Learning Objective #1: compare perceptions of mental health problems and barriers to obtaining mental health care between clients and primary care providers in primary care settings.

Learning Objective #2: identify predictors of mental health service utilization by clients if offered in primary care settings.

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Abstract
 
Purpose : This study aimed to provide baseline data for implementing mental health-primary care integrative services that are accessible and culturally acceptable to Mexican-American clientele in a border city in southwest Texas.

Method :  Study participants were clients and health care providers  in primary care clinics serving predominantly low-income Mexican-American clientele. Interview-questionnaires  were used with  400 Mexican-American clients  regarding  their  perceptions of mental health problems and care;  intentions  and barriers to utilizing  mental health services in primary care settings; and suggestions for making mental health care more accessible and acceptable. Focus groups with 45 Mexican-Americans provided additional data.

Twenty one primary care providers ( 50% Hispanic) returned  mailed questionnaires on their perceptions of mental health problems and care; training  needs; barriers to  using standardized mental health screening tools ; and suggestions for  making mental health care accessible and acceptable in these settings. 

Andersen’s Model of Health Service Use guided the conduct of the study.

Data were analyzed quantitatively and qualitatively.

Results :  Both clients and  primary care providers had similar perceptions of mental health problems and care especially on the need to seek professional help for mental health problems;   97%  of clients
were likely to use mental health services in primary care settings. Regression analysis showed that education and satisfaction with primary care services are major predictors of potential mental health service utilization. Majority (90%) of primary care providers favored using mental health assessment tools in primary care practice and  95 % favored the idea of integrated mental health-primary care services. Both types of  participants underscored cultural factors in making mental health care more accessible and culturally acceptable in primary care settings.

Conclusion: This study raised pertinent implications on health policies for preventive mental health service delivery in primary care settings.
 
 
* Acknowledgement:  R03MH59861-01