Context: Major depressive disorders are frequently underdiagnosed and undertreated. Collaborative Care models developed from the Chronic Care Model during the past 20 years have improved the quality of depression management in the community, raising intervention cost incrementally above usual care. This paper assesses the economic effıciency of collaborative care for management of depressive disorders by comparing its economic costs and economic benefıts to usual care, as informed by a systematic review of the literature. Evidence acquisition: Theeconomicreviewofcollaborativecareformanagementofdepressivedisorders was conducted in tandem with a review of effectiveness, under the guidance of the Community Preventive Services Task Force, a nonfederal, independent group of public health leaders and experts. Economic review methods developed by the Guide to Community Preventive Services were used by two economists to screen, abstract, adjust, and summarize the economic evidence of collaborative care from societal and other perspectives. An earlier economic review that included eight RCTs was included as part of the evidence. The present economic review expanded the evidence with results from studies published from 1980 to 2009 and included both RCTs and other study designs. Evidence synthesis: In addition to the eight RCTs included in the earlier review, 22 more studies

Diabetes mellitus as well as psychiatric disorders are common. These may occur with one another and/or one may worsen the other. Psychological stress may follow screening for diabetes, as well as when diabetes is first identified. Acting through the hypothalamo-pituitary-adrenal axis, stress may initiate or worsen hyperglycaemia. Depression may be a risk factor for the development of diabetes; it also commonly occurs in subjects with diabetes. Identification and management are both important in preventing the disability. A variety of antipsychotic medications, especially the newer agents can induce weight gain, dyslipidaemia, insulin resistance and diabetes. Therefore in choosing a drug, one must consider the risk factors and screen for metabolic syndrome. Subjects with type 1 diabetes can have cognitive dysfunction, eating disorders and developmental disturbances. Physicians caring for people with diabetes must be trained to recognize and manage co-morbid psychiatric conditions that commonly occur. A biopsychosocial disease model for both conditions can leverage the social strengths and medical knowledge in developing countries. Key words Antipsychotic drugs- depression- diabetes The number of people with diabetes mellitus in India is increasing across geographic, ethnic and

Research-generated information about mental disorders is crucial in order to establish the health needs in a given setting, to propose culturally apt and cost-effective individual and collective interventions, to investigate their implementation, and to explore the obstacles that prevent recommended strategies from being implemented. Yet the capacity to undertake such research in low- and middle-income countries is extremely limited. This article describes two methods that have proved successful in strengthening, or that have the potential to strengthen, mental health research capacity in low-resource settings. We identify the central challenges to be faced, review current programs offering training and mentorship, and summarize the key lessons learned. A structured approach is proposed for the career development of research staff at every career stage, to be accompanied by performance monitoring and support. A case example from the Mental Health and Poverty Project in sub-Saharan Africa illustrates how this approach can be put into practice—in particular, by focusing upon training in core transferrable research skills. (HARV REV PSYCHIATRY 2012;20:13–24.) Keywords:

Cantrell LR, et al. The role of public health in addressing racial and ethnic disparities in mental health and mental

Innovation in health care delivery often far outpaces the speed at which health policy changes to accom-modate this innovation. Integrating behavioral health and primary care is a promising approach to de-fragment health care and help health care achieve the triple aim of decreasing costs, improving out-comes, and enhancing patients ’ experiences. However, the problem remains that health policy does not frequently support the integration of care. This commentary describes some of the reasons policy falters as well as potential opportunities to begin to influence health policy to better support practices that take an integrated approach to health care. (J Am Board Fam Med 2015;28:S98–S101.)

Although mental disorders arehighly prevalent in the SouthAfrican population, many of those who suffer from these conditions do not receive adequate treatment. Re-sults from the South African Stress and Health Study (SASH), the first nation-ally representative study of psychiatric morbidity in South Africa, indicate that approximately 30 % of adults have ex-perienced a DSM-IV disorder in their lifetime, yet most are not treated (1–3). Low rates of treatment have been doc-umented in many countries (4–10), and understanding impediments to the use of psychiatric services is of increas-ing global interest. The effectiveness of

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Purpose: The purpose of this study was to understand mental health, substance use, and health behav-ior activities within primary care practices recognized by the National Committee for Quality Assurance as patient-centered medical homes (PCMHs). Methods:We identified 447 practices with all levels of National Committee for Quality Assurance PCMH recognition as of March 1, 2010. We selected the largest practice from multisite groups, and 238 practices were contacted. We received 123 responses, for a 52 % response rate. A 40-item web-based survey was collected. Results: Of PCMH practices, 42 % have a behavioral health clinician on site; social workers were the most frequent category of provider delivering behavioral services. There are also were care managers—distinct from behavioral health clinician—at 62 % of practices. Surveyed practices were less likely to have procedures for referrals, communication, and patient scheduling for responding to mental health and substance use ser-vices than for other medical subspecialties (50 % compared with 73 % for cardiology and 69 % for endocrinol-ogy). More than half of practices (62%) reported using electronic, standardized depression screening and monitoring; practices were less likely to screen for substance use than mental health. Among the practices, 54 % used evidence-based health behavior protocols for mental health and substance use conditions. Prac-tices reported that lack of reimbursement, time, and sufficient knowledge were obstacles. Practices serving a

License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Although racial/ethnic differences have been found in the use of mental health services for depression in the general population, research among Veterans has produced mixed results. This study examined racial/ethnic differences in the use of mental health services among 148 Operation Enduring/Iraqi Freedom (OEF/OIF) Veterans with high levels of depression and posttraumatic stress disorder (PTSD) symptoms and evaluated whether religious coping affected service use. No differences between African American, Hispanic, and Non-Hispanic white Veterans were found in use of secular mental health services or religious counseling. Women Veterans were more likely than men to seek secular treatment. After controlling for PTSD symptoms, depression symptom level was a significant predictor of psychotherapy attendance but not medication treatment. African American Veterans reported higher levels of religious coping than whites. Religious coping was associated with participation in religious counseling, but not secular mental health services. 1.