A promising approach

The stepped care model seems to be a promising approach for improving quality of care for people with common mental disorders. To recap, stepped care is a health care model where interventions are prioritized according to patient needs. When the patient’s health does not improve following the interventions offered, progression towards more complex care is considered. This model would improve the current organization of mental health services.

Stepped care is often recognized as an effective strategy in chronic illness management. Clinical practice guidelines increasingly refer to it in their recommendations pertaining to health care and service models. There are various stepped care models, some of which focus on the role of the family doctor and are distinguished by the integration of the collaborative care concept when describing partners’ roles in different stages, such as that of nurses, psychologists and psychiatrists.

Several studies demonstrate the benefits associated with the implementation of stepped care in different practice settings and their contribution in improving the quality of mental health care and services. Among other things, this model would:

• make specialized resources more easily accessible
• reduce waiting time for specialty care
• increase patient satisfaction regarding the care they receive by adjusting the level of care to the patient’s clinical profile and needs
• standardize the delivery methods targeting specific goals to measure treatment response
• improve health care quality by offering proper treatment according to treatment response
• improve cost-effectiveness of health care delivery by matching clinical expertise of health care providers to patient intervention intensity requirements

Research is still necessary to determine the effectiveness of this promising health care model on clinical and economical levels.