title: Implementing collaborative care programs for psychiatric disorders in medical settings: a practical guide.
abstract: OBJECTIVE
  Collaborative care is a systematic, team-based approach to the management of depression and other psychiatric disorders in medical settings. Collaborative care has been found to be effective and cost-effective, but there is little information to guide its implementation in clinical care. The objective of this article is to provide a practical guide to the implementation of collaborative care programs in real-world settings.
  
  
  METHODS
  Based on our experience delivering collaborative care programs, we provide (a) specific, stepwise recommendations for the successful implementation of collaborative care in outpatient settings and (b) an examination of the additional benefits and challenges of collaborative care programs that begin during hospitalization.
  
  
  RESULTS
  The implementation of collaborative care requires senior buy-in, an effective team, clear treatment components, engaged clinicians, procedures to ensure quality and adequate infrastructure. Beginning these programs with hospitalized patients may offer additional advantages but also requires additional flexibility to adapt to the inpatient setting.
  
  
  CONCLUSIONS
  A systematic approach to the development and implementation of collaborative care programs may allow clinicians to effectively and efficiently treat psychiatric illness in medical populations in both inpatient and outpatient settings.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Beach
authors.affiliation: Psychological Medicine Research, University of Oxford Department of Psychiatry, Oxford OX1 2JD, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Walker
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Celano
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mastromauro
authors.affiliation: Psychological Medicine Research, University of Oxford Department of Psychiatry, Oxford OX1 2JD, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Sharpe
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA. Electronic address: jhuffman@partners.org.
authors.forename: Jeff C
authors.initials: JC
authors.lastname: Huffman
mesh_terms: D003299:Cooperative Behavior; D017408:Guidelines as Topic; D006268:Health Facilities; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D016730:Program Development / Q000379:methods*; D011611:Psychosomatic Medicine
keywords: Collaborative care; Depression; Integrated care; Population health; Psychosomatic medicine