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.
Summary
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.
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 | 
|
$-753 per year
|
-0.036 | 428 |
| Long-term |
|
$732 per year
|
0.035 | 429 | |
| Very long-term |  |
||||
| Increase employment | Short-term |
|
1% (in percentage points)
|
0.034 | 428 |
| Long-term |
|
-2% (in percentage points)
|
-0.060 | 429 | |
| Very long-term | |
||||
| Decrease benefit receipt | Short-term | |
|||
| Long-term | |
||||
| Very long-term | |
||||
| Increase education and training | All measurement periods | |
Effectiveness rating key:
-
Well-supported
-
Supported
-
Not supported
-
Mixed support
-
Insufficient evidence
-
No evidence
Studies of this intervention
| Study quality rating | Study counts per rating |
|---|---|
 High
|
1 |
Implementation details
Cost information
The average cost per participant was $7,686 in 2018 dollars.
This figure is based on cost information reported by authors of the study or studies the Pathways Clearinghouse reviewed for this intervention. The Pathways Clearinghouse converted that information to a single amount expressed in 2018 dollars; for details, see the FAQ. Where there are multiple studies of an intervention rated high or moderate quality, the Pathways Clearinghouse computed the average of costs reported across those studies.
Cost information is not directly comparable across interventions due to differences in the categories of costs reported and the amount of time interventions lasted. Cost information is not an official price tag or guarantee.
State(s) where implemented
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