Differences between ethnic and non ethnic-specific clinics for Portuguese-speaking mental health patients explained by providers

Abstract

Background: A previous quantitative study conducted in a health care system in a Northeastern U.S. metropolitan area identified greater adequacy of mental health care for Portuguese-speaking patients at a ethnic-specific Portuguese Mental Health Program (PMHP) compared to non ethnic-specific clinics. The objective of the present study was to understand, from a provider perspective, the disadvantages and difficulties of treating Portuguese-speaking immigrants with mental illness, and to elicit recommendations for improving care for this population. Methods: We conducted three interviews with providers using a structured interview guide that elicited questions related to the clinic, its patients, provider’s work, and ways in which the providers tailored mental health services to the Portuguese-speaking population. Responses were analyzed using content analysis, recording the frequency and saliency of particular words and phrases, and identifying keywords or repeated ideas. Results: Providers reported that the PMHP clinic is successful because it offers a unique set of services, provides services in the Portuguese language 100% of the time, and has existed for a long time in their community. Important differences between patients from Portugal and patients from Brazil include demographic characteristics, and patients’ and relatives’ feelings about seeking mental health treatment. Conclusion: This study supports policy recommendations to expand the availability of ethnic specific clinics. These clinics may play an especially important role in cost reduction and quality enhancement efforts being undertaken in urban safety net hospitals that serve a large number of individuals of racial/ethnic minority background.