Systemic organizational change for the collaborative care approach to managing depressive disorders.

t v c The U.S. Preventive Services Task Force recommends screening for depression in adults and adolescents in outpatient primary care settings hen adequate systems are in place for effıcient diagnois, treatment, and follow-up of depressive disorders. The revention Practice Committee of the American College f Preventive Medicine subsequently suggested that all rimary care settings should have such systems in place, iven the prevalence and associated morbidity of depresive disorders. In addition to facilitating routine screening and establishing the diagnosis, the collaborative care model, discussed in articles in this issue of the American Journal of PreventiveMedicine, is designed to increase primary care providers’ use of evidence-based protocols inmanaging depressive disorders and to improve clinical and community support for patients’ active engagement in shared decision making and self-management. (Of note, I use the term patient herein for clarity and concision, although modern conceptions of recovery, which mphasize shared decision making and empowerment, ightly prefer terms like consumer, mental health service ser, or client.) As discussed in the articles from the Community Preentive Services Task Force (Task Force; with collaboraors from other institutions, agencies, and associations) n this issue of the Journal, the adoption of an interated, collaborative care model for the management of epressive disorders is a method of establishing adequate ystems to ensure diagnosis, treatment, and follow-up of epressive disorders. Collaborative care models typically employ case managers to liaise among primary care providers, patients, and mental health professionals. Depressive disorders are highly prevalent, andmost patients with such disorders who are in treatment are seen in primary care settings (emphasis is added here to acknowledge the vast problem of lack of treatment and