Cover: Emerging Models of Depression Care

Emerging Models of Depression Care

Multi-Level ('6 P') Strategies

Published in: International Journal of Methods in Psychiatric Research, v. 12, no. 1, 2003, p. 54-63

Posted on 2003

by Harold Alan Pincus, Lin Hough, Jeanie Knox Houtsinger, Bruce L. Rollman, Richard G. Frank

Depression is a prevalent, often chronic condition that has enormous personal, social, and financial consequences. Although technologies for treating depression have advanced notably over the past 20 years, many people continue to suffer needlessly, due in part to the lack of evidence-based treatment applied in primary care settings. Substantial public and private efforts have been devoted to encouraging individuals to seek care, improving recognition and diagnosis by primary care physicians, and implementing evidence-based treatment practices. From these efforts have come new models of care as well as an awareness of the critical barriers impeding clinical, organizational, economic, and policy implementation of effective care strategies. In this paper, the authors describe these clinical and systems barriers and consider the perspectives of various stakeholder groups; present emerging clinical models for providing evidence-based care as well as economic strategies for overcoming barriers to their implementation; and propose community-based approaches that will need to be tested. To achieve maximum benefits from current knowledge, the authors will need to implement a multi-level strategy employing focused efforts involving patients, providers, practice settings, health plans, purchasers (public and private), and populations (or communities): the '6 P' strategy.

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.