TY - JOUR
KW - Adult
KW - Community Mental Health Services
KW - Cultural Competency
KW - Cultural Diversity
KW - Depression/drug therapy/epidemiology/ethnology
KW - Ethnic Groups/psychology
KW - Female
KW - Humans
KW - Interview, Psychological
KW - Male
KW - Middle Aged
KW - Minority Health
KW - Physician-Patient Relations
KW - Primary Health Care/methods/standards
KW - Qualitative Research
KW - Refugees/psychology
KW - Tasmania
KW - Urban Population
KW - Victoria
AU - J. Furler
AU - R. Kokanovic
AU - C. Dowrick
AU - D. Newton
AU - J. Gunn
AU - C. May
A1 - 
AB - PURPOSE: Clinical care for depression in primary care negotiates a path between contrasting views of depression as a universal natural phenomenon and as a socially constructed category. This study explores the complexities of this work through a study of how family physicians experience working with different ethnic minority communities in recognizing, understanding, and caring for patients with depression. METHODS: We undertook an analysis of in-depth interviews with 8 family physicians who had extensive experience in depression care in 3 refugee patient groups in metropolitan Victoria and Tasmania, Australia. RESULTS: Although different cultural beliefs about depression were acknowledged, the physicians saw these beliefs as deeply rooted in the recent historical and social context of patients from these communities. Traumatic refugee experiences, dislocation, and isolation affected the whole of communities, as well as individuals. Physicians nevertheless often offered medication simply because of the impossibility of addressing structural issues. Interpreters were critical to the work of depression care, but their involvement highlighted that much of this clinical work lies beyond words. CONCLUSIONS: The family physicians perceived working across cultural differences, working with biomedical and social models of depression, and working at both community and individual levels, not as a barrier to providing high-quality depression care, but rather as a central element of that care. Negotiating the phenomenon rather than diagnosing depression may be an important way that family physicians continue to work with multiple, contested views of emotional distress. Future observational research could more clearly characterize and measure the process of negotiation and explore its effect on outcomes.
BT - Annals of family medicine
C5 - Healthcare Disparities
CP - 3
CY - United States
DO - 10.1370/afm.1091
IS - 3
JF - Annals of family medicine
N2 - PURPOSE: Clinical care for depression in primary care negotiates a path between contrasting views of depression as a universal natural phenomenon and as a socially constructed category. This study explores the complexities of this work through a study of how family physicians experience working with different ethnic minority communities in recognizing, understanding, and caring for patients with depression. METHODS: We undertook an analysis of in-depth interviews with 8 family physicians who had extensive experience in depression care in 3 refugee patient groups in metropolitan Victoria and Tasmania, Australia. RESULTS: Although different cultural beliefs about depression were acknowledged, the physicians saw these beliefs as deeply rooted in the recent historical and social context of patients from these communities. Traumatic refugee experiences, dislocation, and isolation affected the whole of communities, as well as individuals. Physicians nevertheless often offered medication simply because of the impossibility of addressing structural issues. Interpreters were critical to the work of depression care, but their involvement highlighted that much of this clinical work lies beyond words. CONCLUSIONS: The family physicians perceived working across cultural differences, working with biomedical and social models of depression, and working at both community and individual levels, not as a barrier to providing high-quality depression care, but rather as a central element of that care. Negotiating the phenomenon rather than diagnosing depression may be an important way that family physicians continue to work with multiple, contested views of emotional distress. Future observational research could more clearly characterize and measure the process of negotiation and explore its effect on outcomes.
PP - United States
PY - 2010
SN - 1544-1717; 1544-1709
SP - 231
EP - 236
EP - 
T1 - Managing depression among ethnic communities: A qualitative study
T2 - Annals of family medicine
TI - Managing depression among ethnic communities: A qualitative study
U1 - Healthcare Disparities
U2 - 20458106
U3 - 10.1370/afm.1091
VL - 8
VO - 1544-1717; 1544-1709
Y1 - 2010
ER -