Assigment .Apa seven . All instructions attached.

1

Depression in Low-Income Communities

Eliecer M Rodriguez

FNU

Health Promotion & Role Development in Adv. Nursing Practice

Professor: Nora Hernandez Pupo

March 15, 2025

2

Depression in Low-Income Communities

Depression is a severe mental disorder that affects so many people across the globe. It is

especially common among poor people, who often live under tremendous stress and financial

difficulty and with limited access to mental health care. Depression is one of the significant

causes of disability, as reported by the World Health Organization, and it affects about over 200

million people globally. In the US, data from the National Institute of Mental Health shows that

people living in poverty are more than twice as likely to experience depression as those with

more income. This proposal will seek to improve mental health among poor people through

depression education, building community support networks, and increasing access to mental

health services. The expected result is a decrease in the number of people suffering from

depression and their mental health improvement. It will be measured by tracking the number of

people participating in the program and having better access to mental health care.

Vulnerable Population

Poor people are more vulnerable to depression due to the various challenges they

encounter, including economic instability, limited healthcare access, and poor living conditions.

Economic instability leads to stress, thus increasing the risk of mental illness development. Most

people in poor communities struggle with basic needs such as food, suitable housing, and

employment (Martinez et al., 2021). Such social determinants of health make it difficult to enjoy

good mental health. Furthermore, people in poverty do not access professional mental health

services due to unaffordability, stigma, and lack of awareness of the services available, thus the

high rate of untreated depression. Racial and ethnic minority groups among people with low

incomes suffer even more significant disparities in mental health care. Research conducted by

the American Psychological Association shows that African American and Hispanic patients

3

have more untreated depression than white patients (American Psychological Association, 2017).

It is due to social issues, dialect boundaries, and systemic inequalities in healthcare access.

Review of Literature

Giebel et al. (2022) researched how community-based interventions affect depression

treatment in low-income communities. It showed that peer support methods and culturally

adjusted therapy improved mental health outcomes. Depression patients received peer support

interventions that connected them to others having depression experience so they would develop

improved feelings while reducing their isolation perception. The treatment interventions went

through cultural adaptation to fit the orientation of each participant, thus making them more

accessible and acceptable. Research showed that group therapeutic activities and social support

groups created the most successful act of treatment adherence. The participants exposed to

intervention techniques were likelier to maintain therapy appointments, join therapeutic

discussions, and adhere to treatment protocols. Symptom of become less among the unprivileged

due to therapy interventions that provided them with both emotional support and coping

mechanisms. Furthermore, Matteo Bessone et al. (2024) also researched the application of

depression care techniques that involved task-shifting with trained lay health workers. Shift

supervision strategies require non skilled staff to take over certain functions that were previously

allocated to a psychologist after being taught to them. The use of such care services was made

easier through this method for patients who were both challenged in receiving care from trained

non-staffs managed to significantly improve the intensity of their depression. The teachers

provided counseling services accompanied with education and emotional support to the patients.

In addition, trained health workers attended to patients who were able to use techniques for

4

symptom relieve. The success of task shifting shows that even a small amount of training in

mental healthcare can enable non-professionals to provide basic care.

Evaluation of Literature

Research performed by Giebel et al. (2022) and the study reported by Bessone et al.

(2024) collectively produce significant findings about successful mental health treatment

methods aimed at low-income populations dealing with depressive symptoms. According to

Giebel et al. (2022) successful mental health intervention programs need to develop specific

cultural approaches treating social along with psychological mental health risk factors. The

research demonstrates that peer support best practices foster community membership while

lowering stigma which results in superior treatment results. This research study investigates

urban populations only so it cannot provide complete results about depression experiences in

rural low-income populations.

