Grant: Travel Awards - Institute Community Support

My study seeks to: 1) to examine whether individuals diagnosed with depression receive guideline-recommended care in the form of antidepressant therapy or counseling/psychotherapy, and 2) to determine if the financial incentives started in BC in 2008 improved access to these services. To meet the objectives, I performed a population-based data linkage study using data on physician claims, hospital separations, and prescription fills. The study cohort comprised everyone with inpatient/outpatient diagnosis of depression, but excluding those with a 12-month history of mood disorders and those treated for bipolar I and schizophrenic disorders in a 12-month period before and after the initial diagnosis of depression. Three aspects of depression care were examined: 1) receipt of 4 or more counseling/psychotherapy sessions per year, 2) use of antidepressants for at least 84 days, and 3) either 1 or 2. Existing literature support the use of these thresholds when examining minimally adequate care. The first set of findings indicate that a) about 13% of my cohort received minimally adequate counseling/psychotherapy, with greater use observed among men, younger individuals, and urban resident; b) about 48% received minimally adequate antidepressant therapy, with women, older individuals and rural residents having the highest proportions; and c) around 53% of the cohort received either type of treatment. The second set of results suggest that there is a small but statistically significant increase in the proportion of individuals who receive minimally adequate counseling/psychotherapy after financial incentives were introduced in 2008. Overall, my research findings highlight the magnitude of the existing treatment gap in depression care and the need for new measures and changes in policies to ensure that more people with depression benefit from recommended therapies.