Frequency of Depression Screening and Follow-Up Actions Among English Language Preference and Non-English Language...

IntroductionDepression is a common mental health disorder in the United States and associated with increased morbidity, mortality, and health care costs. We assessed the association between language preferences on the frequency of depression screenings and follow-up actions within a primary care setting.MethodsThis was a retrospective cohort study of adult patients at a Federally Qualified Health Center in 2019. Our exposure was patient preference to use a non-English language. Our primary outcome was a completed annual depression screening. We also assessed follow-up actions after a positive depression screen. We used multivariable logistic regression to predict the odds of having a depression screening while adjusting for age, sex, race and ethnicity.ResultsAmong 10,187 patient encounters, 4,049 (39.8%) received depression screening. English-preference patients were significantly more likely to complete screenings compared to non-English-preference speakers (adjusted odds ratio (aOR) 2.25; 95% Confidence Interval (CI) 1.80-2.81). Compared to white patients, Black patients were less likely to complete a depression screening (aOR 0.74; 95% CI 0.63-0.88). Follow-up actions were documented in 31.3% of patients with English language preference and 23.5% of non-English language preference.ConclusionsPatients with English language preference were more likely to complete a depression screening and receive follow-up actions following a positive screen compared to those with non-English language preference. System-level interventions to improve equitable screening and follow-up are necessary in primary care. Collaborative care models, bilingual providers, and culturally tailored care may help reduce these disparities.