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The Three Component Model
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The Three Component Model (3CM) is a specific clinical model for depression management. The 3CM is a systematic approach that includes certain tools, routines, and a team approach to patient care. The three components include the prepared primary care clinician and practice, care management, and collaborating mental health specialist. Our experience to date with 3CM has involved the quality improvement and care management offices of health care organizations such as medical groups and insurers. However, individual clinicians can implement many of the aspects of the 3CM by reviewing the MacArthur tool kit and other materials included in this website.

The three components include elements shown to improve depression outcomes in recent randomized controlled trials. Telephone support for the depressed patient from a care manager is one central element as is periodic quantitative feedback about the patient's response to treatment from the care manager to the clinician. The feedback is provided through depression severity scores based on PHQ-9. Another element is closer relationships between the primary care clinician and mental health specialists including informal psychiatric advice when needed from a psychiatrist. The psychiatrist also provides weekly supervisory support for the care manager. These elements are integrated into a systematic approach, an office system, for depression diagnosis and management as endorsed by the US Preventive Services Task Force.

The office system includes tools such as the PHQ-9 and patient education materials; defined responsibilities for the primary care clinician and staff, the care manager, and the mental health professionals involved; and routines including a schedule of care manager follow up calls.

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