After six years of meetings and surveys and trial balloons, Kansas Citians were ready to tell their story about the success of the Community Initiative on Depression in Kansas City. More than 250 people—including representatives from two-dozen employers based in cities such as New York, Chicago, Atlanta, and Minneapolis—met in Kansas City in late March to hear the story.

Two events were held. The first, the Town Hall Meeting on Depression sponsored by the Greater Kansas City Chamber of Commerce, drew more than 200 people on March 29 to learn how Kansas City—based companies, including Sprint and Cerner, were addressing depression in the workplace.

The following day APA and the American Psychiatric Foundation's National Partnership for Workplace Mental Health hosted the National Invitational Conference in collaboration with the Mid-America Coalition on Health Care, which had launched the Kansas City depression initiative in 2000. APA sent out 40 invitations to the conference and quickly had to compile a waiting list, according to Clare Miller, director of the partnership.

"These two events were spectacular successes," said Norman Clemens, M.D., chair of the APA Committee on Business Relations. "Not only was APA in the game," he said, "we moved the ball significantly down the field. Kansas City has a model that could work for communities across America."

Joining Clemens in the conference were Marcia Goin, M.D., immediate past president of APA, and Stuart Munro, M.D., chair of the department of psychiatry at the University of Missouri Kansas City School of Medicine and medical director for the depression initiative.

APA and the National Partnership for Workplace Mental Health have been involved with the Kansas City project for three years.

"Early on," said Irvin (Sam) Muszynski, J.D., director of the APA Office of Healthcare Systems and Financing, "APA recognized the potential of the Kansas City project. We were particularly impressed with the community's commitment and the outstanding staff and leadership of the coalition."

William Bruning, J.D., M.B.A., president of the Mid-America Coalition on Health Care, said simply, "We couldn't have done it without APA."

The coalition's depression initiative represents a collaboration of 14 Kansas City employers and the stakeholders in the region's health care delivery system, for example, clinicians, health plans, hospitals, state and local administrators, educators, and researchers.

The effort is unique in two ways: it is the first communitywide initiative undertaken to address undiagnosed and untreated depression, and it brings all stakeholders to the table to address the problem.

"If there's one thing we have learned," said Bruning," it's that employers need to understand the enormous cost of depression in the workplace. Once employers understand what undiagnosed and untreated depression is doing to their bottom line, business becomes the engine for change since they're the major purchasers of health care in the community."

By June, 12 Kansas City employers will have rolled out their version of a depression initiative in their companies. (See APA's newsletter MentalHealth Works, first quarter 2005, for a description of Sprint's roll out. The newsletter's Web address appears at the end of this article.)" By anyone's standards, that's a success," said Muszynski.

The coalition also worked with primary care physicians (PCPs) and insurers to correct the misperception that PCPs would not be reimbursed by third parties if they identified and treated patients for depression in their offices.

"If psychiatrists work with PCPs to improve referral patterns, this effort will help solve an access problem for patients and eventually could lead to better care," said Clemens.

As communities such as Atlanta and New York City prepare to replicate parts of the initiative, APA is poised to help. "We hope the Kansas City experience will be a springboard for other cities," Muszynski said.

Bruning seconded the idea. "A major goal for the coalition at this point is to work in partnership with APA to formalize a national network of other communities interested in replicating the initiative," he stated.FIG1

Thomas Carli, M.D., director of the Depression Center Workplace Initiatives at the University of Michigan Health System and a conference participant, also suggested that APA might serve as the of best practices to which employers and health plans could turn.

"The richness of the dialogue throughout the day was impressive and exciting," said Goin.

Kansas Citians know they did something right. A reporter writing in the Kansas City Star about the initiative observed that it is not often that New Yorkers look to the Midwest for advice, but in the last week in March they did just that.

Highlights from the Town Hall Meeting on Depression and the National Invitational Conference will be available later this year.

More information about the Mid-America Coalition on Health Care's Community Initiative on Depression is available by contacting William Bruning by phone at (816) 753-0654 or by e-mail at bbruning@machc.org. More information about APA's business initiative is available by contacting Miller by phone at (703) 907-8673 or by e-mail at cmiller@psych.org. The APA newsletterMentalHealth Worksis posted at<www.workplacementalhealth.org>.▪