# Symptoms of Mood Disturbance and Depression Diagnosis Among South Asian Home Care Clients in Ontario, Canada: Evidence of Under‐Detection of Mental Health Needs

## TL;DR

South Asian home care clients in Ontario show similar mood disturbance levels but are less likely to be diagnosed with depression, possibly due to cultural factors and stigma.

## Contribution

This study identifies under-diagnosis of depression in South Asian populations despite similar mood disturbance levels, highlighting cultural and clinical factors.

## Key findings

- South Asian home care clients have similar mood disturbance levels but lower depression diagnosis rates.
- Under-diagnosis persists after adjusting for demographics, clinical indicators, and risk factors.
- Cultural factors like stigma and clinician competence may hinder depression detection in South Asians.

## Abstract

Depression poses a significant global health burden yet remains widely undiagnosed and untreated, especially among South Asian populations. Despite higher prevalence rates, depression among South Asian immigrants in countries like Canada is often under‐recognized due to cultural nuances. This study aims to examine patterns of mood disturbance and risk factors for depression diagnosis among South Asian and general home care clients in Ontario, Canada.

Using data from the interRAI Home Care (HC) assessments conducted between 2018 and 2022, demographic and clinical characteristics of South Asian home care clients were compared against the general home care population. Depression diagnosis and mood disturbance severity were assessed using standardized measures. Multivariate logistic regression models were employed to examine risk factors for depression diagnosis.

While mood disturbance prevalence was comparable, the percentages with depression diagnosis were significantly lower 0.50 (95% CI 0.47–0.54) among South Asian home care clients compared to the general home care population. Multivariate analyses confirmed this difference even after accounting for demographic and clinical factors.

The under‐detection of depression among South Asian home care clients suggests potential issues related to cultural competence among health care providers and stigma. Systematic assessment tools like the interRAI HC can aid in identifying mental health needs. Efforts are needed to increase awareness, reduce stigma, and provide culturally appropriate mental health services for South Asian populations.

Depression is under‐recognized among South Asian home care clients in Ontario, Canada, despite a similar prevalence of mood disturbance. Addressing cultural competence and stigma is crucial for improving the detection and treatment of depression in this population.

South‐Asian home care clients have similar levels of mood disturbance to the general home care population, but depression appears to be under‐diagnosedUnder‐diagnosis of depression in South‐Asian home care clients persists after adjusting for demographic characteristics, clinical indicators, protective variables, and risk factorsCultural consideration such as stigma, atypical symptom presentation, and cultural competence of clinicians may contribute to under‐detectionStandard assessments like the interRAI Home Care can support improved detection and response to mood disturbance in cultural minorities

South‐Asian home care clients have similar levels of mood disturbance to the general home care population, but depression appears to be under‐diagnosed

Under‐diagnosis of depression in South‐Asian home care clients persists after adjusting for demographic characteristics, clinical indicators, protective variables, and risk factors

Cultural consideration such as stigma, atypical symptom presentation, and cultural competence of clinicians may contribute to under‐detection

Standard assessments like the interRAI Home Care can support improved detection and response to mood disturbance in cultural minorities