Depression Care for Low-Income, Minority, Safety Net Clinic Populations With Comorbid Illness

Abstract

Objective: Increasingly, mental health care is provided within the general health care sector. Accompanying this significant change is the demand for evidence-based as well as cost-effective or cost-neutral care models. Method: The authors present a pooled analysis of three large randomized clinical trials in which social workers provide depression care in collaboration with patient navigators, treating physicians, and consulting psychiatrists to examine the effects of diverse depression interventions on symptom improvement among low-income minority populations with cancer or diabetes in public safety net care systems. Results: Pooled results find a significant intervention effect over usual care. Results also find stronger benefits of structured psychotherapy and or antidepressant medication (AM) over brief counseling and referral to mental health care. Conclusion: The rapid change in health care delivery underscores an urgent mandate for social work to significantly increase its comparative effectiveness clinical trial research and adapt its mental and health care education.