Many MHP patients could be managed entirely by their GPs or treated in primary care if sufficient expertise is available (prompt psychiatric consultation, collaborative care) without actual referral [ 10, 13, 25].
Also, in collaborative care there is collaboration between different health care professionals, such as GPs, psychiatrists and care managers.
29 A recent UK study has shown the difficulties of disseminating a guideline without guidance on how to implement collaborative care.
The observed treatment effect size (0.3) in our trial was modest and lower than the prespecified effect (0.4) but similar to that achieved in a previous UK study of collaborative care in adults without multimorbidity 45 and comparable with the overall effect size for collaborative care of 0.29 reported in a Cochrane review in 2012.
As indicated by Cape et al. (2010), another point of intervention can be to train primary care providers in diagnosis and treatment strategies without the inclusion of mental health specialists (such as collaborative care), considering limited financial resources of health care systems [ 27].
There is good evidence that collaborative care that includes psychological therapy with or without drugs is more effective than collaborative care that includes only drugs, and our trial would support this finding.
Moreover, the improvement in the outcome at the end of follow up compared favorably with response rates in collaborative care trials, which included patients with and without long term conditions.
However, this review only included studies that evaluated screening alone without further enhancement of care (e.g. case managers, nursing interventions, collaborative care).
As there are significant differences across health care systems in the US and in European countries [ 42], the results of the collaborative care studies might not be generalized to other countries without consideration.
Your relative might benefit from collaborative care or psychotherapy.
