Date of Award

January 2017

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Michelle Silva


Using the principles of lay counseling, health professional students were trained to deliver psychosocial educational interventions and administer substance use screenings to uninsured monolingual Spanish-speaking Latino immigrants with symptomatic depression and/or substance use disorders. Changes in depressive symptoms were assessed with the PHQ-9. Twenty-five patients enrolled in the lay counselor program for depression. PHQ-9 data were available from the 15 individuals who completed the program, among whom the mean baseline score was 11.7 (SD = 6.2) and mean final score was 4.6 (SD = 4.2) (p <0.001). Participants were screened for substance use with the Screening, Brief Intervention and Referral to Treatment (SBIRT), an evidence-based protocol. A total of 199 patients were screened for multiple substances. Previously uncharacterized patterns of substance use were observed in this population. The educational component of the program for depression was evaluated by administering a survey to the student volunteers. Following their participation in the program, students exhibited increased interest in both underserved populations and the mental health field. Lay counselor approaches commonly applied in low-resource settings may help to address mental health disparities, ensure substance use preventive care for first generation Latino immigrants, and recruit students into the psychiatric profession.


This thesis is restricted to Yale network users only. It will be made publicly available on 06/12/2018