Treatment for Depressed Primary Care Patients

Major depression affects 5%-9% of older primary care patients, is often chronic or recurrent
and disabling, and leads to frequent use of medical services. Most depressed elders are
treated by primary care physicians (PCPs) and prior research has shown that collaboration
between primary care physicians and depression care managers is effective in treating
depression. The challenge has been in securing third-party reimbursement for such services.

This research study will address this barrier by developing a collaborative depression care
management model (C-DCM) that encourages collaboration between PCPs and trained social
workers employed by community-based, public and nonprofit mental health clinics. In
addition to developing C-DCM, a total of 112 primary care outpatients will participate in
this study to test whether C-DCM is more effective than the standard of care in decreasing
the severity of depression and disability experienced by older adults. Each subject will be
randomized into either Usual Care or C-DCM. All subjects will be assessed at Baseline and
at 2 and 4 months while the C-DCM subjects will also meet with social worker depression case
managers bi-weekly over four months. If shown effective, C-DCM may bring to bear an
available, yet untapped resource in the care of depressed elders.