an elderly person holding a stress ball while a loved on holds gently holds their arm
Photo by Matthias Zomer from Pexels

The Problem

Primary care providers increasingly serve as the de facto mental health system in the US. Patient preference, stigma, insurance discrimination and the shortage of psychiatrists have all contributed to this shift in the locus of care.

As a result, the majority of prescriptions for psychotropic medications are written in primary care settings. However resource constraints, lack of time and gaps in training all limit the effectiveness of behavioral health care in primary care. Efforts to integrate mental health treatment in primary care, while garnering significant attention, have been less than successful and can be linked to inadequate use of evidence-based models of behavioral health-primary care integration.

Our Solution

We leveraged DukeWell care managers to work with participating pilot practices in implementing a telephonic depression care protocol for patients diagnosed with depression. This intervention was done in the Hillsborough and Sutton Station DPC clinic.

Impact

As a result of this project:

  • 30% of patients enrolled in IMPACT model of care went into remission.
  • Implementation and scaling of Population Health approach to mental health.
  • Duke Primary Care scaled this model from just 2.5 clinics to the network of primary care practices. DPC hired Terry Ervin from DukeWell to sit within DPC to offer IMPACT (now referred to collaborative care for depression) resources to our patients.

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