title: Integrated management of depression: improving system quality and creating effective interfaces.
abstract: Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce.
  
  
  OBJECTIVE
  To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems.
  
  
  METHODS
  After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced.
  
  
  RESULTS
  A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes.
  
  
  CONCLUSIONS
  Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.
authors.affiliation: Strategic Workplace Health Department, Healthcare Benefit Trust, British Columbia, Canada. larry.myette@hbt.ca
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Myette
mesh_terms: D019033:Delivery of Health Care, Integrated; D003863:Depression / Q000628:therapy*; D019468:Disease Management; D019317:Evidence-Based Medicine; D006801:Humans; D009787:Occupational Medicine / Q000458:organization & administration*; D011786:Quality Control; D012648:Self Care