National Alliance on Mental Illness
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For Immediate Release, 14 Jan 00
Contact: Chris Marshall
It is widely known that only 25% to 35% of people with depression get good care, in spite of the availability of effective treatments. The World Health Organization's report on the global burden of disease expects depression to become the second leading cause of disability worldwide in the coming decade, emphasizing the need for better access to effective treatments. The problem has been to find ways to improve the recognition and treatment of depression - and thus improve patient outcomes.
In a study conducted by Dr. Kenneth Wells of the RAND Corporation and reported this month in the Journal of the American Medical Association, 27,000 patients in a wide range of primary care settings across the country were screened for depression. More than 1300 patients with depression were identified. Some clinics were assigned to treat these patients as they usually would, while other clinics were asked to form teams to train other staff and to identify, treat, and monitor patients.
Interestingly, although these teams received training in working collaboratively and in helping other staff identify and treat patients, there were no specific treatment protocols. Instead, sites with research groups chose to change the way they provide services in a variety of ways, including educating staff about the treatment of depression, offering on-site rather than off-site counseling, having a nurse monitor treatment compliance, and eliminating copayments for visits.
These simple and relatively inexpensive interventions - screening, changing the way care was provided in the clinic, and modestly increasing resources to educate patients and staff - had substantial effects. Rates of counseling and appropriate use of medications increased by 30%, recovery rates improved significantly, patients' quality of life improved, and more patients remained on the job.
The Wall Street Journal reported on the study in Tuesday's edition, reminding us of the progress being made both in destigmatizing depression and in making the business community aware of the impact of depression on its employees and the availability of effective treatments.
The research study, Impact of Disseminating Quality Improvement Programs for Depression in Managed Primary Care, can be accessed on the web at http://jama.ama-assn.org/issues/v283n2/full/joc90425.html