Collaborative care models for the management of mental disorders in primary care

Abstract

Abstract This critical review sketches the principles of collaborative care models in general practice for treatment of common mental disorders, such as depressive, anxiety, or somatoform disorders. Such disorders may not be self-limiting and have a tendency to become chronic, and their treatment in the general-practice setting demands a change in organization of general practice according to a chronic care model, i.e. collaborative care. In collaborative care, at least two of the following three professionals work together to alleviate the mental health burden of the patient: the general practitioner (GP), the nurse care-manager (CM), and the consultant psychiatrist (CL). The model is commonly effective but it is also more expensive. The implementation of collaborative care depends on the availability of CMs and CLs, guidelines for psychiatric consultation, reimbursement, and adequate web-based decision aids for the professionals. Its structural implementation in general practice requires a sustained effort at national level.