Behavioral health problems such as depression, anxiety, alcohol or substance abuse are among the most common and disabling health conditions worldwide, collectively robbing millions of their chance to lead healthy and productive lives. The good news is that there are effective treatments for most mental health conditions. The bad news is that most people in need don’t receive effective care due to stigma, a shortage of mental health specialists, and lack of follow through.
Integrated care programs try to address this problem by providing both medical and mental health care in primary care and other clinical settings. Offering mental health treatments in primary care is convenient for patients, can reduce the stigma associated with treatment for mental disorders, builds on existing provider-patient relationships, and can help improve care for the millions of patients who have both medical and mental disorders. There is a wide range of integrated programs, some of which are based on evidence and some of which are not.
Collaborative care is a specific type of integrated care developed at the University of Washington that treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Based on principles of effective chronic illness care, collaborative care focuses on defined patient populations tracked in a registry, measurement-based practice and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who are not improving as expected.
Collaborative care originated in a research culture and has now been tested in more than 80 randomized controlled trials in the US and abroad. Several recent meta-analyses make it clear that collaborative care consistently improves on care as usual. It leads to better patient outcomes, better patient and provider satisfaction, improved functioning, and reductions in health care costs, achieving the Triple Aim of health care reform. Collaborative care necessitates a practice change on multiple levels and is nothing short of a new way to practice medicine, but it works. The bottom line is that patients get better.
Use our Resource Library to find materials about collaborative care, have our Implementation Guide take you through the process of implementation, or browse this section to better understand the model of collaborative care.