Bessone et al. (2024) introduce a cost-effective system by developing lay health

employees to deliver mental health support to communities that lack access to qualified medical

providers. Communities with critical specialist shortages find this approach beneficial because it

creates broad access to essential services. The approach decreases pressure on the healthcare

system by using community members to deliver implemented interventions. The efficacy of this

intervention depends on both the implementation of quality training sessions for lay health

workers and adequate supervision programs. The combination of peer support initiatives with

trained non-specialist mental health employees represents the most practical solution for

reducing depression rates in low-income communities. Community-based peer support, together

with trained non-specialist mental health workers, presents a possible solution to health care

deficits through effective and reachable services. A combined model would utilize culturally

5

specific interventions by task-sharing the workload to address professional shortages. Several

support systems incorporated into this strategy would create comprehensive care that produces

better mental health results for disadvantaged people in city and country areas.

Theoretical Framework

The human ecological model acts as a framework for fully considering the many different

factors that affect an individual’s mental health, and it is particularly useful in dealing with

depression among lower socioeconomic groups. It deals with problems at several levels;

individual, interpersonal, community, and societal, which increases the likelihood of developing

feasible solutions (Kleinman et al., 2023). Individual educational intervention on depression and

coping techniques represents the most fundamental and essential form of psychiatric care. A

significant portion of the low income population has a major health literacy problem which is a

combination of not knowing and misunderstanding the services that are offered. Using

workshops, webinars, and local community programs assist them in recognizing their problems

and taking initiative to receive appropriate care.

Moreover, passing on useful skills in problem-solving, and resilience training equips

individuals to navigate a range of life challenges effectively. Addressing mental health issues at

the personal level puts the groundwork for self-care practices and reduces the incidence of

untreated depression. Supportive relationships are crucial in safeguarding against depression and

mitigating the effects of loneliness and economic hardships. A scalable mental health care

system necessitates collaborative efforts with community clinics, faith-based organizations, and

non-profits, particularly in economically disadvantaged areas, to enhance the availability of

services. Task-shifting offers a viable solution to the shortage of specialized health professionals

by equipping general healthcare providers with essential skills for delivering mental health

6

services. Policy reforms must tackle limitations in insurance coverage and the integration of

primary care services to ensure comprehensive mental health support. The proposed style,

grounded in the SEM, aims to put various involvement that will improve accessibility and

sustainability, and reducing depression among low-income populations.

7

References

American Psychological Association. (2017). Ethnic and Racial Minorities & Socioeconomic

Status. American Psychological Association.

https://www.apa.org/pi/ses/resources/publications/minorities

Giebel, C., Shrestha, N., Reilly, S., White, R. G., Zuluaga, M. I., Saldarriaga, G., Liu, G., Allen,

D., & Gabbay, M. (2022). Community-based mental health and well-being interventions

for older adults in low- and middle-income countries: a systematic review and meta-

analysis. BMC Geriatrics, 22(1), 773. https://doi.org/10.1186/s12877-022-03453-1

Kleinman, M. B., Anvari, M. S., Seitz-Brown, C. J., Bradley, V. D., Tralka, H., Felton, J. W.,

Belcher, A. M., Greenblatt, A. D., & Magidson, J. F. (2023). Psychosocial challenges

affecting patient-defined medication for opioid use disorder treatment outcomes in a low-

income, underserved population: Application of the social-ecological framework. Journal

of Substance Use and Addiction Treatment, 149, 209046.

https://doi.org/10.1016/j.josat.2023.209046

Martinez, S. M., Esaryk, E. E., Moffat, L., & Ritchie, L. (2021). Redefining Basic Needs for

Higher Education: It is More Than Minimal Food and Housing According to California

University Students. American Journal of Health Promotion, 35(6), 089011712199229.

https://doi.org/10.1177/0890117121992295

Matteo Bessone, Bianco, F. L., & Gianluca D'Amico. (2024). Transforming clinical psychology:

An ecological and psychopolitical perspective. An Italian and global case. RIVISTA DI

