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Our integrated clinic developed innovative practice workflows for the management of patients with newly diagnosed depression that achieves rapid improvement in symptoms and provides a concrete example of how to integrate behavioral health (BH) and primary care.

Our urban residency training clinic has employed a psychologist since 1985. Despite co-location, BH services were provided unsystematically. To buck this trend, the clinic identified depression as a priority and developed a strategy to address gaps in care. We identified non-pregnant, adults with a new diagnosis of depression with universal screening then applied adapted evidence-based treatment algorithms.

The workflow includes 6 visits with a BH or medical provider and 5 phone calls over 36 weeks. PHQ-9 scores are assessed at each visit and guide treatment decisions.

After 12-months, 104 patients have participated in the intervention. Mean PHQ-9 scores improved from 16.29 at baseline to 4.73 after visit 6.