The researchers randomly assigned the primary care practices to receive the help of depression care managers or to offer usual care. The depression care managers closely monitored the antidepressant drugs that participants received and served as psychotherapists if participants needed such therapy. Participants in the usual care practices did not receive any special services. However, their doctors attended educational sessions about depression and were notified if researchers detected that their patients were depressed. The researchers then followed participants for 5 years to see whether they died and, if so, why.