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Rural Women with Disabilities and Depression, Part One: Characteristics and Treatment Patterns<\/span><\/strong><\/p>\n July 2007<\/p>\n Depression is a common mental health problem in which a person may experience persistent sadness, be unable to enjoy formerly pleasurable activities, and feel worthless or hopeless. Undetected and untreated depression causes substantial physical and social limitation and may lead to suicidal thoughts or actions. More than 80% of people with depression improve with appropriate treatment (National Institute of Mental Health [NIMH], 2005).<\/p>\n Each year, one in ten Americans experiences depression (NIMH, 2005). Environmental risk factors for depression include unemployment, poverty, exposure to abuse and violence, and other life stressors. Women experience these risk factors at higher rates regardless of where they live or whether they have a disability, and they are twice as likely as men to have a major depressive episode (McGrath et al., 1990).<\/p>\n Approximately 26% of women living in rural areas have disabilities. They face two additional risks for depression: having a disability and living in a rural setting. According to \u201cHealthy People 2010″, 30% of women with disabilities are prevented from being active by feelings of sadness or depression, compared to 8% of women without disabilities (US Department of Health and Human Services, 2000). Research suggests that depression is more prevalent in rural areas and barriers to accessing mental health services are more pervasive (Probst et al., 2005; Probst et al., 2006). Barriers include the overburdened primary health care system, poverty, inadequate funding for mental health services, lack of mental health providers, scarce public transportation, geographic isolation, stigma, and concerns about confidentiality (Sawyer, Gale, & Lambert, 2006; Levine et al., 2001; Mulder et al., 2000; Power, 2003).<\/p>\n Research shows that urban women with physical disabilities have a high prevalence of depression (Hughes et al., 2005; Hughes et al., 2004; Hughes et al., 2001). Rural women\u2019s rate of depression is twice that of other women (Power, 2003) and rural women with disabilities face additional risks and unique barriers, such as poorer health, less education, and greater dependence on government programs than their urban counterparts (Szalda-Petree et al., 1999). Moreover, the lack of trained personal care providers may force them to rely on family for personal assistance \u2013 a situation that may not be in their best interest (Nosek & Howland, 1992). To learn more, Dr. Rosemary Hughes and colleagues at Houston\u2019s Center for Research on Women with Disabilities conducted a study called \u201cDepression and Rural Women with Disabilities: Testing a Center for Independent Living-based Self-Management Program\u201d.<\/p>\n Method:<\/strong> The study tested the effectiveness of a peer-led depression self-management intervention for rural women with physical disabilities. Part One of this series focuses on the analysis of data gathered from 134 women at the time they enrolled in the study: demographic and disability-related characteristics, patterns of treatment for depression, and demographic and disability-related correlates of depression and depression treatment (Hughes et al., 2007). Part Two of this series will report on the depression self-management program itself.<\/p>\n <\/a>Table 1 lists nine Centers for Independent Living (CILs) recruited and selected for the study. Each serves consumers in rural areas. CILs recruited, screened, and enrolled participants, and conducted the depression self-management program. Description of Table 1.<\/a><\/p>\n\n