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Engaging an Asian Immigrant Older Adult in Depression Care: Collaborative Care, Patient-Provider Communication and Ethnic Identity

      Highlights

      • What is the primary question addressed by this study? How can clinicians increase access and engage Asian older adults in mental health treatment and services?
      • What is the main finding of this study? An Asian older adult who faced barriers to obtaining depression care, had unique needs in terms of language and experienced a complicated social context used mental health services in primary care that used a patient-oriented, collaborative approach. During the care process, the interdisciplinary team was able to understand and navigate the complexity of physician-patient communication and patient ethnic identity with reduction of depression and provision of important social resources to the patient.
      • What is the meaning of the finding? Asian immigrant older adults can access and engage in mental health services, and specific models of depression care as well as use of strategies to understand and address the unique needs of the Asian patient may contribute to successfully serving this underserved group.

      Abstract

      Minority older adults face multiple barriers when trying to access mental health services and often present with more severe symptoms of mental health conditions. We describe the multilevel factors that contributed to the engagement of an Asian immigrant older adult with depression. Systems-level innovations such as collaborative care in primary care can increase access to care for all, including minority older adults; however, one size fits all interventions may not meet the needs of communities of older adults with different life experiences, language needs, norms and values regarding help-seeking for mental health. Health outcomes remain unequal , suggesting the need to tailor interventions for minority older adults. For the patient, specific factors related to language and ethnic concordance between patient and healthcare provider, communication behaviors, ethnic identity, and social norms may be important to take into account. The recognition of the heterogeneity of patients and the limitations of cultural competence approaches defined as broad, general knowledge about ethnic cultures may be needed. A need to learn continuously from clinical experience and adopt a patient-oriented model of communication and decision-making may successfully engage Asian immigrant older adults in depression care services.

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