Collaborative care regarding major depressed patients: A review of guidelines and current practices

- Current evidence suggests that collaborative care is superior than treatment as usual to treat major depressive disorder.
- Collaborative care for severely depressed patients, however, is not common.
- Our study reveals that international guidelines' directives to organise collaborative care were few and rather vague.
- Yet, an additional systematic literature search suggests that relatively little efforts may result in collaborative care.

Major Depressive Disorder (MDD) is a severe and common mental disorder. A growing body of evidence suggests that stepped and/or collaborative care treatment models have several advantages for severely depressed patients and caretakers. However, despite the availability of these treatment strategies and guidance initiatives, many depressive patients are solely treated by the general practitioner (GP), and collaborative care is not common. In this paper, we review a selected set of international guidelines to inventory the best strategies for GPs and secondary mental health care providers to collaborate when treating depressed patients. Additionally, we systematically searched the literature, listing potential ways of cooperation, and potentially supporting tools. We conclude that the prevailing guidelines only include few and rather vague directions regarding the cooperation between GPs and specialised mental health practitioners. Inspiring recent studies, however, suggest that relatively little efforts may result in effective collaborative care and a broader implementation of the guidelines in general.