Perspectives on task-shifting depression care to peers for depressed Latina mothers.


“Task shifting,” where tasks typically reserved for specialist providers are redistributed to trained nonspecialists (e.g., peers), has been an effective approach to increase access to quality health services in developing countries. Such an approach may be an effective method to address the treatment gap in the United States between mental health services received by Latina mothers and mothers who are non-Latina and White. This study explores perspectives of Latina women (n = 16) and local health care providers (n = 14) on a peer-delivered therapy model. A community-based research approach and qualitative methods were used, including focus groups and semistructured interviews. Themes were identified using a grounded theory and framework analysis approach. The findings indicate important barriers to care, including the fact that, among Latinas, depression is often viewed as a sign of weakness, isolation, or shame. Participants also indicated that mental health resources were insufficient, and other barriers to accessing services included language and lack of transportation. All participants reported a positive view of the concept of a peer-delivered model, yet concerns were also expressed regarding ensuring adequate supervision and confidentiality, as well as how to recruit and retain women in the program. Additional cultural considerations also were identified, including trust concerns, how to respond to histories of trauma, and the importance of biculturalism and a sense of community. These findings highlight the importance of a collaborative approach to build on key lessons and codevelop a peer model with Latina women to ensure effective cultural adaptation and sustainability. (PsycINFO Database Record (c) 2019 APA, all rights reserved)