The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4293.0: Tuesday, November 18, 2003 - Table 6

Abstract #56850

Recognizing and treating depression in primary care: Innovations in behavioral health integration

Linda Weinreb, MD1, Carole Upshur, EdD1, Annette Hanson, MD2, and Michael Norton, MSW2. (1) Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, 508-856-3225,, (2) Office of Clinical Affairs, Massachusetts Division of Medical Assistance, 600 Washington Street, Boston, MA 02111

There is increasing recognition of depression as a major chronic illness affecting 8-10% of the US adult population, and much higher proportions of disadvantaged populations. In 1990 it was ranked as the 4th highest cause of disability internationally. It is highly prevalent in adults with other chronic conditions such as asthma, diabetes and chronic heart disease. However, there is widespread evidence that depression frequently remains undiagnosed, and when treated, a majority of patients fail to sustain medications, therapy or self-management activities, resulting in repeat episodes of treatment initiation and high health care utilization. Patient behavior and lifestyle play important roles in symptom resolution, yet, like other chronic conditions neither the primary care system, nor the mental health system is adequately prepared to provide the structured support and patient self-management assistance required to successfully help patients with major depression. As part of the Robert Wood Johnson Foundation initiative on Depression in Primary Care, the University of Massachusetts Medical School’s Department of Family Medicine and Community Health in conjunction with the Massachusetts Division of Medical Assistance (i.e., Medicaid) has undertaken a demonstration project to test the implementation of the chronic care model for depression treatment of adult Medicaid patients in a range of primary care delivery sites.. This paper reports results of the first six months of implementation of the project which addresses the difficulties of integration between behavioral and physical health and treatment innovations in both primary care and mental health services that have resulted in improved patient outcomes.

Learning Objectives:

Keywords: Depression, Mental Health

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Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

New Approaches to Mental Health Service Delivery

The 131st Annual Meeting (November 15-19, 2003) of APHA