Comparative Studies of Collaborative Team Depression Care Adoption in Safety Net Clinics
Research on Social Work Practice
Published online on March 31, 2016
Abstract
To evaluate three approaches adopting collaborative depression care model in Los Angeles County safety net clinics with predominantly Latino type 2 diabetes patients.
Pre–post differences in treatment rates and symptom reductions were compared between baseline, 6-month, and 12-month follow-ups for each approach: (a) Multifaceted Depression and Diabetes Program (MDDP) grant–hired social workers dedicated for depression care, (b) Diabetes–Depression Care-Management Adoption Trial (DCAT) supported care (SC) by clinic social workers in diabetes disease management teams, and (c) DCAT-automated care-management technology-facilitated care (TC) model. All social workers were guided by a depression care protocol.
All approaches significantly increased treatment rate, the largest improvement being MDDP (40%), followed by TC (30%) and then SC (20%). Similar patterns were found in symptom improvement (≥50% depression score reductions) and self-rated health. TC was the only approach to significantly improve patient diabetes self-care.
Activated social workers and technology facilitation provide promising effective adoption of collaborative depression team care in safety net.