(McClatchy-Tribune Information Services) -- Depression symptoms have disappeared for four of 10 patients taking part in a new treatment approach offered by family doctors in Minnesota.

Creators of the so-called Diamond program are hoping this remarkable success rate will encourage more doctors to offer it, even though their clinics might lose money in the process. The data were released last week to mark the first complete year of the program.

"It's beyond what we had hoped for," said Nancy Jaeckels of the Institute for Clinical Systems Improvement in Bloomington, which is managing the program. "When you're looking at past or other data across the country, there hasn't been a program that has had this kind of success."

The program seeks to support busy family doctors, who whirl from patient to patient and exam room to exam room and struggle to meet the complex needs of depressed patients. Most family clinics achieve remission in fewer than 10 percent of their depressed patients.

Health insurers pay participating clinics to hire care managers who check in regularly with depressed patients and discuss their struggles and their progress with treatment between office visits. Diamond clinics also have quick access to consulting psychiatrists who guide their care of depressed patients.

Diamond leaders contacted 316 patients who had taken part in the depression program for at least six months and found that 42 percent were in remission. Another 13 percent have seen their depression symptoms reduced by

half.

More than 1,800 patients have taken part in Diamond at 45 participating clinics, but some patients haven't reached the key six-month mark yet. The success rate also didn't include patients who didn't answer the phone -- patients who may still be struggling with depression.

Even if those missed patients counted against the success rate, Jaeckels said, it still outpaces the results achieved through traditional depression care in primary care clinics. The survey also included patients who hadn't been involved in the treatment program in recent months, she added, meaning the approach has lasting benefits and prevents relapse.

The Diamond experiment is receiving national attention, because few clinics have figured out how to increase their success rate with depressed patients. (The name stands for Depression Improvement Across Minnesota, Offering a New Direction.)

Insurers hope their investment in Diamond will shorten the typical course of depression, which is one of the most costly chronic diseases for the nation's health care system and the economy.

The challenge is making the Diamond program affordable in the long run. The program is still too new, Jaeckels said, to know whether it has reduced Minnesota's overall health care spending.

Some clinics have found they're not receiving enough from insurers to cover the cost of their care managers. The program was initially based on a ratio of one care manager per 150 patients, but some managers have found that number too high. Clinics are also determining what level of health care professional is needed for the care manager role. Some have used nurses while others have had success with cheaper medical assistants.

Mary Lichtor, a medical assistant with training in psychology, has a caseload of 117 people between two HealthPartners clinics in Roseville and Lino Lakes. She reported some remarkable turnarounds, including a woman who was suicidal at the start of her depression care and who reached remission in four months.

"The big thing for them is knowing they have someone who cares," she said, "who they can check in with and who will listen to them and understand."

Copyright (C) 2009, Pioneer Press, St. Paul, Minn.