Dec 31, 1999
Over the next decade, depression is expected to become the second-leading cause of disability worldwide. About 20 percent of all primary care patients have significant symptoms of depression and require further assessment and patient education. About 6 percent of primary care patients are clinically depressed and require antidepressants or psychotherapy. National clinical guidelines define appropriate treatment strategies for this highly treatable condition, but studies over the past decade have consistently found low rates of detection and appropriate treatment in primary care, the setting from which most depressed persons seek care, if at all. Partners in Care is a real-world trial to determine whether diverse primary care practices can implement previously tested, effective models of care for depression. A collaborative effort of researchers and clinicians at many institutions, the study involves more than 27,000 patients, 125 providers, and 46 primary care clinics within six nonacademic managed care practices in various locations across the United States. The messages emerging from this study are hopeful ones. For patients: their mental health and daily functioning can be significantly improved by treatment their own doctors can initiate. For employers, managed care organizations, and insurers: good outcomes, including lower job-loss rates, can come through modest, practical programs in primary care settings.