Grant: Operating Grant

Approximately 1.5 million Canadians experience depression in any given year. Antidepressant medications and talk therapies both work well to treat depression but many patients cannot tolerate medications or prefer talk therapy. Cognitive behavioral therapy (CBT) is one talk therapy that has been shown to be as effective as medications in treating depression. However, across Canada, CBT is not readily available to the people who need them. To help address this need for CBT, British Columbia (BC) is the first and only province to put into service a new CBT self-help program Bounce Back: Reclaim your health for primary care patients suffering from mild to moderate depression. This new program consists of CBT self-help workbooks (that are mailed out to the patient) and brief coaching sessions (over the telephone). Bounce Back is a flexible program and as such, depressed individuals have greater access to much needed mental health services, especially those in rural communities. We will directly test the effectiveness of Bounce Back to determine whether this program adds value to the health care system and would be effective as a treatment for all Canadians diagnosed with mild to moderate depression. The proposed study is designed to test the effectiveness of the Bounce Back program as compared to usual care by a family doctor. Since telephone coaching is the largest cost of the Bounce Back program, this study will also evaluate whether supporting patients' use of the Bounce Back self-help materials with telephone support is more effective than patients working with the materials on their own. This work will influence, initially, the delivery of primary care mental health services across Canada. As a result, this study may help all Canadians suffering from mild-moderate depression especially those who typically do not seek treatment due to stigma or geographic barriers.