Abstract
Depression is a disorder which affects many youth, and only one third of adolescents receive mental health treatment for their depression. Yet, approximately 90% of adolescents visit their primary care providers on average 2 - 3 times per year. This number suggests the important role that primary care settings can play regarding the early diagnosis and treatment of depression during adolescence. This paper presents findings of clinically significant depressive symptoms in African American male adolescents receiving routine health care services within an adolescent reproductive health clinic. The adolescent reproductive health clinic is housed within a large urban, university-affiliated teaching hospital. 49 African American male adolescents (ages 13 to 19) completed the Center for Epidemiologic Studies Depression Scale (CES-D) (Radloff, 1977), a brief depression screening questionnaire, as a part of their clinic visit. Results revealed higher rates of depressive symptoms in this subsample of African American male adolescents when compared to estimated prevalence rates of depression for adolescents as reported by large-scale studies and meta-analysis data. This supports the notion that primary and reproductive healthcare settings are viable settings for the identification of depressive symptoms, particularly among low-income, African American male adolescents. Risk factors, symptom presentation, and mental health stigma associated with this population are discussed. Psychosocial interventions and recommendations for the integration of primary healthcare and behavioral health consultation services are presented.
Highlights
IntroductionFemale adolescents have a 2 to 3 times higher prevalence rate of major depressive episode (12% - 13%), whereas the prevalence rate of major depressive episode for male adolescents is approximately 4% to 6% (Substance Abuse and Mental Health Services Administration Office of Applied Studies, 2008)
Depression in children and adolescents was scarcely recognized in the empirical literature until the 1970s (Angold, Worthmon, & Costello, 2003), but has become a major public health concern (Cote et al, 2003) due in part to large-scale studies reporting that up to 3% of children and 8% of adolescents suffer from depression (US Department of Health and Human Services, 2001)
The reported rates of depressive symptoms within the overall sample and subsample of African American male adolescents in the present study are higher than the estimated prevalence rates of depression reported for adolescents ages 13 - 18 (5% - 15%) (Costello et al, 2006)
Summary
Female adolescents have a 2 to 3 times higher prevalence rate of major depressive episode (12% - 13%), whereas the prevalence rate of major depressive episode for male adolescents is approximately 4% to 6% (Substance Abuse and Mental Health Services Administration Office of Applied Studies, 2008). Urban, low-income African American adolescents living in high-risk environments (i.e., characterized by crime and violence, poverty, substance abuse) may experience depression at higher levels than adolescents from other racial/ethnic groups in the US (Cardemil et al, 2002; Lindsey, Joe, & Nebbitt, 2010; US Department of Health and Human Services, 2001). Institutional barriers to mental health care, such as the absence of or inadequate health insurance and the prevalence of culturally inappropriate screening measures, diagnostic procedures, and treatment modalities exist that diminish help-seeking and treatment compliant behaviors (Atdjian & Vega, 2005; Copeland, 2006)
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