Stepped Care for depression and anxiety: from primary to secondary care (WC2005-092)

Background

Starting date: 01/09/2006 Mood and anxiety disorders are highly prevalent and have important consequences on the lives of the affected individuals. Furthermore, they are leading causes of the burden of disease on a societal level and generate high economic costs. Therefore, from a public health perspective, as well as from the perspective of the individual patient, optimal treatment of these disorders is highly important. Currently, many patients are either over- or under treated. The introduction of a stepped care model in primary care might be a way to enhance mental health care. In a stepped care model all patients are offered the same low intensity (evidence based) treatment as a first step. Only those who do not recover, step up to a more intensive treatment. This is in line with recent development in Dutch mental health care. The number of psychiatric nurses (or psychologists) from (specialized) mental health institutions who work together with a general practitioner in primary care is increasing. A stepped care model could provide a more effective continuity between primary care and specialized mental health care.