Depression and Access to Treatment Among U.S. Hispanics: Review of the Literature and Recommendations for Policy and Research

Ethnic and racial diversity in the United States increases daily through immigration and population shifts, and multiculturalism in the mental health field has had a difficult time keeping pace. Delivery of adequate mental health care to Hispanics, now the largest and fastest-growing ethnic minority, has been plagued by low utilization rates and inadequate or delayed mental health services. Among the issues compounding the problem are the diversity that exists within the Hispanic population, the varied ways that symptoms are experienced and expressed, and the unique sets of risk factors and barriers facing U.S. Hispanic groups. This review provides an epidemiologic overview of the mental health status of the three largest U.S. Hispanic subgroups, with particular attention to diagnosis and treatment of major depressive disorder. Also discussed is the gap between the need for and the delivery of services, which is characterized in terms of problems with access to care, utilization of mental health services, and quality of care. Mental health research on Hispanic populations is relatively sparse. The data summarized here suggest that although response to antidepressant treatment is comparable between Hispanics and the general population, treatment compliance appears to be an area of concern. Research needs and other efforts to improve mental health care and treatment outcomes in Hispanics are addressed.