A Qualitative Study zyxwv of Mexican American Adolescents and Depression zyxwv Laura B. Fornos, Virginia Seguin Mika, Bryan Bayles, Alberto C. Serrano, Roberto L. Jimenez, Roberto Villarreal ABSTRACT: zyxwvutsrqponml Depressive disorders are present in a high percentuge of Mexican Americcin adolescents. Among the US Mexican American population, suicide zyxwvutsrq is the,fourth leuding zyxwvutsrq cause of denth umong 10- to 19-year-olds.Little research, however. has focused on Mexican American adolescents ’ knowledge and views about depression and seeking help,for depression. Results,from a qualitutive .study on Mexican American adolescents’ attitudes about depression are investigated in this puper: Sixty-five high school and middle school students in u lurgely Mexican American, urban school districr in Sari Antonio, Ten,participated in 9 semistructured, zyx focus group interviews where participants were asked questions to elicit their utiderstanding of depression, treatmentfiv depression, and words used zyxwvutsrqpon to describe it. Coding of salient words and themes,from transcribed interviews were entered into Atlas.ti,for qucilitative analvsis. Three themes emerged: (1) adolescents’ definitions of depression, (2) beliefs about adolescent depression, and ( 3 )treatment j%r adolescent depression. While depressive symptoms among Mexican American adolescents are common and recognized, resource and treattnent knowledge is scarce. An understanding of the beliefs, attitudes, arid knowledge of these adolescents can provide crucial infiorn~utiori about the content and structure uf a universal. school-based.peer-facilitated depression awareness pmgram. zyxw (J Sch Health. 2005;75(5):162-170) epression represents a serious mental illness, and if D left untreated, can progress to the point of becoming life threatening. Depressive disorders are present in a high percentage of Mexican American adolescents. Among the US Mexican American population, suicide is the fourth leading cause of death among 10- to 19-year-olds,’ and from 1997 to 2001 suicide was the third leading cause of death among young Hispanics aged 10 to 24 years.* Little research, however, has focused on Mexican American ado- lescents’ knowledge and views about depression. While depressive symptoms among Mexican American adoles- cents are common and are recognized by adolescents, re- source and treatment knowledge is scarce. Schools are a major public health resource offering a venue for alcohol, tobacco, and other drug control strate- gies for adolescents. Many evaluated, school-based suicide prevention programs However, these programs use a general suicide education strategy and do not deal specifi- cally with depression. Rather, depression is addressed only as an early warning sign of suicide. A literature review of science-based suicide prevention programs revealed no peer-facilitated education programs that target Mexican American adolescents (Table 1). Two unevaluated programs in the secondary school population, the Youth Suicide Project and The Link-Up Program,I4 used a peer-support model but only for youth who made a prior suicide attempt or for adolescents identified at risk for suicide. Crisis centers and hotlines have been evaluated, but the effectiveness of such programs on suicide rates re- mains uncertain. ’‘ This project identified the help-seeking behavior of urban middle and high school Mexican Ameri- Laura B. Fornos, MA, Social Science Research Associate, (fomos@uthscsa. edu); Virginia Seguin Mika, MPH, Assistant Director. (seguin @ uthscsa. edu); Bryan Bayles, PhD. Instnictor/Researcher. (baylesb@uthscsLi.edu): Alberto C. Serrano, MD, Clinical Professor: Psychiatry. (albertocserrano@ aol.com): Roberto L. Jimenez, MD, FARA, Clinical Pmfessor: Psychia- ty3 (aljirnenez@aol.com); and Roberto Wlheal, MD, MPH, Director. (villarrealr@uth.scsa.edu~. The South Texas Health Reseamh Center. The Uni- versity of Texas Health Science Center ut Sun Antonio, 7703 Floyd Curl Drive. Mail Code 7791, San Antonio, TX 78229-3900. Funding for this ptuject was provided bv The Universiy Health System of Bexar County? Texas. can students in south Texas. To accomplish this goal, semi- structured, open-ended focus groups among middle and high school students were conducted and analyzed. METHODS From May through December 2003, the authors con- ducted 9 focus groups with 65 students in a San Antonio, Tex, inner-city school district where 89% of the students are Mexican American and 84% are classified as economi- cally disadvantaged. Three focus groups were conducted with high school students (grades 9- 12), and 6 focus groups were conducted with middle school students (grades 6-8). Each focus group lasted approximately 1 Y2 hours, with 5 to 8 participants per group. Students ranged in age from 13 to 18 years. Focus groups were tape recorded and transcribed. Institutional Review Board approval was obtained from the University of Texas Health Science Center at San Antonio, Tex. The research protocol also was reviewed and approved by the school district. Focus group tran- scripts were entered into Atlas.ti (Scientific Software Development, Berlin, Germany) for analysis and coding of salient words and themes. The primary focus of the research was to learn more about Mexican American adolescents’ knowledge and attitudes about depression, but a secondary focus was to explore the acceptability of a school-based intervention that used peer facilitators to increase the tendency for adolescents to seek professional help. RESULTS Definitions of Depression The nature of the relationship between participants’ con- cepts of depression was interpreted as 2-fold: (1) depres- sion develops from certain etiological factors and (2) depression is associated with particular symptoms. When asked, “How would you define depression?,” student re- sponses varied and included negative behavioral symptoms such as sadness or irritability: (1) “Where you feel sad all the time.” (2) “Something’s wrong and you don’t know how to tell somebody.” (3) “You can’t take it anymore.” 162 Journal of School Health May 2005, Vol. 75, No. 5