Treatment of Depression in Primary Care: Provider Views of Issues and Barriers
The Robert Wood Johnson Foundation Depression in Primary Care Initiative & the Massachusetts Consortium on Depression in Primary Care
Massachusetts Consortium on Depression in Primary Care
Research Forum Presentation The Society for Teachers of Family Medicine Annual Conference
Atlanta, GA, September 21, 2003
Linda Weinreb, MD &Carole Upshur, EdD
Department of Family Medicine
University of Massachusetts Medical School
Membership
Department of Family Medicine, University of Massachusetts Medical School Division of Medical Assistance, state Medicaid agency Boston Medical Center Health Net Plan Fallon Community Health Plan Neighborhood Health Plan Network Health Primary Care Clinician Plan Massachusetts Behavioral Health Partnership
Planning grant activities
Understand purchasing and quality improvement options for DMA Understand prevalence and characteristics of depression in MassHealth population Understand current outcomes and treatment Understand barriers to improved treatment and outcomes Implement systems changes that address all of the above
Depression as a major chronic illness
Affects 10% of all adult Americans at any one time Prevalence more than double this in urban low income populations Majority goes untreated or under treated High utilizers of care Often complicates treatment of diabetes, CHF, post-MI etc.
Literature: What we knew before we started
Simon (General Hosp. Psychiatry 2002)
Most patients with depression receive primary care services but few receive mental health specialty care (community surveys) Half of primary care patients with depression unrecognized or untreated (comparison of pcp diagnosis with structured screening)