Promising results in treating depression

Jun 25, 2010 By Maura Lerner

Only 6 percent of Minnesotans treated for depression at primary care clinics report that they're free of symptoms within six months, according to a new report by MN Community Measurement, a health-care quality group.

But an innovative treatment program known as "Diamond" was able to boost the success rate to 26 percent, the organization found in a report released Friday.

The Diamond program, which started in 2008, relies on "care managers" to maintain frequent contact with patients suffering from .

"We knew improving depression care was a very difficult task," said Jim Chase, president of MN Community Measurement, which tracks quality measures at medical clinics statewide. "We're now starting to see that clinics that implement changes ... have better outcomes."

As part of the Diamond project, clinic employees check on patients by phone to see if they're taking their medications or experiencing side effects, and offer coaching on how to cope with their symptoms. It started as a pilot project at 10 Minnesota clinics, and has since spread to 83 clinics statewide.

The report found that patients enrolled in the Diamond program were much more likely to report that they were no longer depressed, or had less severe symptoms, than other patients six months after starting treatment.

The best results were at Mayo's Northwest Clinic in Rochester, which reported a six-month success rate of 36 percent.

"We have story after story of patients that say why don't we do this for all chronic illnesses," said Dr. Mark Williams, the lead psychiatrist for the Diamond Project at the Mayo Clinic.

Clinics are rated on how many patients, after treatment, score in the normal range on a nine-point questionnaire known as the PHQ-9, which asks about depression symptoms such as trouble sleeping and feelings of hopelessness.

Williams said the questionnaire is a good, if imperfect measure of depression, and helps doctors track whether their patients are improving.

He noted that many primary care doctors struggle to treat patients with depression, and the Diamond project was designed to help them do a better job.

It's well known that depressed people can give up on treatment easily if left to their own initiative. With Diamond, "we are the people tracking them down," Williams said, and that has paid off in better outcomes. "We've had people say 'I didn't know that I could feel this good'."

As part of the project, several insurance companies have agreed to pay an extra monthly fee to the clinics to cover the costs. But so far, the federal Medicare program has refused to pay, which has limited the program's enrollment, said Nancy Jaeckels, vice president of the Institute for Clinical Systems Improvement, which launched the Diamond project in Minnesota.

Still, she said the program has proven its worth in multiple research studies, and now in practice across Minnesota.

Among patients who stuck with the program for six months, the results were even higher: 45 percent were free of depression symptoms and another 16 percent reported significant improvement. About 42 percent of the 3,037 Diamond patients could not be reached six months later and were presumed still to be depressed, Chase said, even though some of them probably recovered as well.

One reason the general success rate is so low -- 5.8 percent statewide -- is that many depressed patients are lost to follow-up because they don't return to their doctors, said Chase.

"We know some of those patients are not coming back because they're better," he said. "We know the majority of them aren't. That's how the system has, I think, failed in the past."

The key to the Diamond project, he said, is that patients are more likely to stay in treatment. "We've been trying to show there are ways to redesign the care to give better results."

Explore further: Religious music brings benefit to seniors' mental health

More information: To see the clinic scores, go to
For a list of Diamond clinics, go to

4.5 /5 (2 votes)
add to favorites email to friend print save as pdf

Related Stories

Minority health-care clinics separate but unequal

Feb 09, 2009

A study published today in the Archives of Internal Medicine may shed new light on why minority Americans have poorer health outcomes from chronic conditions such as hypertension, heart disease and diabetes.

Recommended for you

Religious music brings benefit to seniors' mental health

Apr 18, 2014

A new article published online in The Gerontologist reports that among older Christians, listening to religious music is associated with a decrease in anxiety about death and increases in life satisfaction, self-e ...

User comments : 0

More news stories

Less-schooled whites lose longevity, study finds

Barbara Gentry slowly shifts her heavy frame out of a chair and uses a walker to move the dozen feet to a chair not far from the pool table at the Buford Senior Center. Her hair is white and a cough sometimes interrupts her ...

How to keep your fitness goals on track

(HealthDay)—The New Year's resolutions many made to get fit have stalled by now. And one expert thinks that's because many people set their goals too high.

Low tolerance for pain? The reason may be in your genes

Researchers may have identified key genes linked to why some people have a higher tolerance for pain than others, according to a study released today that will be presented at the American Academy of Neurology's 66th Annual ...

Growing app industry has developers racing to keep up

Smartphone application developers say they are challenged by the glut of apps as well as the need to update their software to keep up with evolving phone technology, making creative pricing strategies essential to finding ...

Making graphene in your kitchen

Graphene has been touted as a wonder material—the world's thinnest substance, but super-strong. Now scientists say it is so easy to make you could produce some in your kitchen.