The Practitioner Conection
Volume XXVII, 3rd Quarter

NATIONAL CARE CENTER'S DEPRESSION PREVENTIVE HEALTH PROGRAM

For participants aged 18 and over who are assisted through the National Care Center (NCC), any first admission in a calendar year with a diagnosis of Major Depression triggers mailing of two separate information packets to the participant’s home. The first packet contains depression education information, community resource information, and treatment support tools. The second packet, mailed approximately 30-days later, contains relapse prevention/recovery materials, and a self-addressed, postage prepaid envelope with a survey on the mailings’ helpfulness. Interventions are intended to increase understanding of depression, to encourage beneficial self-care/monitoring, and to support outpatient treatment engagement to reduce depression impact and progression. Both mailings additionally direct participants to CIGNA's behavioral health Website for supplemental materials. Those who lack Internet access are directed to our Advocacy Department for hard copies of materials.

Through feedback received from returned surveys, program effectiveness is assessed, opportunities for future program improvement are identified and recommended, and ongoing monitoring measures program impact.

2007 and first half of 2008 findings:

We're reaching more people:
The average monthly volume of eligible persons identified nearly doubled in the first six months of 2008. The volume for admissions has been relatively stable, and the improvement was driven by automated reporting and centralized ownership of mailing. 100% of eligible people received packet mailings in 2008. Separately, our Advocates distributed 1,593 more packets to callers who expressed interest in the information.

Demographics show that roughly 2/3 of depression responders are female. Comparing 2007 to the first half of 2008, we see a shift to an older population of responders. However, the 35-54 age range continues to account for the largest number of responders. The majority of responders are high school and college graduates.

What they are saying:
Assessment of program helpfulness continues at a high level. Roughly a third of responders accessed the Internet Web site; most found the information there to be helpful. Most responders reported that the mailed packets were comprehensive and the information received did improve their treatment experience. Nearly all would recommend the program to others.

Satisfaction with treatment progress, while still very high, did decline modestly. At the same time, reported use of program tools in the treatment process declined slightly. Nevertheless, reports of individual experience indicate that more than 3/4 of responders feel better and are able to do more as a result of treatment.

The most highly rated and helpful materials were: A Personal Recovery Plan, Doctor/patient Checklist for Appointments, Description of Depression and Steps Toward Recovery, Pregnancy and Depression, Tips for Self-care, Personal Inventory, Supporting Loved Ones Who Are Depressed, Warning Signs of Depression Relapse, and Healthy Goal Setting. More information was requested on medication interactions and how to handle emergencies and crises.

Next steps:
In 2008 for 2009, we will look to sharpening and consolidating program materials, and moving from two mailings to one while addressing new information being requested by participants. Consistent feedback from practitioners and providers concerning our preventive health programs suggests that a stronger outreach to network practitioners might increase use of preventive health program materials as a part of treatment. Further, given positive participant response following use of the Web site, we will explore ways to better prompt its usage. A current initiative is underway to develop a single preventive health program with multiple modules that flexibly target and respond to many different challenges facing our participants and we will explore ways to include NCC population in this national preventive health initiative.

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2008 LEVEL OF CARE GUIDELINES

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