Collaborative Care for Depression of Adults and Adolescents: Measuring the Effectiveness of Screening and Treatment Uptake

Psychiatr Serv. 2019 Jul 1;70(7):604-607. doi: 10.1176/ Epub 2019 Apr 26.


Objective: This study analyzed effectiveness of screening, referrals, and treatment uptake of a collaborative care for depression intervention across 10 primary care clinics in Chicago.

Methods: Between November 2016 and December 2017, patients (N=25,369) were screened with the Patient Health Questionnaire-2 and the Patient Health Questionnaire-9 on the basis of an eligibility algorithm. Electronic health record data were analyzed for sample characteristics, screening rates, referrals, and treatment pathways. To identify disparities, a test of proportions was conducted between eligible and screened patients as well as referred and treated patients.

Results: Screenings, referrals, and uptake occurred proportionately across subgroups except for patients ages 12-17. Adolescent age was associated with disproportionate Patient Health Questionnaire-9 screenings and with treatment disengagement.

Conclusions: The intervention shows promise in expanding access to care and reducing disparities. Greater access to psychotherapies and innovative treatment modalities, particularly for adolescents, may improve overall treatment uptake.

Keywords: Collaborative care; Depression; Health disparities; Population health; Primary care; Screening.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chicago
  • Child
  • Delivery of Health Care, Integrated / statistics & numerical data*
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care / statistics & numerical data*
  • Patient Health Questionnaire / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data*
  • Treatment Adherence and Compliance / statistics & numerical data*
  • Young Adult