Navigating mental health care: latine perceptions, barriers, and pathways to engagement

Background: Latine individuals in the U.S. experience similar or higher rates of depression compared to non-Hispanic Whites but remain less likely to receive timely or effective mental health care. While structural and cultural barriers have been well-documented, limited research has examined how Latine primary care patients conceptualize depression and depression care. This study explores the factors shaping engagement in depression care among Latine patients. Methods: We conducted a qualitative study of 10 Latine patients (13 interviews). Eligible participants included those who: (1) were ≥ 18 years old, (2) had received care in a primary care clinic between November 1, 2019 and March 31, 2020, (3) self-identified as Latine and spoke English or Spanish, and (4) had depressive symptoms (defined as a PHQ-2 score ≥3) and/or PHQ-9 (score ≥10) or had a diagnosis of depression on their problem list or an ICD-10 code for depression (F32.0 - F33.3) between November 1, 2019 to December 31, 2020. Semi-structured interviews were conducted in English or Spanish and analyzed using consensual qualitative research methods. Results: In addition to structural barriers like limited language concordant care, four themes emerged from our data; 1) importance of trust in primary care physicians (PCPs) and creating a safe space for discussing mental health; (2) reliance on culturally informed coping strategies to manage depressive symptoms; (3) variable understanding of depression diagnosis impacts care; and (4) beliefs about the etiology of depression may influence willingness to engage in care. Conclusions: Our findings show that trust, cultural values, and illness beliefs shape how Latine patients engage in depression care. Interventions that validate patient perspectives, address language barriers, and build longitudinal trust may promote more equitable, culturally responsive depression care. These findings offer guidance for health systems and PCPs aiming to improve depression care engagement and outcomes among Latine populations.