Professor Cabassa’s Culturally Sensitive “Fotonovela” to Be Tested in Innovative NIH Study

Hispanics are just as likely to struggle with depression as any other group—but more likely to let cultural concerns, social stigma and other fears keep them from seeking mental health care.

Additionally, Hispanics identify many barriers to treatment for depression including lack of insurance, costs of treatment and medications, lack of Spanish-speaking staff and concerns about immigration status.

Some time ago, Associate Professor Leopoldo Cabassa participated in developing a health-education fotonovela—a comic-book style pamplet that is popular in Hispanic and Latino culture, including in health care settings. And now this fotonovela will play a central role within an innovative research project called “METRIC: Measurement, Education and Tracking in Integrated Care: Strategies to Increase Patient Engagement and Reduce Mental Health Disparities among Hispanics,” in which Dr. Cabassa is taking part, with funding from the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities (NIMHD).

Dr. Cabassa is collaborating with two other researchers—Drs. Katherine Sanchez of the University of Texas at Arlington’s School of Social Work and Madhukar Trivedi, a world-renowned depression researcher, medical doctor, and director of the Comprehensive Center for Depression at UT Southwestern Medical Center. They will be testing an integrated health care treatment model in which test patients will receive the fotonovela.

“It is a great honor to be collaborating with Drs. Sanchez and Trivedi in this innovative project,” Dr. Cabassa said. “METRIC will enable us to advance the science of our depression fotonovela by measuring the impact of this culturally-adapted mental health literacy tool in reducing disparities in depression care in the Hispanic community. It will provide a unique opportunity to examine to what extent the depression fotonovela helps in reducing stigma, improving depression treatment knowledge, and helping Latinos access depression care.”

It is estimated that the lifetime prevalence of a psychiatric disorder for Hispanics residing in the United States is 28.1 percent for men and 30.2 percent for women. Hispanics have a higher prevalence of diabetes but also have double the risk of comorbid depression than the general population, with rates as high as 33 percent. Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication and low use of anti-depressant medications.

Dr. Sanchez will serve as the lead researcher on the project, the grant for which is part of the NIH R15 (AREA) program, which supports research in educational institutions that provide baccalaureate or advanced degrees for a significant number of the nation’s research scientists but are not major recipients of NIH support. She said she was excited about using the fotonovela in the research. “Common concerns among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and fear of what other people in their home and social environments might say,” she said. “The fotonovela will help allay fears of engaging in treatment.”

Image: Cover of Professor Cabassa’s fotonovela (supplied); Professor Leopoldo Cabassa, by Masao Katagami.