Most people with depression are looked after by their GPs. However, there have been many problems with how this has worked in practice, including the fact that treatments that work (for example brief psychological therapies) have not been introduced. In recent years a new model of care has been introduced called collaborative care.
Collaborative Care is a model whereby non-medical specialists, called case managers, form a close collaboration with the patient and others involved in his or her care. The case manager has access to the GP and also to a mental health specialist. The case manager provides treatment and also makes sure there is good communication between people involved in the patient’s care.
In the CASPER and CASPER Plus trials, case managers offered a treatment called Behavioural Activation. Case managers also provide information and help patients to access appropriate services such as social care and voluntary sector services.
The case manager works in different ways with people, depending on the severity and nature of their depression. For example, participants in the CASPER Plus trial had more severe levels of depression than participants in the CASPER trial. They were more likely to be taking anti-depressant medication and therefore case managers for these participants advised on and monitored anti-depressant use.