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In 1995 the John D. and Catherine T. MacArthur Foundation assembled a multidisciplinary group of interested scientists and challenged them to nationally make a difference in the primary care management of depression. To that end, The MacArthur Initiative on Depression and Primary Care launched a variety of projects to better understand current primary care management approaches and to develop strategies to enhance that management.

The Re-Engineering Systems for Primary Care Treatment of Depression Project (RESPECT-Depression) was a major culmination of the Foundationís charge. The project was based on five years of initial pilot test investigation. With oversight of the Steering Committee, RESPECT-Depression explored the impact, dissemination and sustainability of an evidence-based approach to enhancing depression management, the Three Component Model (3CM). In this model, prepared primary care clinicians and their practices forge close relationships with mental health and care management professionals. Together, the primary care clinician, a care manager, and mental health professionals cooperate and work with the patient in providing care.

RESPECT-Depression combined elements of research, demonstration, and dissemination by exploring the impact of 3CM, demonstrating the feasibility of sustaining its application, and disseminating 3CM widely. Through this systematic approach, implementation may be adapted to a variety of practices to improve diagnostic assessment, patient care, and quantitative monitoring of treatment.

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