Collaborative Care for Depression

Abstract

Depression is soon to become the second leading cause of disability worldwide.¹ It affects between 5% and 10% of individuals and is the third most common reason for consultation in primary care.² Management falls below accepted evidence-based standards,^3,4 and the enhanced management of depression in primary care is central to the World Health Organization strategy for mental health.⁵ Many organizational and educational strategies targeted at health care professionals have been proposed to improve the recognition and management of depression in primary care.⁶ These include the following: educational strategies, such as guidelines, targeted at health care professionals⁷; consultation-liaison, with an educative role for practitioners working more closely with nonspecialist clinicians⁸; and collaborative care involving a structured approach to care based on chronic disease management principles and a greater role for nonmedical specialists such as nurse practitioners working in conjunction with the primary care physician and a mental health specialist.⁹