Added September 12, 2018

For healthcare providers, there are two types of depression they need to consider as they treat depressed patients. The first type of depression is short-term and episodic. This depression only lasts a few days and is more easily managed by physiatrists. The right anti-depressant drug and therapy can assist short-term depression by effectively managing the condition. Quality of life doesn’t typically suffer from short-term episodic depression.

The second type is long-term chronic depression. This depression lasts a minimum of 20 weeks and could continue for more than two years. Chronic long-term depression is more difficult to manage. It can require various anti-depressant drugs and multiple care providers. With a person experiencing such a long period of time with depression, it can have a life-changing effect. It can impact a person’s job, their relationship with their family, and their overall well-being.

According to Harvard Health, because of the duration that a person experiences chronic depression, the greater that person has of receiving other chronic conditions. Chronic depression paves the way for patients experiencing other life-altering physical or phycological chronic conditions.

“The differences between episodic and chronic depression encompass more than just duration. Studies show that compared with episodic major depression, chronic depression causes more functional impairment, increases the risk of suicide, and is more likely to occur in conjunction with other psychiatric disorders.” 1

Relapse frequently occurs in chronic depression patients. For healthcare providers, this can be a difficult challenge to manage.

“About half of patients with chronic depression who respond to treatment (whether with antidepressants, psychotherapy, or a combination of the two) will suffer a relapse within one to two years if they stop treatment. For that reason, some type of maintenance therapy may be necessary.”2

Care management teams from behavioral health hospitals and acute hospitals are looking at ways to revolutionize the way they manage patients who have chronic depression. They are focused on decreasing overall patient demand, reducing preventable visits and admissions, improving quality of care, and assisting patients in achieving an overall better well-being. This can have clinical as well as a financial impact on the psychiatric hospital. There are five areas where chronic depression is getting revolutionized.

1. Proactive Outreach. Psychiatric hospitals are spending more time assisting chronic depression patients outside of the hospital. This comes in the form of proactive outreach, patient updates, tracking symptoms, and assessing patients needs. Mental health facilities who are actively focusing on proactive outreach are providing support patients need to overcome their chronic condition.
2. Symptom Tracking. Tracking symptoms once the patient returns home has always been a good idea but is rarely implemented and followed up on. Remote symptom tracking can provide care teams with early warning signs depression is getting worse or returning after remission. By tracking symptoms, psychiatric hospitals understand where their assistance is best utilized.
3. Long-term Treatment. Revolutionizing care management for chronic depression must focus on the long-term treatment plans of the patient. This long-term view of the patient should focus on 1-2 years or more of working with the patient. As a care team considers such a long view, they will recognize the need to keep the continuity of care seamless through the entire life of the patient. This may not be possible for a care team without the technology to support the long-approach to care management.
4. Focus on Education. Patients themselves are in the best position to manage their own chronic depression. However, it requires them to be taught. Care teams who put themselves in the role of patient educator can give the patient the knowledge and understanding patient needs to manage their condition. Education is an on-going process. Care teams who focus on education as the avenue to assist patients continue to educate patients during the many months of chronic depression. Educational assistance includes videos, assessments, thought leadership and more.
5. Empathetic Care. Empathetic care focuses on the whole patient and the needs of the patient clinically, physically, and emotionally. Managing chronic depression requires a care team to consider the whole patient. By providing empathetic care, care teams can provide the support the patient needs. Empathetic care includes ongoing communication, personalized interactions, and a unique focus on the patient.

Thoughts from a care provider on empathetic care:

“I was inspired by the groups of people who were actively seeking alternative viewpoints, hoping to make the healthcare experience something that focused on patient well-being and whole-person care instead of checking boxes on a form.  As a patient advocate, I feel the clinical encounter can be changed – for the better – by empowering patients to raise their voices.”

• Simulations for Empathic Care Workshop, July 24, 2017

Care teams can take their care to the next level. Revolutionizing the way chronic care is getting managed can provide patients with the support they need to achieve a better way of living. Psychiatric hospitals can stay out in front of the needs of their patients. This can provide financial and clinical benefits to the hospital.

1&2 Harvard Health Publishing, Managing Chronic Depression, 2009