Through intensive telephonic outreach from care managers, Working toward Wellness aimed to increase the use of mental health services and to improve employment outcomes for parents with low income who suffered from depression.

Through intensive telephonic outreach from care managers, Working toward Wellness aimed to increase the use of mental health services and to improve employment outcomes for parents with low income who suffered from depression.

Master’s-level care managers placed telephone calls to Working toward Wellness participants to encourage them to seek treatment for their depression. The care managers also helped coordinate health appointments, encouraged and monitored follow-through on appointments and treatment plans, and provided supplemental information and counseling. To build rapport and identify potential referral services, care managers also asked participants about their employment status and goals and about barriers to employment, such as child care. Care managers called participants once per month, on average, though the frequency was higher during the first few months and was higher for participants whose depression was more severe. At the end of the program, care managers and participants developed plans for how the participants would continue care and self-monitor. Participants who resisted seeking professional treatment were offered a structured psychoeducational program that the care manager administered over the phone using a written workbook that included homework assignments for participants. The goal of this structured psychoeducational program was to establish a positive relationship between care managers and participants and maintain participant engagement. Care managers spoke with participants for 12 months. Working toward Wellness served Medicaid recipients who had children and were clinically depressed. Working toward Wellness was implemented in Rhode Island.

Year evaluation began: 2004
Populations and employment barriers: Parents, Mental illness
Intervention services: Case management, Education, Health services, Substance use disorder treatment and mental health services
Setting(s): Tested in multiple settings

Effectiveness Rating and Effect By Outcome Domain

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Outcome domain Term Effectiveness rating Effect in 2018 dollars and percentages Effect in standard deviations Sample size
Increase earnings Short-term Little evidence to assess support unfavorable $-753 per year -0.04 428
Long-term Little evidence to assess support favorable $732 per year 0.04 429
Very long-term No evidence to assess support
Increase employment Short-term Little evidence to assess support favorable 1% (in percentage points) 0.03 428
Long-term Little evidence to assess support unfavorable -2% (in percentage points) -0.06 429
Very long-term No evidence to assess support
Decrease benefit receipt Short-term No evidence to assess support
Long-term No evidence to assess support
Very long-term No evidence to assess support
Increase education and training All measurement periods No evidence to assess support

Studies of this Intervention

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Study Quality Rating Study Counts per Rating
High High 1