Abstract
Although current guidelines recommend collaborative care for severely depressed patients, few patients get adequate treatment. In this study we aimed to identify the thresholds for interdisciplinary collaboration amongst practitioners when treating severely depressed patients. In addition, we aimed to identify specific and feasible steps that may add to improved collaboration amongst first and second level Belgian health care providers when treating depressed patients. In two standard focus groups (n = 8; n = 12), general practitioners and psychiatrists first outlined current practice and its shortcomings. In a next phase, the same participants were gathered in nominal groups to identify and prioritise steps that could give rise to improved collaboration. Thematic analyses were performed. Though some barriers for interdisciplinary collaboration may seem easy to overcome, participants stressed the importance of certain boundary conditions on a macro- (e.g., financing of care, secure communication technology) and meso-level (e.g., support for first level practitioner). Findings are discussed against the background of frameworks on collaboration in healthcare and recent developments in mental health care.
Highlights
Major depressive disorder (MDD, [1]) is highly prevalent [2] and its personal and societal impact is significant [3]
Each of the following paragraphs starts with a summary of the information we retrieved from the standard focus group discussions about current interdisciplinary collaboration, subsequently completed with the most important suggestions for improvement proposed in the nominal group
Our findings suggest that collaborative care regarding severely depressed patients today is limited in Belgium
Summary
Major depressive disorder (MDD, [1]) is highly prevalent [2] and its personal and societal impact is significant [3]. Though effective treatment interventions exist, it is estimated that only half of the depressed patients in Europe receive adequate treatment within an acceptable timeframe [4]. Different factors contribute to this treatment gap, i.e., a substantial portion of depressed patients is reluctant to seek help [5,6], and some depressive episodes are misdiagnosed or remain unrecognized [7]. Even those patients who are correctly diagnosed, often do not get the most effective treatment. Treatment should be multi-professional, involving the patient’s general practitioner (GP) and at least one other health professional, and health care
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