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Program for screening, diagnosis and comprehensive treatment of depression

Organization: Chilean Ministry of Health

Country: Chile

Forum: Mental health

The Program for Screening, Diagnosis and Comprehensive Treatment of Depression was introduced in 2001 and became a national program in 2003. It functions in a network of 500 primary care centers throughout Chile. The program seeks to bridge the treatment gap for depression by integrating detection and treatment into primary care. Under the program:

  • Any primary care health professional can detect depression during regular consultations.
  • Possible cases are referred to a primary care physician for further assessment and diagnosis and severe cases are referred to a mental health specialist.
  • Confirmed cases enter a depression-management program with checks every two weeks, antidepressant medication and individual or group psychotherapy.
  • Monitoring of confirmed cases is maintained for at least six months and patients are referred to a specialist if there has been no improvement.

The program has delivered the following outcomes:

  • Within the first four years of implementation, over 125,000 people accessed depression services through their primary care providers.
  • In randomized control trials, participants’ recovery rates were 70% (40% higher than of those receiving usual treatment).
  • Between 2003 and 2008, the number of full-time psychologists in primary care increased by 344%
  • The programme is now covering close to 50% of the population affected by depression.

Subsequent programs targeted at schizophrenia and substance misuse have since been introduced and make use of the existing resources and models in primary care that were made available through the depression program.

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