Working Toward Wellness (WtW)

Enhanced Services for the Hard to Employ Demonstration: Telephonic Care Management for Depressed Medicaid Recipients

Working toward Wellness is a telephone care management and outreach monitoring program designed to help Medicaid recipients who are experiencing major depression to enter and remain in evidence-based treatment. To study the effects of Working toward Wellness, individuals receiving Medicaid in Rhode Island who are eligible for mental health services through United Behavioral Health were screened by telephone for depression. Those who were found to have major depression and who agreed to be in the study were randomly assigned. Program participants received intensive monitoring from Master's level clinicians called care managers to facilitate and support clinical treatment. The control group received usual care that included only referrals to mental health treatment providers. The study hypothesis is that telephonic care management would increase visits to mental health professionals and use of appropriate medication, which in turn would reduce depression severity and lead to greater employment and productivity at work.

Study Overview

• Status: Completed
• Conditions: Depression
• Intervention / Treatment: Behavioral: Telephonic care management

• Study Type: Interventional
• Enrollment (Actual): 499
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Rhode Island
    • Warwick, Rhode Island, United States
      • United Behavioral Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Score of 5 or higher on Quick Inventory of Depression Symptomatology
• receiving Medicaid
• at least one child in household

Exclusion Criteria:

• Bipolar disorder
• alcohol or substance abuse
• currently in active treatment for depression
• receiving Supplemental Security Income

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Use of mental health services	Through 36 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Depression severity	6, 18, and 36 months

Collaborators and Investigators

• Sponsor: MDRC
• Collaborators: Department of Health and Human Services; Kaiser Permanente; United Behavioral Health
• Investigators: Principal Investigator: David Butler, MDRC

Publications and helpful links

General Publications

• Kim SE, Le Blanc AJ, Michalopoulos C, Azocar F, Ludman EJ, Butler DM, Simon GE. Does telephone care management help Medicaid beneficiaries with depression? Am J Manag Care. 2011 Oct 1;17(10):e375-82.
• Kim S, Leblanc A, Morris P, Simon G, Walter J. Working toward wellness: Telephone care management for Medicaid recipients with depression, thirty-six months after random assignment. New York: MDRC. December 2011.

Study record dates

Study Major Dates

• Study Start: October 1, 2004
• Primary Completion (Actual): September 1, 2010
• Study Completion (Actual): September 1, 2011

Study Registration Dates

• First Submitted: June 5, 2008
• First Submitted That Met QC Criteria: June 9, 2008
• First Posted (Estimate): June 10, 2008

Study Record Updates

• Last Update Posted (Estimate): March 27, 2012
• Last Update Submitted That Met QC Criteria: March 23, 2012
• Last Verified: March 1, 2012

More Information

Terms related to this study

• Keywords: Telephonic care management
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: HHS-233-01-0012-RI