Depression Improvement Across Minnesota, Offering a New Direction

DIAMOND (Depression Improvement Across Minnesota, Offering a New Direction) depression care is offered at Northwest Family Physicians.  The depression care model was developed by the Institute for Clinical Systems Improvement (ICSI).  It is an innovative method of care delivery aimed at improving care and outcomes for patients with depression.  Patients with depression will be referred to a DIAMOND care manager and will receive support from a team of their primary care physician, care manager, and consulting psychiatrist.

Many ask, "What is depression?" Symptoms that may indicate depression are:

▪ Little interest or pleasure in doing things
▪ Feeling down, depressed or hopeless
▪ Trouble falling or staying asleep or sleeping too much
▪ Feeling tired or having little energy
▪ Poor appetite or overeating
▪ Feeling bad about yourself- or that you are a failure or have let yourself or your family down.
▪ Trouble concentrating on things, such as reading the newspaper or watching television
▪ Moving or talking so slowly that other people could have noticed or the opposite
▪ Thoughts that you would be better off dead, or of hurting yourself in some way.

If you suffer from depression, or think you may be depressed, ask your provider for more information about DIAMOND.

What is different about DIAMOND compared to usual depression treatment?

The DIAMOND approach includes these six things:

  • A measurement tool – a brief questionnaire called the PHQ-9 -- that helps the care team detect and monitor symptoms of depression.
  • A tracking system used by the care team to regularly monitor patient progress.
  • A proven medical guide to help primary care providers know how best to change or intensify treatment.
  • Tools to keep a patient who is getting better from falling back into major depression.
  • A care manager to provide education and support to help the patient reduce their depression symptoms and improve their ability to function.
  • A psychiatrist to review patient cases with the care manager and consult with the primary care physician on any recommended changes in treatment.

What is a care manager?

This is a new role created in the primary care clinic. The care manager has frequent contact with patients to help them manage their depression. He or she provides education about the condition, coordinates treatment, monitors progress and supports the patient’s self-management goals. The care manager does this work under the direction of the doctor and the psychiatrist. 

What does the psychiatrist do in DIAMOND?

The psychiatrist reviews patient cases and consults with the care manager. If a patient is not getting better, the psychiatrist may suggest a change in treatment. This might include recommending that the patient sees a mental health provider or has a change in medication or dosage. In all cases, the primary care doctor makes final treatment decisions.

How do other mental health providers fit into this model?

Psychologists, social workers and other mental health providers continue to play a key role. Patients may be referred for behavioral therapy and other services as part of their treatment plans.