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Latino patients differ in expectations of depression treatment based on primary language

Researchers found that English-speaking Latino patients were four times less likely to attend a referral visit for treatment of depression than Spanish-speaking patients if they were personally introduced to a behavioral health provider rather than receiving a prescribed referral, according to a recent study.

“Qualitative findings from this study suggest that English and Spanish speakers may have different expectations of treatment; thus tailoring a warm handoff to an individual patient is critical,” Elizabeth Horevitz, LCSW, PhD, of the University of California, San Francisco, and colleagues wrote in their study.

Horevitz and colleagues retrospectively reviewed the medical records of 431 patients who were referred to integrated behavioral health centers for depression treatment. The researchers analyzed whether the patient was given a warm handoff (a personal introduction to a behavioral health center colleague by either the primary care physician or a medical assistant) or a prescribed referral. They also conducted interviews with 16 of the 431 patients to ask them what influenced their decision to follow through with a referral.

The results showed that there was no one factor that determined whether a patient would follow through with a referral. There was no significant association with follow through based on referral type, primary language, gender or racial-ethnic match between primary care providers and patients or matches between behavioral health providers and patients. However, Horevitz and colleagues found that warm handoffs made English-speaking patients four times less likely to follow through with a visit to a behavior health provider (OR = .57; 95% CI, .29-11.98) compared with Spanish-speaking patients (OR = 3.93; 95% CI, 1.29-11.98).

The researchers also noted that, due to the lack of reimbursement for warm handoffs and the fast-paced nature of primary care, the task might be handed to lower cost medical staff.

“Although the warm handoff has been touted as a best practice of integrated care, this study highlights a gap between ideal and real-world implementation of the practice,” Horevitz and colleagues wrote. “Given that a majority of interview participants did not receive a warm handoff and that many of those who received a warm handoff found it confusing, more research is needed to identify specific elements of the warm handoff that help engage patients in care, particularly among patients with varying levels of acculturation.” – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.