Stepping out of the Shadows: Collaborating to Improve Services for Patients with Depression

Depression is a serious medical illness that goes beyond temporary feelings of sadness. As many as 870,000 British Columbians may experience a major depressive episode in their lifetime. Unfortunately, those who seek treatment for depression face a fragmented health care system hampered by a history of chronic under-funding for mental health services. The result is that too few patients are recognized and diagnosed, and among those who are correctly diagnosed, too few are able to access medically necessary follow-up care.

Fortunately, recent initiatives in the delivery of mental health services for patients with depression – including collaborative efforts between the Doctors of BC and the BC Ministry of Health Services – suggest that there is no lack of knowledge about how to improve care. The 2002 release of BC’s Provincial Depression Strategy, the implementation of the Changeways program in the Vancouver Coastal Health Authority, the introduction of new GP mental health planning and related fees, and the launch of the mental health practice support program all point to the willingness and potential for government, physicians, and other health care stakeholders to work together to improve access to, and the quality of, care for patients with depression.

In this policy paper, the physicians of BC offer 14 recommendations to improve the status quo. These include:

• A call for the provincial government to adopt wait time benchmarks for the treatment of depression.
• The introduction of tax incentives for employers that implement a workplace mental health strategy.
• The creation of a Provincial Mental Health Commission to provide leadership at a provincial level and improve the delivery of primary care services for patients with depression.

Creating and implementing such policies requires, first and foremost, collaboration. Indeed, the experiences with current Doctors of BC-Ministry of Health Services chronic disease collaborative efforts bode well for such an approach. If there is a theme among the recommendations posed in this paper, it is that greater collaboration among stakeholders – namely the business community, government, and providers – is the most promising route to tangible improvements. We hope that together we can work to step out of the shadows of depression and improve the lives of patients.

For the full policy paper, please see “Stepping out of the Shadows: Collaborating to Improve Services for Patients with Depression”.