 An example of integrated health care:
Combined Diabetes and Depression
Care Management
... Depression is a condition associated with a variety of other medical problems, including more suffering and physical pain, decreases in physical ability and self-care of chronic illnesses, and a high potential for suicide. It also can significantly increase medical costs. Treating depression is not only important for mental health, it's important for physical illness as well.
... According to a study published in the October 2005 issue of Diabetic Medicine, more than 40 percent of patients with diabetes worldwide reported poor psychological well-being, with thoughts ranging from fears about the disease worsening to worries that diabetes will make it difficult for them to care for their families.
... One study published in the August 2007 issue of Diabetes Care concluded that depression in diabetic patients is associated with increased symptoms of diabetes, impaired functioning, higher medical costs, and increased mortality. In addition, patients with depression often have poor self-care, a behavior that can lead to diabetes complications and even death. The research provides added proof that diabetes plays a role in depression and vice versa.
... Most researchers found that for patients that are diabetic who have become depressed, anxiety and worry play a central role. This disease is considered chronic, and these patients must think constantly about their diet as well as the possibility of complications, which could include peripheral nerve problems, heart disease and blindness.
... The Department of Family and Preventive Medicine at the University of California, San Diego partnered with the San Diego County Adult and Older Adult Mental Health Services, the Council of Community Clinics, and Medi-Cal to enhance treatment for patients with depression and diabetes.
... The project expanded Project Dulce, the existing diabetes management program in San Diego County community clinics, to include care management for consumers with diabetes and depression using the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) model. While Project Dulce and IMPACT have been individually implemented and independently evaluated in the past (showing positive results), this project provided an opportunity to test and evaluate the combination of the two models.
... The study conducted by UCSD the University of California, San Diego researchers found that adding a depression care manager to an existing diabetes management team was effective at reducing depressive symptoms at a reasonable cost. This study suggests treatment does make a difference.
... Thirty-three percent of patients in a low-income, predominantly Spanish speaking Latino community clinic population had symptoms of major depression. The researchers reported interventions that increase exercise and improve glycemic control may also decrease depressive symptoms in patients with diabetes, pointing to potential positive reinforcing effects of integrating depression care with diabetes management.
... The researchers found that the IMPACT model of depression care helped patients who have depression. Patients in the IMPACT program also had improved functioning and quality of life and lower overall medical costs.
Since mental health and physical health are clearly connected there is a need for a collaborative system of care between mental health care and primary health care to improve the services for individuals with mental health conditions.
Continued on page 5
|
info
...MHSA PROP 63
