Primary-Care Models to Be Developed

To increase the use of effective models for treating depression in primary care settings, the Robert Wood Johnson Foundation is funding the five-year, $12 million program “Depression in Primary Care: Linking Clinical and System Strategies.”

National program director Harold Alan Pincus, M.D., explained that depression is commonly encountered in primary care patients, but it may go undetected or untreated due to barriers at the level of both the clinician and the health system.

“We know that depression is a serious and chronic illness that should be conceptualized no differently from any other chronic illness,” Pincus said. “We also know what works to improve care, but it is not being implemented because of barriers at multiple levels. The way to overcome those barriers is by working at these multiple levels.”

Pincus said that putting these models into place will require a combination of clinical and economic and system strategies at multiple levels, engaging patients, providers, practices, plans, and purchasers.

“A lot of the disconnectedness between physicians and nonphysicians, between HMOs and carveouts, and between behavioral health and general health has a lot to do with perverse incentives built into the system,” Pincus said.

More information about the program is posted at www.wpic.pitt.edu/dppc.