Bridging the gap between primary care and mental health.

Major depression is a leading cause of disability in the United States and is frequently diagnosed and managed within a primary care setting, with less-than-optimal results. Studies have shown that adequate follow up significantly affects patient outcomes, including mortality; however, primary care providers face many challenges in providing this care within the constraints of a primary care setting. Collaborative care models have been shown to be effective in managing depression, and accordingly, the Translating Initiatives for Depression into Effective Solutions (TIDES) model was selected by the Bay Pines Veterans Affairs Healthcare System to help primary care providers manage depressed patients within the primary care setting. This article describes the implementation of TIDES and identifies a new role for mental health nurses outside of the traditional mental health setting.