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Editorial |

Reducing the Burden of Depression:  Building Villages for Coordinated Care

Kenneth B. Wells, MD, MPH; Jeanne Miranda, PhD
JAMA. 2007;298(12):1451-1452. doi:10.1001/jama.298.12.1451.
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In this issue of JAMA, Wang et al1 provide evidence that implementing depression care programs through employer-sponsored managed behavioral health can improve clinical outcomes, job retention, and effective hours worked compared with usual care. The programs encouraged depressed workers to learn about and use evidence-based depression treatments, supported clinicians in following practice guidelines, and offered telephone counseling and self-help workbooks. The monetary value of the increased work time under the program exceeded the direct intervention costs and likely exceeded or was within the range of cost increases due to greater mental health specialty use under the intervention. While formal estimates of cost-effectiveness and employer return on investment are pending, it appears to be in the business interests of many employers to implement such programs to protect their investments in the retention and productivity of workers they have hired and trained.

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