Date: 15 March 2017
Category: Collaborative care
As a graduate mental health worker, I was directly involved in the CADET trial. Our primary care mental health team in Bolton was one of the study sites and I was allocated to provide the collaborative care arm of the study.
After an initial one-hour assessment, we would support patients by means of a 20-minute phone call once a week for twelve weeks. The essence of the intervention was guided self-help for the patient. We recognised that every patient was different but used a standard package of materials as the basis of helping them to understand the nature of depression and what they could do. Patients benefitted from help, tailored to their needs, with managing their medication and their symptoms.
Behavioural activation was a particular element of the way in which we supported patients. This approach helps people to be more motivated to get momentum going in their life. We would help them to record what they did during the day and then plan, thinking about the nature of their activities and how easy they found it to do the routine, pleasurable or necessary things in their life. Gradually, people could be supported to see that getting things done – even before they felt like doing them – helped them to feel better.
I saw real improvements in the patients that were allocated to me. I don’t say a collaborative care intervention would be right for everyone but it was great for people who wanted to access treatment largely at home and by phone, especially if they found it hard to take time off work and/or didn’t want others around them to know they were receiving treatment.
Acting as a case manager, I learned – more than I had in previous practice – to combine flexibility of approach with a strong commitment to ‘being present in the moment’ with patients. In future, I would like to see collaborative care offered as an option to patients who come to our service.
Graduate Mental Health Worker Champa Mistry would like to see collaborative care offered as an option to patients with depression.
Graduate Mental Health Worker