University of California, Los Angeles
Depression is disabling and affects one in five Veterans. VA's Primary Care-Mental health Integration (PCMHI) enables specialists to support medication treatment in primary care, but timely and sufficient access to psychotherapy is unattainable despite Veteran preference for psychotherapy. This study aims to close the gap in psychotherapy access for VA primary care patients with depression by adapting PCMHI collaborative care models to improve uptake of peer-supported computerized cognitive behavioral therapy (cCBT).
Background: VA's Primary Care-Mental Health Integration (PCMHI) is rooted in evidence-based collaborative care models, where care managers, mental health specialists, and primary care providers jointly treat depression in primary care. While PCMHI enabled specialists to support medication treatment in primary care, access to psychotherapy is not timely and sufficient. Alternative therapy modalities are needed. Peer-supported cCBT for depression has been shown to be effective but is not yet widely used within VA. Significance/Impact: Depression is disabling and affects one in five Veterans. Ps…
Inclusion Criteria: * Must be enrolled in the VHA and currently receiving primary care services at VA Los Angeles or San Diego * Have access to computer (mobile or desktop), internet, telephone, and email * Able to read English text on a computer screen * Score 10 or higher on the PHQ-9 Exclusion Criteria: * Have moderate-high suicide risk (e.g. suicide flag) or active suicidality * Have other serious mental illness (e.g. bipolar disorder, psychosis) * Have medical disorder that would prevent/ interfere with participation (e.g. dementia/cognitive impairment, terminal illness)
Enhanced usual care includes all the usual depression care at the VA and access to an online therapy program with no peer support sessions. The online therapy program offered consists of several modules for depression care, specifically tailored for Veterans.
Supported Online Self-help for Depression (SOS-Depression) includes all the usual depression care at the VA and access to an online therapy program with support sessions with a peer. The online therapy program consists of several modules for depression care, specifically tailored for Veterans.
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