The Learning Curve After Implementation of Collaborative Care in a State Mental Health Integration Program

What is it about?

Collaborative care is an evidence-based treatment model for common mental health disorders, such as depression, in the primary care setting. Its success derives from the usage of a specialized behavioral health care manager to provide direct patient care and closely track outcomes with the support of a psychiatric consultant. Research has shown that effective implementation of collaborative care requires substantial primary care resource investment and workflow modification. Little is known, however, about the “learning curve” for collaborative care implementation across diverse community clinics outside of formal research settings. The authors analyzed data from more than thirteen thousand patients in eight community healthcare organizations throughout Washington State. Findings demonstrate that it takes up to five years to reach maximum performance in treating depression and that there is considerable between-organization variability in outcomes over time. This suggests that implementing collaborative care requires significant upfront practice change and resource investment and that adherence to the model’s core components may be important for organizations to achieve sustained outcome improvement over time.

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