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Lindsay Nakaishi MD, MPH

  • Graduate 2018
Scholarly Research Project

Community Support Groups to Sustainably Address the Burden of Mental Health in Rural Honduras

Lindsay Nakaishi, MD, MPH, Heena Panchal, MD, Michael R Huijon, MD, Tania Castillo, MD, Mark Meyer, MD


Sustainably address the burden of mental health in rural Honduras


Depression and anxiety prevalence were calculated from Spanish Patient Health Questionnaire-9 (PHQ9) and Generalized Anxiety Disorder-7 (GAD7) questionnaires. Focus groups assessed attitudes and perceptions. We then developed a behavioral health curriculum and a community-led support group. Outcome measures included PHQ9/GAD7 scores, plus supplemental survey questions.  Seven women were selected to participate in the first support group (mean PHQ9 6.4, mean GAD7 6.4).


Prevalence of depression and anxiety are 48% and 38%, respectively (n=163). Focus group themes included suicide, inconsistent definitions and stigma (n=19). Training improved clinic staff’s ability to manage mental health.


Depression and anxiety prevalence rates are twice as high in San José as the US and resources are scarce. Clinical staff education was effective and well-received, whereas the peer-to-peer support group was a novel concept for the community. 


Support groups may be an effective intervention, but will require additional community education and culturally appropriate modifications to reduce stigma and encourage participation.