Back to Insights and Updates for ProvidersJuly 2023

Screening for depression in the primary care setting

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According to the National Alliance on Mental Illness (NAMI), about 21 million adults in the U.S. (more than 8% of the population) experienced at least one major depressive episode in 2020. Although reduced societal stigma and increased understanding of depression as a serious medical condition have positively impacted the number of patients seeking help, research suggests that fewer than half of Americans living with depression are treated.

The good news is there are several depression screening tools available for use in the primary care setting, which Point32Health recommends as a starting point for diagnosis and coordination of follow-up care. A simple first step is the two-question Patient Health Questionnaire (PHQ-2), comprised of the first two questions on the longer PHQ-9. If a patient answers “yes” to either question regarding feelings of hopelessness, depression, or lack of interest, the PHQ-9 is recommended. The PHQ‐9 takes only a few minutes to complete and rates the frequency of depressive symptoms. Physicians can quickly score results of the PHQ-9 and administer it multiple times throughout a patient’s treatment to monitor changes in depressive symptoms. The PHQ-9 is considered a reliable, efficient tool that serves as a strong base for diagnosis and determination of treatment, including specialty and collaborative care when appropriate.

For recommendations on next steps after obtaining a patient’s initial PHQ-9 score, refer to Point32Health’s Guide for Treating Depression in the Primary Care Setting.

Other tools and resources
Additional screening tools available for use in primary care include the Beck Depression Inventory (BDI), a 21-item, self-report rating inventory, the Center for Epidemiological Studies Depression Scale (CES-D), designed to measure symptoms of depression in caregivers, and the Edinburgh Postnatal Depression Scale (EPDS) for detecting postpartum depression. EPDS assesses mood symptoms and self-destructive thoughts and can be administered in OB/GYN, pediatric, and behavioral health care settings. To screen for depression in seniors, the Geriatric Depression Scale (GDS) is often utilized.

In the Caring for Your Patient section of the Harvard Pilgrim provider website, you can find more depression screening tools and information, as well as links to resources available through the American Psychological Association.

Point32Health supports our primary care partners in following recommended depression screening guidelines — providing routine screening for seniors, adults, and adolescents during regular medical office visits, with annual screenings to follow unless otherwise clinically indicated. Working together, we can continue to make a positive impact on the number of patients experiencing depression who decide to seek help for this treatable condition.

Assistance facilitating follow-up care
If you need help finding a behavioral health clinician for your Tufts Health Plan patients, call the Tufts Health Plan Provider Service Center.

For assistance with behavioral health referrals for Harvard Pilgrim Health Care members, call 888-777-4742.

Editor’s note: Updated the Tufts Health Plan behavioral health contact number on 9/5/23.

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