Benchmarks in Integration of Primary and Behavioral Health

Thursday, October 15th, 2009
This post was written by Melanie Matthews

Several strategies to minimize the direct and indirect impacts of depression on healthcare utilization and cost include the screening for depression by disease management programs, particularly for patients with chronic illnesses associated with high rates of depression. In addition, the adoption of the patient-centered medical home (PCMH) model, which coordinates all aspects of an individual’s care under one medical home roof, is another vehicle for improving the care delivered to individuals with severe mental illnesses.

The Depression and Disease Management in 2008 survey set out to measure the prevalence of depression management programs in the healthcare industry and identify successful program elements and delivery methods.

Responses to the 2008 survey were submitted by 261 organizations. Of 122 respondents with depression management programs that identified their organization type, 20.5 percent were disease management organizations, 19.7 percent were health plans, 12.3 percent were behavioral healthcare providers, 9 percent were PCPs and almost 5 percent were employees. Almost a quarter of respondents — 23.8 percent — categorized their organization type as “Other,” a category that included health systems, health departments, healthcare consultants, population health management and employee assistance programs, among others.

Prevalence of Depression Management Programs

More than two-thirds — 67.2 percent — of healthcare professionals responding to the e-survey target depression as part of their disease management programs. Of 82 responding organizations that do not target depression, almost half — 47.4 percent — plan to do so in the next 12 months. While some programs that will be launched in the next 12 months are still in development, some of these respondents indicate that they plan to target employees of self-insured companies, a percentage of the elderly population (aged 60 and over) and commercial and Medicare Advantage plans.

In other future initiatives, a health and wellness organization plans to target employers for group coaching for depression and stress management, while a PCP will respond to high teenage suicide rates with regular screening for depression among this group.

Twenty-one percent of respondents noted that their depression management programs were stand-alone efforts, while 68.9 percent responded that their efforts were integrated programs. Others described their programs as “integrated to a point,” “a multiple-modality behavioral health intervention,” based on the “pyscho-social rehabilitation model” and “referring to community mental health agencies.”

According to survey responses, depression management programs are delivered via several methods, including:

  • Telephonic (67.2 percent);
  • Printed materials (58.8 percent);
  • In-person (48.7 percent); and
  • Web-based (31.9 percent).

Respondents also noted other methods of program delivery, including direct presentation, remote monitoring technology/interactive voice response (IVR) and community referrals to mental health agencies.

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