Using Staged Care to Provide Right Care First Time to People With Common Affective Disorders

An ongoing need exists for innovation in service delivery to ensure that mental health services deliver high-quality treatment and prevention in the population. This Special Article proposes the adoption of staged care as a population health-oriented service delivery model for packages of specialized services delivered largely in ambulatory care settings for individuals with common affective disorders. Staged care integrates measures of clinical need alongside clinical stage and personal choice to select hierarchically arranged service packages for individuals. Packages then vary according to the intensity, duration, and mix of treatment options. This Special Article describes five levels of care in staged care: self- or family-directed monitoring and management, low-intensity services, moderate-intensity services, high-intensity services, and acute and specialist community mental health services. The care environment, treatment team, and length of treatment are also described, and provisional criteria are specified for assigning individuals to different care levels on the basis of current clinical need and clinical stage. Staged care is presented as a model that guides treatment selection and health service delivery to ensure that the high-quality care aims of right care first time and prevention are achieved and optimal use of available resources is considered.

Automated summary

This article proposes a staged care model for mental health services, which aims to provide specialized services in a hierarchical manner based on clinical need, clinical stage, and personal choice. The model includes five levels of care, ranging from self-management to acute and specialist community mental health services, and emphasizes the importance of quality care, prevention, and optimal resource utilization.