The study may have answered a rather different question: Which is more effective, supervised or unsupervised mental health treatment? The intervention used nurses with no prior mental health experience as depression care managers. Both the practice-based and the telemedicine-based nurses received an initial 1 day of training and a training manual. Thereafter, the telemedicine-based nurses received weekly supervision, which included a discussion of patients who were not responding to treatment. In contrast, the practice-based depression care managers received no clinical supervision.