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Bioscience-Medicine

$10 Million Dollars Will Fund New Mental Health Effort In Texas

The Dallas-based Meadows Mental Health Policy Institute was recently awarded $10 million dollars as part of the Lone Star Prize, a competition aimed at improving the lives of Texans.

The money will help the institute implement what's known as The Lone Star Depression Challenge, which focuses on early detection and treatment of depression in primary care.

Interview highlights were lightly edited for clarity.

INTERVIEW HIGHLIGHTS

On How The Award Will Be Used:

We've partnered for the last several years with the University of Texas Southwestern Medical Center for Depression Research and Clinical Care.

The CDRC is our main partner on this. And we've been working through a project called Cloudbreak with health systems in North Texas to help them implement screening and detection so that they find people who have depression sooner.

So if we can begin to treat depression within months of its emergence, as opposed to right now waiting eight to 10 years, then it's going to be much easier to treat folks and help folks.

On The Reasons Behind Poor Mental Health Care In Texas:

Right now only about 6% of people with depression get adequate care. One of the roadblocks is that we don't detect, we don't ask people. So, people go into their primary care doctor, less than 50% of them are found to have depression when they have depression when they go into their primary care doctor.

First we have to get the detection in place and that takes some effort. I mean, you have to rework the electronic health record, the workflows, the protocols. It's actually not hard at all to do the detection. We can detect it with 90% accuracy. The issue is just reworking the workflow.

The second thing is that we lose another 50% of people when we expect them to go to a second appointment, to go find a specialist. First of all, it's very hard to find a specialist. A lot of times the specialists in our networks actually aren't in our networks. There's these ghost networks that a lot of us have where we have to call 10, 12 psychologists, therapists, before we find somebody.

So the second barrier is put the clinician in the office. Most depression can be treated in a primary care office with the right supports. I mean the primary care doc doesn't have time, but if you put someone else in there to help them, then you're going to get those outcomes.

On People Of Color Receiving Adequate Care:

Well, fortunately, the research-based approach we're using — collaborative care — has been highly researched by people of color. And what we've found is it's more effective than other means for Black participants, as well as Latino participants, as well as older adults.

One of the big reasons for that, there's several reasons. One is a lot of people of color, particularly the Latino community, the Asian community; we see a much of a preference for integrated care.

There's a belief that mental health is holistic — it's part of the rest of your health. So the idea going to see some separate person for the therapy, for the mental health part, actually is an attitudinal barrier because folks believe they should have it treated at the regular doctor, if you will.

Stigma also gets in the way of folks. Also, we know that many people of color are at higher risk for being in poverty.

And if you're in poverty, or if you have a job where you don't have great benefits, and you can't take time off work, it is super hard to get to the doctor. And if you get there once, we better do as much for you as we can, because to get you get there a second time or a third time, it's going to be pretty difficult.

So, this collaborative care model where we put the care right there in the primary care office has really been shown to work really well for Black and Latino participants, as well as white participants.

I think the second thing is, we can't do only that because we know that there's health care deserts. We know that there's mistrust of health systems for good reasons that communities have experienced. And so we need to put community health workers in place who represent, who are from the communities we're trying to reach out to and who can help build trust. We've done that with veterans. We've done that with first responders. We've done that with communities of color.

So we just need to scale those interventions up and empower those folks with the tools they need to help people access care.

Got a tip? Email Justin Martin at Jmartin@kera.org. You can follow Justin on Twitter @MisterJMart.

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