Setting Denver Health is an integrated healthcare system. During the time period that the trial was conducted, 2010 to 2012, Denver Health comprised eight federally qualified community health facilities serving primarily uninsured and Medicaid patients in Denver, Colorado, USA. The mainstay treatment for depression was antidepressant medication only, as access to specialty mental health counseling or psychiatric services was not readily available at the participating primary care facilities during the time frame of the trial.