The DIAMOND program: Leading the way…

By Brett Dumke, Education Coordinator

In a recent article in the journal of Preventing Chronic Disease, published by the Centers for Disease Control and Prevention (CDC), the authors stressed the critical role of primary care providers (PCPs) in “bridging mental health and public health.”   With the shift of care from mental health specialists to primary care, mental health delivery within these settings can provide a central focus on prevention from early detection, and effective continuation of care. But as the article suggests, time constraints and financial disincentives to treat mental disorders limit the ability for PCPs to provide high-quality care for these types of health conditions.  Implementing an integrated or collaborative approach for PCPs can help ensure that high standards of care can be achieved.

One such approach has been implemented right here in Minnesota and is receiving national recognition. Leading the way for improving depression care in the primary care setting is the DIAMOND (Depression Improvement Across Minnesota, Offering a New Direction) program. Based upon the “IMPACT” study, the program was developed by the Institute for Clinical Systems Improvement (ICSI) and supported by members representing area heath plans, medical groups, patients, employer groups, and purchasers. The program involves a collaborative effort involving the primary care physician, consulting psychiatrist, care manager, and other mental health specialists.  The care manager plays a pivotal role in managing the essential components of the program for each patient, while the patient has an active part in determining his or her care.

So far, the success of the program is encouraging. According to the ICSI website, of the participants that have been active in the program for six months, “43% are in remission, and an additional 17% have seen at least a 50% reduction in the severity of their depression. These results are 5-10 times better than for patients with depression treated under  ‘usual’ primary care.”  Along with effective treatment results, the initial cost of treatment under programs like this can expect to be offset by substantial long-term cost savings. To track the effectiveness of this program the National Institute of Mental Health (NIMH) has provided a five-year grant to HealthPartners Research Foundation.

For more information on who is eligible for this program and what clinics are participating in this program, visit the ICSI website.