Public Release: 

Reducing mental health disparities among Hispanic populations

UTA Researcher uses fotonovela approach

University of Texas at Arlington


IMAGE: Dr. Katherine Sanchez is an assistant professor in the UTA School of Social Work. view more

Credit: UT Arlington

ARLINGTON, Texas -- Hispanics are just as likely to struggle with depression as any other group - but more likely to let cultural concerns, social stigma and other fears keep them from seeking mental health care.

Additionally, Hispanics identify many barriers to treatment for depression including lack of insurance, costs of treatment and medications, lack of Spanish-speaking staff and concerns about immigration status.

A University of Texas at Arlington social work researcher is taking a fotonovela, a popular comic-book style education tool that uses culturally sensitive images, to overcome the barriers to treatment and encourage Hispanic patients to seek care.

Katherine Sanchez, an assistant professor in the School of Social Work, recently won a nearly $400,000 three-year research grant from the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities (NIMHD) Academic Research Enhancement Awards (AREA) program for her proposal, "METRIC: Measurement, Education and Tracking in Integrated Care: Strategies to Increase Patient Engagement and Reduce Mental Health Disparities among Hispanics." She hopes to reduce mental health disparities among Hispanics through integrated health care and culturally adapted depression education.

"We know from over 20 years of research that integrated health care is an effective model for the treatment of depression," said Sanchez, who won a $200,000 grant from the Centers for Medicare and Medicaid last year to screen Hispanic patients for depression and educate them about the disease and treatment options available.

"My hope is that METRIC will advance the scientific knowledge about integrated health care to reduce disparities in the treatment of depression for Hispanic patients by increasing knowledge of the disorder, its causes, symptoms and its role in chronic disease."

It is estimated that the lifetime prevalence of a psychiatric disorder for Hispanics residing in the United States is 28.1 percent for men and 30.2 percent for women. Hispanics have a higher prevalence of diabetes but also have double the risk of comorbid depression than the general population, with rates as high as 33 percent. Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication and low use of anti-depressant medications.

"Common concerns among Hispanics also include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and fear of what other people in their home and social environments might say. The fotonovela will help allay fears of engaging in treatment."

Sanchez said that by participating in an integrated health care treatment model and testing the fotonovela, it is expected that patients will have time to understand treatment options, participate in shared decision making with their provider about treatment, and increase engagement in treatment of depression, which will lead to improved overall health.

Sanchez will implement her project with nationally recognized collaborators, Drs. Madhukar Trivedi and Leopoldo J. Cabassa. Dr. Trivedi is a world-renowned depression researcher and director of the Comprehensive Center for Depression at UT Southwestern Medical Center.

"The University of Texas at Arlington research environment will be strengthened, and its undergraduate student population will no doubt benefit from exposure to the Latino mental health disparities research that Dr. Sanchez pursues so passionately," Trivedi said.

"Most importantly, her dedication to the cause of enhancing education and reducing health disparities is sorely needed to serve the rapidly expanding Latino population in Texas and around the country. This NIH-funded grant will also provide an invaluable opportunity for research participation in the UT Arlington community."

One of the fotonovela developers, Dr. Cabassa, is an associate professor at the Columbia School of Social Work and assistant director of the New York State Center of Excellence for Cultural Competence at the New York State Psychiatric Institute. He also is a mental health disparities researcher with expertise in Hispanics and other racial and ethnic minorities with serious mental illness, implementation science, and mental health literacy tools for the Latino community.

"It is a great honor to be collaborating with Drs. Sanchez and Trivedi in this innovative project. METRIC will enable us to advance the science of our depression fotonovela by testing the impact of this culturally-adapted mental health literacy tool in reducing disparities in depression care in the Hispanic community," Cabassa said. "This project will provide us a unique opportunity to examine the impact of our depression fotonovela in reducing stigma, improving depression treatment knowledge, and helping Latinos access depression care."


The NIH R15 (AREA) program supports research in educational institutions that provide baccalaureate or advanced degrees for a significant number of the nation's research scientists but are not major recipients of NIH support. This initiative is intended to enable qualified scientists at eligible institutions to receive support for research projects that align with the mission and scientific interests of the NIMHD.

About UT Arlington

The University of Texas at Arlington is a comprehensive research institution of more than 51,000 students in campus-based and online degree programs and is the second largest institution in The University of Texas System. The Chronicle of Higher Education ranked UT Arlington as one of the 20 fastest-growing public research universities in the nation in 2014. U.S. News & World Report ranks UT Arlington fifth in the nation for undergraduate diversity. The University is a Hispanic-Serving Institution and is ranked as a "Best for Vets" college by Military Times magazine. Visit to learn more, and find UT Arlington rankings and recognition at

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