Screening for Depression Among Minority

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Screening for Depression Among Minority Young Males Attending a Family Planning Clinic

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Ruth S. Buzi and Peggy B. Smith Baylor College of Medicine

Maxine L. Weinman University of Houston

The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression among 535 African American and Hispanic young males ages 14 to 27 attending a family planning clinic. The assessment indicated that 119 (22.2%) males met criteria for depression. The study also examined the associations between depression, sociodemographics, and service requests. Depressed males were more likely than nondepressed males to be Hispanic and to request services related to relationships, feelings, financial resources, physical issues, and well-being. The findings indicated that young males who are affected by depression have unmet needs, but when given an opportunity, are able to express those needs. Because family planning clinics are increasing the number of male clients, they are well positioned to screen them for depression.

Keywords: young males, depression, request for services

Major Depressive Disorder (MDD) is recognized as one of the most common chronic conditions today. According to the U.S. Department of Health and Human Services (2012), ap- proximately 2 million adolescents, or 8.0% of the population ages 12 to 17, had at least one major depressive episode during 2010. A recent report by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2012) indicates that one in five American adults aged 18 or older, or 45.6 million, people had mental illness in the past year. The rate of mental illness was twice as high among those 18 25 (29.8%) than among those aged 50 and older (14.3%).

Males experience more persistent depressive symptoms and disorders from adolescence into adulthood than females (Dunn & Goodyer, 2006; Colman, Wadsworth, Croudace, & Jones, 2007). Non-Hispanic African American males tend to have the highest rates of MDD at 13.2%, followed by Hispanics or Latinos (12.7%) and then non-Hispanic Whites (8.7%) U.S. Department of Health & Human Services, 2012). Depression among minority adolescents and young adults was found to be

related to stress, lack of social resources, and low socioeco- nomic status (Brown, Meadows, & Elder, 2007). Risk factors for African American mens depression include economic strain, interpersonal conflicts, and racial discrimination (Wat- kins, Green, Rivers, & Rowell, 2006). Hispanic and African American males also display significantly earlier onset of MDD compared with their White counterparts (Riolo, Nguyen, Gre- den, & King, 2005).

Despite the fact that males also suffer from depression, they seek mental help from health care professionals less frequently than females, which only further decreases the likelihood of diagnosing their mental health disorders (Addis & Mahalik, 2003; Smith, Braunack-Mayer, & Wittert, 2006). Males often feel pressured to avoid emotional expression, conceal weak- nesses and vulnerability, and solve problems without requesting the help of others (Rochlen, McKelley, & Pituch, 2006). That pressure to be masculine may explain why men more readily than women express anger and irritability when depressed (Winkler, Pjrek, & Kasper, 2005).

Previous studies have found a strong association between somatic symptoms and depression (Saluja et al., 2004; Haug, Mykletun, & Dahl, 2004). Research also has indicated males who experience physical symptoms of depression are more likely to seek medical attention (Ferrin, Gledhill, Kramer, & Garrada, 2009). The National Institute of Mental Health has reported males are not always aware of symptoms of depres- sion, which include physical issues such as headaches, stomach problems, and chronic pain (Harvard Medical School, 2011).

Family planning clinics provide access to reproductive health services to males. This can provide an opportunity to assess and address their mental health needs. However, research on mental health needs of males in these settings is scant. The purpose of

This article was published Online First February 18, 2013. Ruth S. Buzi and Peggy B. Smith, Population Program, Baylor College

of Medicine; Maxine L. Weinman, Graduate College of Social Work, University of Houston.

This project was funded in part by the Texas Department of State Health Services (TDSHS), the Office of Population Affairs/Office of Family Planning (OPA/OFP) Department of Health and Human Service, and the McGovern Foundation.

Correspondence concerning this article should be addressed to Ruth S. Buzi, LCSW, PhD, Associate Professor, Population Program, Baylor Col- lege of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail: [email protected]

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Psychology of Men & Masculinity 2013 American Psychological Association 2014, Vol. 15, No. 1, 116 119 1524-9220/14/$12.00 DOI: 10.1037/a0031574

116

 

 

this study was to assess depression among young males attend- ing a family planning clinic and whether depression varied by sociodemographics and service requests. This study can begin to fill the gaps and provide some useful information for future studies and interventions targeting this understudied popula- tion.

Method

Participants

The study included a convenience sample of 535 African American and Hispanic young males who attended a family planning clinic with designated hours for males ages 1325. The sample reflects the profile of clients receiving services at the clinic. The clinic is located in an inner-city neighborhood in a large city in the southwest United States. The clinic provides low-cost to free comprehensive family planning and reproduc- tive health services to indigent adolescents and young adults who reside in the inner city. Services provided include repro- ductive health screening related to puberty development, im- munization status, abuse history, mental health, substance abuse history, sexual health risk assessment, screening and treatment for a sexually transmitted disease (STD), and risk reduction counseling. Males come to the clinic mainly for STD testing and treatment. Informed consent was obtained before data col- lection. Parental consent for clinical services is solicited but not required from minors serviced at Title Xfunded clinics.

The study included 535 African American and Hispanic young males. Their mean age was 20.07, SD 2.64, range 14 27. Three hundred fifty-three (66.0%) were African Amer- ican, and 182 (34.0%) were Hispanic. The majority, 482 (92.2%), were single. One hundred sixty-five (31.0%) were fathers. Two hundred forty-three (46.6%) were in school, and 67.2% had graduated high school or were in college. A total of 196 (36.6%) young males were employed, and 124 (23.7%) had health insurance. Three hundred sixty-one (67.7%) reported they came for STD testing or treatment, and 247 (46.3%) reported they came for a check-up.

Procedure

Participants were recruited to the study during their visit to the family planning clinic on male designated days. Recruit- ment to the study took place only on the designated days for males. Males who came on other days were not recruited to the study. The sample reflects approximately 61% of the males seen during the study period at the clinics. A clinic staff member explained that the purpose of the study was to better understand the needs of young males who access family planning services. Informed consent was obtained before data were collected. To protect participants confidentiality, they completed the ques- tionnaires in a private room. The staff member was also avail- able to clarify answers to any questions. The Institutional Review Board of the affiliated institution approved the study.


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