title: Care managers' experiences in a collaborative care program for high risk mothers with depression.
abstract: OBJECTIVE
  The aim of this study was to understand care managers' experiences in caring for depressed mothers in an integrated behavioral health program.
  
  
  METHODS
  As part of a quality improvement project, we conducted a focus group interview with six care managers caring for low income mothers with behavioral health needs in a safety net program in King County, WA. Using thematic analysis, codes were organized into themes that described the care managers' experiences.
  
  
  RESULTS
  Two organizing themes along with associated themes emerged: (1) Assets for improving depression outcomes: patient-provider interactions, including the importance of engagement; program resources such as care coordination and (2) Barriers to improved depression outcomes: patient-provider interactions, including difficulty engaging patient; patient-related factors such as multiple stressors; program resources such as need for more psychiatric support; and difficulty accessing outside resources.
  
  
  CONCLUSIONS
  Numerous potentially modifiable factors including levels of engagement, motivational interviewing, and increased psychiatric support were identified by care managers as affecting depression care and outcomes. Implications for care management training and approaches to psychiatric consultations are discussed.
authors.affiliation: Cambridge Health Alliance, Department of Psychiatry, Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, USA. Hhuang@cha.harvard.edu
authors.forename: Hsiang
authors.initials: H
authors.lastname: Huang
authors.forename: Amy M
authors.initials: AM
authors.lastname: Bauer
authors.forename: Jessica Knaster
authors.initials: JK
authors.lastname: Wasse
authors.forename: Anna
authors.initials: A
authors.lastname: Ratzliff
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Chan
authors.forename: David
authors.initials: D
authors.lastname: Harrison
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
mesh_terms: D001291:Attitude of Health Personnel; D001521:Behavior Therapy; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D009035:Mothers / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010346:Patient Care Management; D011203:Poverty; D011247:Pregnancy; D011320:Primary Health Care / Q000592:standards*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D058996:Quality Improvement; D012017:Referral and Consultation; D012306:Risk; D016896:Treatment Outcome; D014861:Washington