Towards integrated primary health care for depressive disorder in the Netherlands. The depression initiative

In the Netherlands, principles of integrated care are seldom applied in the primary care setting, although such a care model might be indicated in diseases and mental disorders of a chronic and complex nature that are prevalent in the primary care setting. For example, in terms of mental health, depressive disorder warrants such an approach due to its high prevalence, chronic course, and burden for patients, health care and society [1–3]. However, treatment of depressive disorder in the primary care setting generally does not occur according to the principles of integrated care [4]. An integrated care model should follow the principles of disease management such as e.g. in disease management programs that have proven effective [5]. Such a program should encompass prevention, diagnosis, treatment according to guidelines, monitoring of treatment, attaining remission and relapse prevention [5]. Attaining implementation of such an integrated care treatment program for depressive disorder, and evaluating its effectiveness, is the goal of the depression initiative [6].