Principal Investigator: Luis H. Zayas, Ph.D.
Funder: National Institute of Mental Health (NIMH - R21 MH065921)
Timeframe: 03/07/03-02/28/06
Affiliation: Center for Mental Health Services Research (CMHSR)
Project Contact: Luis H. Zayas (Principal Investigator)
Office Phone: (314) 935-5687
E-mail: lzayas@gwbmail.wustl.edu
Project Staff: M.Carmela Perez, Ph.D., New York Medical College, Co-PI
A. Indurkhya, Ph.D., Harvard University, Consultant
L. Cabassa, Ph.D. University of California, InvestigatorR. Lewis-Fernandez, M.D., Columbia University, Consultant
Participating Organizations:
St. Vincent's Catholic Medical Centers of New York (*see description below)Project Update as of 07/08/2008
Stage: Analyzing data and publishing findings.Description:
Clinician-patient communication is essential for accurate diagnosis which in turn is vital to proper psychiatric treatment. When clinicians and their patients differ in ethnicity, culture and language, problems in assessing psychiatric disorders and their severity are more apt to arise. Even with translators assisting in such diagnostic situations, we know very little about the impact of ethnicity and language on psychiatric diagnosis. In order to examine how ethnic and linguistic similarity and difference between clinicians and patients affect diagnosis, this revised exploratory/developmental application had as its specific aims to (1) To compare clinician-rendered diagnoses of Spanish-only and bilingual Hispanic patients when clinicians are English-speaking, non-Hispanic clinicians and bilingual Hispanic clinicians; (2) explore clinicians’ rationales for diagnoses based on their interpretations of patients’ behaviors, and examine interactional process during diagnostic interviews; (3) differences between clinician-rendered and structured-interview diagnoses for Spanish-only and bilingual Hispanics; and (4) effects of translator presence in clinician-rendered diagnoses of Spanish-only patients. The study design had 150 foreign-born adult Hispanic immigrants seeking psychiatric services assigned at intake to either a monolingual (English) non-Hispanic clinician or a bilingual Hispanic clinicians. A trained translator translated during interviews of monolingual patients who are matched with English-only clinicians. Interviews were videotaped. Clinicians rendered DSM-IV diagnoses on all five axes, and completed research questionnaires. A structured clinical interview was also administered to patients before or after the videotaping. Then, a second clinician (blind to the clinician and SCID diagnoses) also rendered DSM-IV diagnoses on all five axes and completed research protocol based on the videotape. In Spanish-only taped interviews, the second clinician who was monolingual (English) was also assisted by the translator. Data analysis consists of both quantitative and qualitative approaches.Performance Site
Latino Mental Health Treatment Program, Department of Psychiatry
St. Vincent’s Catholic Medical Centers of New York
West 12th Street
New York, New York* Saint Vincent Catholic Medical Center (SVCMC) provides cost effective care across a broad set of services, with a total of 2,600 acute medical /surgical beds; primary care, behavioral health and ambulatory care sites; 800 long-term care beds; 1 million home care visits; approximately 530 primary care physicians; 1,500 physicians specialist; and 15,000 employees. SVCMC provides an array of acute psychiatric inpatient services geared toward crises intervention and stabilization. The Centers operate inpatients psychiatric units in Manhattan, Staten Island, Queens, and Westchester, including specialized units for children and adolescents.
Total Direct Cost: $200,000