Women who received collaborative care for depression at two University of Washington Medicine obstetrics and gynecology clinics showed fewer symptoms after treatment than women receiving usual depression care, according to a new study.
Led by Drs. Wayne Katon, a psychiatrist, and Susan Reed, an ob/gyn, the study found that collaborative care helped decrease depression symptoms for most women by at least 50 percent after one year of treatment.
Women who received collaborative care also were more likely to return for follow-up care and reported greater satisfaction with the care they received, the researchers reported.
“More women than men experience depression, and underserved poor and minority women have a greater chance of experiencing this disorder,” said Katon. “Since many of these women seek depression care with a primary or specialty care provider, we wanted to offer more thorough care in a setting that’s easier for these women to access.”
The collaborative approach comprises counseling and greater patient engagement than is typical of mental health care at specialty clinics, he noted. It involves psychiatrists, clinicians, specialists, and depression care managers.
The team meets weekly to review patient progress and provide treatment recommendations. A care manager follows up with patients, he explained.
“Collaborative care benefits the community not only by helping women with depression regain function in their lives, but also by lowering health care costs,” said Reed, director of women’s health at Harborview Medical Center.
“We anticipate fewer women will go to emergency rooms for acute care problems related to mental health, and more women will be able to rejoin the workforce.”
The approach, called Depression Attention for Women Now (DAWN), was tested at Harborview Medical Center and University of Washington Medical Center’s Roosevelt Clinic. Of the 205 participants, more than half were managing posttraumatic stress disorder (PTSD), as well as depression symptoms.
Many had low incomes and little or no health insurance. Nearly half were women of color, according to the researchers.
For the study, women were randomly assigned to receive the collaborative care intervention or typical care.
The women in each group received treatment for up to 12 months. Follow-up continued for an additional six months, the researchers noted.
Women who received collaborative care could opt for follow-ups in person or by phone, and choose whether they wanted counseling, medication or a combination of both, the researchers added.
According to Reed, many of the women said it was the first time they felt anyone cared about their mental health. One participant wrote that the approach gave her tools to manage her depression on her own, she said.
The researchers have begun implementing the collaborative-care model at Harborview Medical Center’s Women’s Clinic.
“The collaborative-care model could be adapted for other types of specialty care,” Reed said. “As we saw, the model was especially beneficial for women who faced barriers to health care, as collaborative care addressed multiple health concerns — not just obstetric and gynecologic health, but also mental health — in one place.”
Funded by a National Institute of Mental Health grant, the study was published in the journal Obstetrics & Gynecology.
Source: University of Washington