Recorded presentation

Carole Upshur, EdD¹, Linda Weinreb, MD¹, and Michael Norton, MSW². (1) Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Ave. North, Worcester, MA 01655, 508-334-7267, carole.upshur@umassmed.edu, (2) Massachusetts Division of Medical Assistance, 600 Washington St., 5th floor, Boston, MA 02111

The Massachusetts Consortium on Depression in Primary Care (MCDPC) was formed by the Commonwealth of Massachusetts’ Division of Medical Assistance (DMA) with the collaboration of the Department of Family Medicine and Community Health at the University of Massachusetts Medical School/UMass Memorial Health Care to meet the challenge of improving depression care management for MassHealth (e.g., Medicaid) insured adults in Massachusetts. PCPs screen patients using the 9-item PHQ-9 instrument. Patients who score in the range indicating major depression are referred to a care manager, and are given options of medication and/or behavioral health services. Data are collected on co-morbid health and mental health conditions, compliance with medications and behavioral health, and periodic re-assessment of depressive symptoms. This paper reports on outcomes of several hundred screened patients (n=326). Data show that the number of patients with co-morbid medical conditions increases dramatically the higher the depression score: 39% of those scoring in the asymptomatic range had a co-morbid condition, while 50% in the moderate depression range, and 70% in the major depression range had other major health conditions. The most frequent conditions are diabetes, hypertension and asthma. For those patients scoring in the major depression range, additional mental health assessment is conducted, revealing high rates of co-morbid panic, anxiety and trauma history. Addressing depression among those with multiple conditions has proved complicated. Analysis will be provided on characteristics of patients with successful and unsuccessful depression outcomes based on their pattern of co-morbid medical and mental health conditions. Implications for practice will be discussed.

Learning Objectives: At the conclusion of this session, the participant will

• Recognize the prevalence of depression in chronic illness.
• Identify systems to target mental health intervention for patients with chronic illness.
• Articulate key steps to implement mental health screening and treatment in primary care.

Keywords: Mental Health Care, Depression

Related Web page: MCDPC.org

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.

Recorded presentation