In 2004, The University of Washington AIMS Center was founded, pioneering a Collaborative Care model representing an evidence-based approach to integrated care. Their model of integrated care was developed to treat common and persistent mental health conditions such as depression and anxiety.
The MIDUS program is based on the AIMS Center Collaborative Care model with the intention of identifying and treating depressive symptoms specifically among people living with HIV/AIDS. This particular audience experiences higher rates of mental illness (than the general population), increased rates of substance abuse, and are more likely to have experienced trauma within their lifetime.
In June 2015, healthcare providers at the MetroHealth HIV Clinic began implementing a collaborative care model with the intention of identifying and treating depressive symptoms among people living with HIV. This model has been used in other primary care settings to bridge the gap in depression care and has been shown to improve access to care, processes, and outcomes.
Patients were screened annually in the clinic for depressive symptoms using the Patient Health Questionnaire (PHQ 2/9) as a part of the patient’s health maintenance items. Based on a score of 10 or higher, the patient would work with a behavioral health care manager (BHC) for further mental health assessment. The BHC works with the consulting psychiatrist to obtain a diagnosis and treatment plan, which is then carried out by the HIV physician and monitored by the BHC.
A typical referral appointment for a mental health evaluation from a psychiatrist may take months. This model takes the timeline from evaluation to recommendation for treatment down to one-to-two weeks.