Funding Mechanisms for Depression Care Management: Opportunities and Challenges

There is overwhelming evidence that depression care management works well for patients and is a cost-effective treatment. However, inconsistent third-party reimbursement for depression care management is a significant economic barrier to utilization and sustainability in primary care settings. Seven funding mechanisms, mostly under-utilized and not widely publicized, are described. While substantial obstacles remain in the way of fully implementing these depression care management funding mechanisms, several recent policy advancements provide some optimism for the potential adoption of financial mechanisms to support and disseminate these evidence-based practices.

Teaching Psychiatry Residents to Work at the Interface of Mental Health and Primary Care

There is now a variety of well-established educational experiences in integrated care within psychiatry residencies. This article proposes core competencies to be taught and highlight rotations and educational methods in five different programs, which provide experience in different models of integrated care, as a psychiatric consultant, overseeing population-based mental health care, and delivering medical care for psychiatric patients. The authors present examples of programs educating psychiatry residents to work in integrated healthcare settings.

Evidence Base for Collaborative Care

A substantial body of evidence for Collaborative Care has emerged since its development at the University of Washington in the 1990s. Beginning with the seminal IMPACT Trial published in 2002, more than ninety randomized controlled trials and several meta-analyses show that Collaborative Care (CoCM) is more effective than usual care for patients with depression, anxiety, and other behavioral health conditions.

CoCM is also shown to be highly effective in treating co-morbid mental health and physical conditions such as cancer, diabetes, and HIV. The document summarizes several selected research, review, and practice-based articles that demonstrate Collaborative Care significantly improves patient lives.