More and more, patients are turning to their family doctors for help with depression and other mental health issues. Depression is listed as a diagnosis for 1 in 10 office visits, and primary care physicians prescribe more than half of all antidepressants.
To support both patients and their primary care providers the University of Michigan Health System developed the Michigan Depression Outreach and Collaborative Care Program, or M-DOCC, over a decade ago. To date over 4,500 patients have been enrolled in this innovative depression support program, which can now be accessed through all 12 of U-M’s primary care sites.
M-DOCC is a telephone-based depression management program designed to complement the care provided by the patient’s primary care physician. Any adult patient with diagnosed or suspected depression, at any stage of treatment is eligible, including those with additional psychiatric diagnoses. Patients may be referred from any UMHS primary care clinic or the U-M Eisenberg Family Depression Center, regardless of their insurance status.
Between office visits, patients participate in regular follow-up calls with a care manager. Each an experienced mental health social worker, care managers help monitor how well the patient is responding to treatment and provide 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 outcomes for mental health treatment by providing small amounts of flexible, targeted follow-up care,” says Michael S. Klinkman, M.D., M.S., a professor in the University of Michigan Department of Family Medicine and director of the U-M Eisenberg Family Depression Center's Primary Care Research Network, who leads the program and conducts ongoing research to evaluate M-DOCC’s effectiveness.
“The key is to help people to 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. The metrics to date are impressive. Participating patients have shown significantly better remission rates and an average 35 percent increase in work productivity while participating in the program, compared to usual care.
One of the original disease management programs created by the UMHS Medical Management Center, the program has been significantly refined over the past decade, and continues to evolve. The program has been expanded to support two primary care practices in Michigan – Jackson County in partnership with Allegiance Health (the MyHealthPath program) and in Hillsdale County in partnership with LifeWays Community Mental Health (the LINC program). The LifeWays program is testing a ‘reverse referral’ process that will support patients as they return to primary care after receiving specialty mental health care services. Klinkman has also led the development of a comprehensive software application that supports all aspects of care manager workflow, the M-DOCC Clinical Record, now being used in the Jackson and Hillsdale programs.
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.
Learn more about the Michigan Depression Outreach and Collaborative Care Program (M-DOCC) here.
To consult with one of our Family Medicine clinicians or refer a patient, contact us through M-LINE, our 24/7 physician-to-physician portal, at 800-962-3555.