Table 1.

Core Processes and Provider Roles in Collaborative Care^a

	Providers
Process	Care Manager	Mental Health Expert	Primary Care Provider	Information Tracking and Exchange
Systematic diagnosis and tracking of outcomes	Measure, document, and track mental health outcome	Supervise case-loads with care managers, based on measured outcomes	Receive feedback from care managers about outcomes	Database of symptom severity over time for all patients
		Consult on diagnosis for difficult cases
Stepped care:
a) Changes to treatment using evidence-based algorithm if patient is not improving	Educate about medications and their use; encourage adherence Counsel patients Facilitate treatment change or referral to mental health as clinically indicated	Consult on patients who are not improving as expected Recommend additional treatments or referral to specialty mental health care according to evidence-based guidelines	Prescribe medications Reinforce and support treatment plan Collaborate with mental health expert and care manager to make necessary treatment changes	Treatments received Changes to treatment
b) Relapse prevention once patient is improved	Track symptoms after initial improvement; follow algorithms	No formal role during maintenance phase	Reinforce relapse prevention plan	Reminders to ensure ongoing contact and symptom monitoring

^aReprinted with permission from Thielke et al.¹⁰