CG123 Common mental health disorders - National Institute for ...

Systems for organising and developing local care pathwaysIneffective strategies included guidelines and educationalstrategies when not accompanied by organisational support,chronic care clinics and computer-based decision supportsystems.GILBODY2006 Depression symptoms at 6 months Collaborative care had a positive effect on depression outcomesat 6 months compared with standard care (SMD 0.25, 95%CI, 0.18–0.32), which were maintained at 12 months (SMD 0.31; 95% CI, 0.01 to 0.53), 18 months (SMD 0.25; 95% CI,0.03 to 0.46) and 5 years (SMD 0.15; 95% CI, 0.001 to 0.30).Regular supervision and the mental health background of casemanagers were significantly related to study effect size(0.15; 95% CI, –0.02 to –0.31 and 0.18; 95% CI,0.04 to 0.32, respectively).The addition of psychotherapy to medication management incollaborative care was not associated with any significantlyincreased effect size (0.10, 95% CI, –0.05 to 0.25).The number of case management sessions had no impact oneffect size (0.02; 95% CI, –0.008 to 0.04).GRIFFITHS2008 Depression symptoms The following were associated with an improvement indepression outcomes relative to treatment-as-usual or controlcondition:• Care management• Enhanced/extended care• Guided self-help in general practice(Continued)207