174946 Depression and Diabetes: Creating a Community Health Model

Monday, October 27, 2008

Jenifer Fabian, MPH , Quality and Performance Improvement, Access Community Health Network, Chicago, IL
Kerry Clark, MHA , Quality and Performance Improvement, Access Community Health Network, Chicago, IL
Peter Novota, MD , Genesis Center, Access Community Health Network, Chicago, IL
Access Community Health Network (ACCESS), is one of the nation's largest community health center networks, and is accredited by the Joint Commission and designated as a federally-qualified health center. Across 50 locations, ACCESS serves over 16,000 diabetic patients using the chronic care model.

The availability of community mental health services in low-income communities is a problem nationally and in the Chicago area. Studies have shown that individuals with diabetes are up to twice as likely to have depression as people without diabetes. Internal quality reviews have identified challenges in identifying patients with depression, and accessing appropriate resources. Community health centers are well-positioned to address these issues. ACCESS has developed develop a program that incorporates depression care into the treatment of patients with diabetes in primary care settings. The goal is to effectively identify and treat depression, allowing patients to focus on improving their physical health and ultimately reduce the incidence of co-morbidities.

Diabetic patients are screened annually for depression at their primary care visits using a standardized, reliable screening tool. Those that have a positive screen receive medical management, referrals for appropriate mental health services, and supportive information and education to help improve their overall health.

We will evaluate the effectiveness and sustainability of the model, and apply key learnings to benefit patients with other chronic conditions.

Learning Objectives:
1. Build a model of depression screening, referrals, and treatment that is appropriate for underserved diabetic patients in the Chicago area, including communities with limited mental health resources. 2. Develop self-management tools and patient education materials that are appropriate to low-literacy, limited-income communities that will help patients develop a plan to address their depression and will encourage patients to be a participant in their care. 3. Create educational materials that emphasize the importance of mental health treatment and teach patients how to identify possible patterns of depression in their own lives. 4. Educate medical providers on when and how to screen for depression using the standardized Patient Health Questionnaire (PHQ-9) and train them on appropriate management and treatment options.

Keywords: Depression, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have 13 years of experience developing and implementing programs within underserved communities. I direct the planning, execution and evaluation of quality improvement initiatives to accomplish strategic goals of the organization. My duties include directing and implementing strategies for chronic disease management, as well as overseeing quality committees that are charged with improving patient safety, management of medical records, and ensuring effective systems of care. I earned my MPH from the University of Illinois in 2004.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.