U-M expands depression support program for primary care patients

August 23, 2011

More and more, patients are turning to their family doctor for help with depression and other mental health issues. Depression is listed as a diagnosis for 1 in 10 office visits, and primary care doctors prescribe more than half of all antidepressants.

Accordingly, the University of Michigan Health System is expanding an innovative depression support program to patients at all 12 of its primary care sites.

The Michigan Depression Outreach and Collaborative Care Program, or M-DOCC, complements care provided by the patient’s primary care physician.

Between office visits, patients participate in regular follow-up calls with an experienced mental health social worker known as a care manager. The care manager helps monitor how well the patient is responding to treatment and provides feedback to the patient’s primary care doctor on how he or she is doing.

Care managers are also there to answer the patient’s questions and provide support, education and self-management skills in areas like diet, exercise and sleep, which are critical to long-term resilience.
“The goal is to improve and sustain mental health results by providing small amounts of flexible, targeted follow-up care,” says Michael S. Klinkman, M.D., M.S., a professor of family medicine at the University of Michigan Medical School and member of the U-M Depression Center, who led the program’s development and conducted research to evaluate its effectiveness.

“The key is to help the patient stay engaged in treatment over time and be actively involved in their own care – rather than just sending them to a website for more information,” Klinkman adds.

M-DOCC’s services are free to enrolled patients, and the program accepts all U-M primary care patients with depression, including those with additional mental health diagnoses, at any phase of treatment. Patients are free to opt out of the program at any time. M-DOCC is designed to provide long-term assessment and monitoring, so participants are encouraged to continue in the program even after they achieve recovery or remission to help prevent relapse of depression.

Since 2003, more than 2,000 patients have been referred to M-DOCC, and participating patients have shown significantly better remission rates and an average 35 percent increase in work productivity while in the program compared to usual care.

M-DOCC’s unique care model has attracted the attention of other health systems seeking to replicate the effectiveness of a program based on “health coach” or “health navigator” support to primary care doctors – not just for depression management, but for other chronic conditions as well.

M-DOCC is guiding Allegiance Health in Jackson, Mich., in establishing a similarly structured depression outreach program. This is the first community outreach from a UMHS disease management program to be integrated into the clinical operations of an external health care system.
As one of the original disease management programs created by the UMHS Medical Management Center in 2000, M-DOCC has been significantly refined over the past decade. It is run through the U-M Depression Center and the Departments of Psychiatry and Family Medicine.

M-DOCC is offered to patients at the following primary care locations: Briarwood Family Medicine, Brighton Health Center, Canton Health Center, Chelsea Health Center, Dexter Family Medicine, Family Medicine at Domino Farms, East Ann Arbor Health Center, Livonia Health Center, Saline Health Center, Taubman Health Center, West Ann Arbor Health Center and Ypsilanti Health Center.

The program is also available to patients being seen by specialists in the U-M Depression Center.

Current or prospective patients with questions can call 734-936-8706 or 866-340-0013.