Two in every five cancer patients will experience depression, which can worsen over the course of treatment and persist long after treatment ends. Oncologists often fail to treat or even recognize depression and its symptoms. Low-income cancer patients, and those with inadequate or no health insurance, are especially vulnerable because they lack access to mental health services.
In 2005, we conducted a pilot study at the Los Angeles County/USC Medical Center (LAC/USC) with 55 female Hispanics to see if a collaborative-care program for depression could work in public-sector oncology clinics that serve low-income Hispanic patients. (“Collaborative care” includes the involvement of mental health professionals in the primary care of patients.)
Our findings and their implications for dissemination to communities with Hispanic individuals facing cancer were significant. Though Hispanics are the largest ethnic minority group in the United States, there are very few quality-of-life studies among economically disadvantaged Hispanic cancer survivors, and this may be the first that explores their mental health needs in community-based healthcare setting.
The study’s success indicates that ADAPt-C and other collaborative-care models for depression treatment are likely to translate across the spectrum of cancer types, and also widely to those who are economically disadvantaged no matter their racial or ethnic group.
I would be delighted to speak more about the project and the lessons learned and hope you will share your thoughts and experiences with this and other interventions that seek to address the needs of cancer survivors.