How Quality Improvement Interventions for Depression Affect Stigma Concerns Over Time

OBJECTIVE: This study examined the long-term impact on stigma concerns of two quality improvement (QI) interventions for depression in primary care. METHODS: Data were from a nine-year follow-up of 805 participants in Partners in Care, a group-level randomized trial comparing patients enrolled in interventions with enhanced resources for therapy (QI-therapy) (N=284) or medication management (QI-meds) (N=267) with those in usual care (N=254). Participants were asked about stigma in regard to friends, health insurance, and employers. RESULTS: Individuals in QI-therapy were significantly less likely than those in usual care and QI-meds to report concerns about friends learning about a history of depression (odds ratio [OR]=.66 and .65, respectively), and those in QI-meds were more likely than those in QI-therapy and usual care to have concerns about getting insurance (OR=1.42 and 1.68, respectively). CONCLUSIONS: Quality improvement programs for depression can raise or lower stigma concerns, depending on program design and resources for specific treatments.