PSICOLOGIA CLINICA, 1, 35–60. https://doi.org/10.3280/rpc1-2024oa18051

1

Depression in Low-Income Communities

Eliecer M Rodriguez

FNU

Health Promotion & Role Development in Adv. Nursing Practice

Professor: Nora Hernandez Pupo

March 15, 2025

2

Depression in Low-Income Communities

Depression is a severe mental disorder that affects so many people across the globe. It is

especially common among poor people, who often live under tremendous stress and financial

difficulty and with limited access to mental health care. Depression is one of the significant

causes of disability, as reported by the World Health Organization, and it affects about over 200

million people globally. In the US, data from the National Institute of Mental Health shows that

people living in poverty are more than twice as likely to experience depression as those with

more income. This proposal will seek to improve mental health among poor people through

depression education, building community support networks, and increasing access to mental

health services. The expected result is a decrease in the number of people suffering from

depression and their mental health improvement. It will be measured by tracking the number of

people participating in the program and having better access to mental health care.

Vulnerable Population

Poor people are more vulnerable to depression due to the various challenges they

encounter, including economic instability, limited healthcare access, and poor living conditions.

Economic instability leads to stress, thus increasing the risk of mental illness development. Most

people in poor communities struggle with basic needs such as food, suitable housing, and

employment (Martinez et al., 2021). Such social determinants of health make it difficult to enjoy

good mental health. Furthermore, people in poverty do not access professional mental health

services due to unaffordability, stigma, and lack of awareness of the services available, thus the

high rate of untreated depression. Racial and ethnic minority groups among people with low

incomes suffer even more significant disparities in mental health care. Research conducted by

the American Psychological Association shows that African American and Hispanic patients

3

have more untreated depression than white patients (American Psychological Association, 2017).

It is due to social issues, dialect boundaries, and systemic inequalities in healthcare access.

Review of Literature

Giebel et al. (2022) researched how community-based interventions affect depression

treatment in low-income communities. It showed that peer support methods and culturally

adjusted therapy improved mental health outcomes. Depression patients received peer support

interventions that connected them to others having depression experience so they would develop

improved feelings while reducing their isolation perception. The treatment interventions went

through cultural adaptation to fit the orientation of each participant, thus making them more

accessible and acceptable. Research showed that group therapeutic activities and social support

groups created the most successful act of treatment adherence. The participants exposed to

intervention techniques were likelier to maintain therapy appointments, join therapeutic

discussions, and adhere to treatment protocols. Symptom of become less among the unprivileged

due to therapy interventions that provided them with both emotional support and coping

mechanisms. Furthermore, Matteo Bessone et al. (2024) also researched the application of

depression care techniques that involved task-shifting with trained lay health workers. Shift

supervision strategies require non skilled staff to take over certain functions that were previously

allocated to a psychologist after being taught to them. The use of such care services was made

easier through this method for patients who were both challenged in receiving care from trained

non-staffs managed to significantly improve the intensity of their depression. The teachers

provided counseling services accompanied with education and emotional support to the patients.

In addition, trained health workers attended to patients who were able to use techniques for

4

symptom relieve. The success of task shifting shows that even a small amount of training in

mental healthcare can enable non-professionals to provide basic care.

Evaluation of Literature

Research performed by Giebel et al. (2022) and the study reported by Bessone et al.

(2024) collectively produce significant findings about successful mental health treatment

methods aimed at low-income populations dealing with depressive symptoms. According to

Giebel et al. (2022) successful mental health intervention programs need to develop specific

cultural approaches treating social along with psychological mental health risk factors. The

research demonstrates that peer support best practices foster community membership while

lowering stigma which results in superior treatment results. This research study investigates

urban populations only so it cannot provide complete results about depression experiences in

rural low-income populations.

