Background: An estimated 14.8 million Americans experience major depression in a given year. Also, every year approximately 1.5 percent of the adult U.S. population experience dysthymic disorder — a chronic depressive illness that is less severe than major depressive disorder. Stigma, additional health issues and complexities of treatment delivery prevent many from receiving adequate treatment.

Strategies: The Task Force on Community Preventive Services recommends several strategies to manage depressive disorders. Each recommendation is based on evidence from a systematic review of the published scientific literature examining the effectiveness of the strategy.

Collaborative Care for the Management of Depressive Disorders is designed to: 1) improve routine screening and diagnosis of depressive disorders; 2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and 3) improve clinical and community support for active patient engagement in treatment goal setting and self-management.  This is a multi-component, health care system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists.  This type of intervention improves depression outcomes and is applicable to adult populations in most settings.

Home-based Depression Care Management for Older Adults involves: 1) active screening for depression; 2) measurement-based outcomes; 3) trained depression care managers; 4) case management; 5) patient education, and 6) a supervising psychiatrist.  This type of intervention improves short-term depression outcomes in adults, 60 years of age or older.

Clinic-based Depression Care Management for Older Adults includes: 1) active screening for depression; 2) measurement-based outcomes; 3) trained depression care managers providing case management; 4) a primary care provider and  patient education, anti-depressant treatment and/or psychotherapy with a supervising psychiatrist. This type of intervention improves short-term outcomes in adults 60 years of age or older who have major depression or chronic low levels of depression (dysthymia).

What is the Guide to Community Preventive Services (Community Guide)?
The Community Guide is an essential resource for people who want to know what works in public health. It provides evidence-based recommendations and findings about public health interventions and policies to improve health and promote safety. The Task Force on Community Preventive Services (Task Force) -- an independent, non-federal, volunteer body of public health and prevention experts -- makes these findings and recommendations based on systematic reviews of scientific literature conducted under the auspices of the Community Guide. The Centers for Disease Control and Prevention provides ongoing scientific, administrative and technical support for the Task Force.

Visit www.thecommunityguide.org for more information on these strategies and others reviewed to manage depressive disorders.