Harvard Mental Health Letter

Commentary: Mental health at a reasonable cost


Mental health at a reasonable cost

As a new U.S. administration starts dealing with reorganizing the health care system, we hope those in charge understand the value of providing adequate mental health care. Health system designers should be heartened by two studies in a British journal, The Lancet. Studying two very different populations, researchers demonstrated that improved mental health care and quality of life can be achieved at a reasonable cost.

A July 2008 study demonstrated the value of a standardized depression intervention for cancer patients. A September 2008 report showed that community health workers can treat maternal depression effectively.

In the first study, investigators in Scotland identified 200 cancer patients with major depression, then randomized them either to treatment as usual or to a psychoeducational and cognitive behavioral intervention delivered by oncology nurses who were trained through written materials, tutorials, and supervision. The nurses had no prior mental health experience. In up to 10 in-person or phone sessions over three months, the nurses taught their patients about depression and its treatment. They coached patients in problem-solving and coping strategies. And they regularly discussed the depression treatment with the patients' oncologists and primary-care doctors.

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