This article published on PsychCentral,
Dr. Rick Nauert points out the problem people have getting proper care for depression. He writes of a study done in Ontario,
Canada which supports the collaborative care model adding the inclusion
of the primary care (PMD) or family doctor
to help people follow through with the proper treatment.

A new women’s health study suggests that less than half of men and women suffering from depression see a doctor to treat their potentially debilitating condition…

Nearly half a million Ontarians, aged 15 and older, suffer from
depression. Worldwide, an estimated 154 million people are afflicted by
the condition, which is responsible for lost productivity, increased
disability claims and greater use of health-care services.
Key findings of the study include:

  • – Less than 50 percent of men and women with depression visited a doctor for care for their condition
  • – 33 percent of men and women discharged from hospital for severe
    depression did not see a doctor for a followup visit within 30 days
  • – 17 percent visited a hospital emergency room within 30 days of
    discharge from hospital while about 8 percent were readmitted to
  • – Many older adults started on antidepressant medication did not receive the recommended number of followup visits to manage their condition
  • – The lack of coordinated care for patients suggests the need for a
    collaborative care model involving a team of health care professionals,
    including mental health professionals and primary care providers.

    When I worked at the Erie County Medical Center, discharge follow-up was a constant concern. Even ten years ago, it was known that the closer the provider team (inpatient, out-patient and urgent care staff: psychiatrists, psychologists, social workers, discharge planners, nurses) worked together the more likely it was that the patient would comply with on-going treatment after discharge and the greater the chance they would not need to be admitted again.

    Researchers at St. Michael’s Hospital in Ontario conducted the study on local residents. The investigators learned that many individuals hospitalized for
    severe depression fail to see a doctor for followup care within 30 days
    of being discharged. These individuals often land in hospital emergency
    departments for care.

    The findings suggest the need for a comprehensive care model
    involving a multidisciplinary team of health care professionals,
    including family doctors and mental health specialists, to help women
    and men and better manage depression and improve their quality of life.

    Dr. Arlene
    Bierman, a physician at St. Michael’s Hospital, where the study was conducted, and principal
    investigator of the study, said,

    “Many Ontarians with depression are not treated for their condition
    and those who are often receive less than desired care. While there is
    a lot that is known about how to improve depression, we need to apply
    this to our work with patients if we want to improve the diagnosis and
    management of depression.

    “This involves better coordination among primary care and mental
    health care professionals in both community and hospital settings.”

    As a provider, whether you work in a hospital setting or an out-patient office, the effort to acquire the needed releases so that you can communicate with all your patient's health providers is a good investment.

    It's not easy, I know. There's a lot of phone tag involved and this time is not billable. But even a quick three minute conversation with my patients' PMD or psychiatrist, helps me feel like we really are all on the same team instead of like the blind men attending to different pieces of the elephant (the elephant being the depression, not the patient).

    If you are receiving or need treatment for depression at any level, you can enhance your care by helping all the members of your team talk to each other. You can do this by signing off on the required releases of confidential information, compile a list of all your providers with phone numbers and distribute it to everyone on the team, and just ask: "Did you talk to my psychiatrist yet?" That's not nagging, that's being an assertive, educated consumer.

    Photo courtesy geekgirly via Flickr