The key to battling depression in teens may lie in the concerted efforts of parents, specialized mental health care providers, and primary care physicians, a recent study suggests. The study, published in JAMA Internal Medicine this week, found that young people who received “collaborative care” experienced better outcomes than those whose doctors left them to their own devices.
The collaborative care model integrates specialized mental health services with primary care and tailors treatment so that it benefits not only the individual, but the entire family. The practice expands across the entire health care process — including diagnosis, treatment, surveillance, health communications, management, and support services — in a manner that allows families to make their own healthcare decisions.
During the three-year randomized clinical trial, researchers followed 101 depressed teenagers at Group Health Cooperative in Seattle after sorting them into groups: those who had traditional treatment and those who received collaborative care. Test subjects in the collaborative care group were assigned depression care managers who maintained contact with them via phone for a year. Teens in that group also attended education sessions with their parents, during which they discussed a host of treatment options and their side effects with a physician.
“Intervention youth compared with those who received usual care had greater decreases in depressive symptoms by 12 months,” a JAMA press release said. “Sixty-eight percent of intervention youth had a 50 percent or greater reduction in depressive symptoms compared to 39 percent among control youth. The overall rate of depression remission at 12 months was 50.4 percent for intervention youth and 20.7 percent for control youth. These findings suggest that mental health services for adolescents with depression can be effectively integrated into primary care.”
Dr. Mark Riddle, a professor of psychiatry and pediatrics at the Johns Hopkins University School of Medicine, put it a different way. “This, to me, is what I call the ‘slam dunk,’” Riddle said in an interview with Live Science. “This is very convincing in terms of how it works.”
In spite of its benefits, health care networks have been slow to take on the collaborative care model, posing a tremendous health risk for people in need of mental health care services. Data collected by the Centers for Medicare & Medicaid Services shows that only one out of five adults with mental health disorders see mental health care specialists. Additionally, primary care providers that screened for mental health problems didn’t have the resources to follow up with patients who positively tested for these conditions.
Experts give a host of reasons as to why the barriers to collaborative care exist. A 2011 study published in the International Journal of Integrated Care, for example, found that the burden to partner with specialized health care providers, social service organizations, and schools often falls on physicians. Researchers concluded that when managers of the various organizations committed to reaching out across disciplines, support for medical professionals increased, and once-convoluted mental health care processes improved over time.
In its 2007 discussion paper, the Canadian Medical Association also found that when communication between patients and physicians increased, access to specialized care and enhancement of said care improved. The collaborative care model also clarified the role of healthcare providers, according to the discussion paper.
The collaborative model could do wonders for the mental health care system during a time when more than 10 percent of adolescents develop a depressive disorder before the age of 18. Today, common mental ailments among that population include depression, anxiety, and conduct disorder. Traumatic life events and the stress of adolescent change can distort one’s feelings, actions, and perceptions, ultimately triggering a mental disorder. When left untreated, teen depression counts among the leading causes of disability among people between the ages of 14 and 55.