DukeWELL Collaborative Care Management Diagram

The DukeWELL Collaborative Care Management team has partnered with pediatric and adult primary care providers to support mental health and treat mental illness. The team-based approach coordinates care for depression and anxiety, provides brief and effective therapeutic interventions, and if needed can assist in identifying the most effective mental health medications. The DukeWELL Collaborative Care Management team is led by the patient’s primary care doctor and includes a care manager and psychiatrist. By working together as a team, we can ensure that patients have everything they need to reach their health goals.

What is the patient’s role?

The patient is the most important person on the team! They will get the best care by participating actively with their care team:

  • Work with the team to track symptoms using a simple checklist
  • Tell them what is working and what is not
  • Know what medicines are prescribed and how to take them
  • Let them know if there are any questions or concerns

What can patients expect?

  1. A DukeWELL care manager will reach out to the patient by phone to ask if they would like to participate.
  2. If the patient agrees, they will have phone calls with their care manager every other week to discuss symptoms and how the treatment is working.
  3. The care manager will check in regularly with the patient’s primary care provider and the team’s psychiatrist to develop a treatment plan for any mental health needs.
  4. If needed, the Collaborative Care Management team will help connect the patient to mental health and community resources and ensure they are getting the best treatment for their depression or anxiety.
  5. The care manager will also be available between appointments to provide any help needed.
  6. This service comes at no extra cost to Medicaid members. There may be a co-pay associated with participation in this program for private insurance plans.