Managing treatment resistant depression in primary care settings

Major depression is a leading cause of disability worldwide. There is improved detection of major depression leading to increased demand—supply mismatch for mental health services, which is slated to get worse. Only a small percentage of those identified receive adequate care. Poor follow-up with specialty mental health services, poor medication adherence further impact treatment outcomes. A large percentage of patients do not respond to adequate trials of currently available treatment options for depression. These patients require multidisciplinary, algorithm-based stepped intensification of treatment. Opportunity exists to improve detection and management of treatment resistant depression in primary care settings through collaborative care treatment model and use of technology to expand capacity of primary care practices and delivery of care.