Piedmont Health Collaborative Care Program

Depression presents a large burden of disease to the public. The lifetime and 12- month prevalence of depression in the United States ranges from 13-16%. Depression affects individuals throughout their lifetime with societal costs seen in families, employment, and health care. Furthermore, depression ranks among the leading global causes of disability. There is a reciprocal relationship between depression and physical illness, particularly diabetes. Diabetes affects approximately 12 percent of the U.S. population. Lifestyle changes, self-monitoring schedules, and treatments for diabetes present significant psychological and behavioral challenges for individuals with diabetes. Moreover, diabetics experiencing depression often have poorer health outcomes, more difficulty at home and at work, and higher health costs when compared to diabetics without depression. The care for these individuals generally occurs in primary care settings, prompting program planners to develop targeted depression screening programs for individuals with chronic medical illnesses, such as diabetes. Collaborative care programs within primary care grew from the realization that screening for depression alone would not achieve improvement in depression. These programs use mental health specialists within primary care to serve as consultants to care managers and primary care providers involved in depression screening efforts within their clinic population. The Piedmont Collaborative Care program occurs at the Carrboro Community Health Center in Carrboro, NC. The clinic cares for an underserved population, the majority of whom are Latino individuals. The program aims to improve the health of adults with poorly controlled diabetes. The program achieves improvements in health through better screening and treatment for depression.Master of Public Healt