The case for stepped care
Exploring the applicability and cost-utility of stepped-care strategies in the management of depression
Today’s topics in mental health care concern finding solutions for providing good patient care with a perceived scarcity of resources in the face of growing financial and administrative pressures and increasing caseloads. The current way of organising depression care may not always lead to the best treatment for patients.
This PhD thesis presents an approach to support care professionals in improved clinical decision making with stepped-care heuristics that reduce uncertainty around the prognosis and progression of depression, while avoiding both over-treatment and under-treatment in individual treatment strategies. This thesis also addresses quality improvement in depression care through stepped-care service delivery with care improvement strategies from a chronic care management approach.
With the aim of advancing depression care for the direct benefit of all patients, Jolanda Meeuwissen explores the applicability and cost-utility of stepped-care strategies. The findings and implications resulting from the studies in this thesis may serve the care debate on healthcare policy and practice related to these issues.