January 2018—As PCORI-funded studies produce results of interest to patients and those who care for them, we are updating the stories of those projects. The article below was published in February 2014. You can read an update to this story here.

When Pluscedia Williams was growing up in the Compton neighborhood of Los Angeles, nobody talked about depression. For that reason, Williams had no name to give the problems that first beset her as a young woman: crying, mood swings, not wanting to talk to anyone, or even care for her baby.

“I didn’t know I was depressed,” says Williams, now 64. “In the African-American community,” she adds, “we are told that if you’re down or depressed or whatever, you’re crazy. So, I kept it to myself.”

Even if she had decided to seek care, reaching it would have been difficult. “In the area where I grew up, services were not accessible,” says Williams. Doctor’s appointments, she notes, meant long rides on a train or bus and frequently missed appointments. Worse, prescriptions were often too expensive to fill.

Williams went for years without getting treatment for depression. Then, for years more, she was “lost in the cracks,” she says, haphazardly receiving medication. “They don’t figure out what’s causing it,” she says. “They just give you a lot of pills.”