Bessone et al. (2024) introduce a cost-effective system by developing lay health

employees to deliver mental health support to communities that lack access to qualified medical

providers. Communities with critical specialist shortages find this approach beneficial because it

creates broad access to essential services. The approach decreases pressure on the healthcare

system by using community members to deliver implemented interventions. The efficacy of this

intervention depends on both the implementation of quality training sessions for lay health

workers and adequate supervision programs. The combination of peer support initiatives with

trained non-specialist mental health employees represents the most practical solution for

reducing depression rates in low-income communities. Community-based peer support, together

with trained non-specialist mental health workers, presents a possible solution to health care

deficits through effective and reachable services. A combined model would utilize culturally

5

specific interventions by task-sharing the workload to address professional shortages. Several

support systems incorporated into this strategy would create comprehensive care that produces

better mental health results for disadvantaged people in city and country areas.

Theoretical Framework

The human ecological model acts as a framework for fully considering the many different

factors that affect an individual’s mental health, and it is particularly useful in dealing with

depression among lower socioeconomic groups. It deals with problems at several levels;

individual, interpersonal, community, and societal, which increases the likelihood of developing

feasible solutions (Kleinman et al., 2023). Individual educational intervention on depression and

coping techniques represents the most fundamental and essential form of psychiatric care. A

significant portion of the low income population has a major health literacy problem which is a

combination of not knowing and misunderstanding the services that are offered. Using

workshops, webinars, and local community programs assist them in recognizing their problems

and taking initiative to receive appropriate care.

Moreover, passing on useful skills in problem-solving, and resilience training equips

individuals to navigate a range of life challenges effectively. Addressing mental health issues at

the personal level puts the groundwork for self-care practices and reduces the incidence of

untreated depression. Supportive relationships are crucial in safeguarding against depression and

mitigating the effects of loneliness and economic hardships. A scalable mental health care

system necessitates collaborative efforts with community clinics, faith-based organizations, and

non-profits, particularly in economically disadvantaged areas, to enhance the availability of

services. Task-shifting offers a viable solution to the shortage of specialized health professionals

by equipping general healthcare providers with essential skills for delivering mental health

6

services. Policy reforms must tackle limitations in insurance coverage and the integration of

primary care services to ensure comprehensive mental health support. The proposed style,

grounded in the SEM, aims to put various involvement that will improve accessibility and

sustainability, and reducing depression among low-income populations.

7

References

American Psychological Association. (2017). Ethnic and Racial Minorities & Socioeconomic

Status. American Psychological Association.

https://www.apa.org/pi/ses/resources/publications/minorities

Giebel, C., Shrestha, N., Reilly, S., White, R. G., Zuluaga, M. I., Saldarriaga, G., Liu, G., Allen,

D., & Gabbay, M. (2022). Community-based mental health and well-being interventions

for older adults in low- and middle-income countries: a systematic review and meta-

analysis. BMC Geriatrics, 22(1), 773. https://doi.org/10.1186/s12877-022-03453-1

Kleinman, M. B., Anvari, M. S., Seitz-Brown, C. J., Bradley, V. D., Tralka, H., Felton, J. W.,

Belcher, A. M., Greenblatt, A. D., & Magidson, J. F. (2023). Psychosocial challenges

affecting patient-defined medication for opioid use disorder treatment outcomes in a low-

income, underserved population: Application of the social-ecological framework. Journal

of Substance Use and Addiction Treatment, 149, 209046.

https://doi.org/10.1016/j.josat.2023.209046

Martinez, S. M., Esaryk, E. E., Moffat, L., & Ritchie, L. (2021). Redefining Basic Needs for

Higher Education: It is More Than Minimal Food and Housing According to California

University Students. American Journal of Health Promotion, 35(6), 089011712199229.

https://doi.org/10.1177/0890117121992295

Matteo Bessone, Bianco, F. L., & Gianluca D'Amico. (2024). Transforming clinical psychology:

An ecological and psychopolitical perspective. An Italian and global case. RIVISTA DI

PSICOLOGIA CLINICA, 1, 35–60. https://doi.org/10.3280/rpc1-2024oa18051