hard to find — benefit when community groups such as churches and even barber shops lend support, according to a new study from the RAND Corporation.
The study was conducted in two large, under-resourced areas of Los Angeles and included researchers from the RAND Corporation and UCLA, and community partners from Healthy African American Families, QueensCare Health and Faith Partnership, and Behavioral Health Services.
Researchers found that community-led support helped improve clients’ mental health, increased their physical activity, lowered their risk of becoming homeless and decreased hospitalizations for behavioral problems, as opposed to strictly technological efforts to assuage depression.
Depression is one of the world’s leading causes of impairment and affects 15 to 20 percent of people from all cultural groups at some point in their lives, and has been characterized as a “silent monster” in the low-income neighborhoods studied. Evidence-based treatments for depression, such as antidepressants or therapy, are generally not available in these neighborhoods because of poor access to services and other obstacles such as stigma or cost.
The study team worked together for a decade to determine how to address depression in communities with few resources. This 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 approach involved community engagement, in which 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.
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.
The community engagement approach increased support for depressed clients in nontraditional settings, with gains in quality of life and social outcomes like homelessness risk factors, in contrast to traditional depression improvement programs affecting use of depression treatments and symptoms.
There are few studies showing that community engagement and planning can improve health more than traditional training approaches; this is one of the largest and most rigorous studies of that issue in the field of mental health, researchers state.
Source: RAND Corporation , June 25, 2013
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