Screening adults for depression in primary care: A position statement of the American College of Preventive Medicine

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Applied Evidence

Screening adults for depression in primary care: A position statement of the American College of Preventive Medicine

J Fam Pract. 2009 October;58(10):535-538

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References

1. U.S. Preventive Services Task Force. Recommendations and rationale: screening for depression. Available at http://www.ahrq.gov/clinic/3rduspstf/depression/depressrr.htm. Accessed March 18, 2009.

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What you need are “systems in place”

The USPSTF recommended screening for depression in “clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up.” Given the prevalence and gravity of the problem, the ACPM recommends that all primary care practices have such systems in place. These systems may be either:

within your own practice, using clinical guidelines for the diagnosis and treatment of depression, or
within an established system of referral to mental health professionals.

FAST TRACK

Working with a patient’s employee assistance program may be the best way to ensure that he or she receives treatment and follow-up.

If you treat patients with depression within your own practice, keep in mind that using standardized treatments with established efficacy in psychiatric patients has been shown to be more effective than “usual care.”³⁰ If you choose to partner with mental health professionals, you can employ various levels of collaboration. Depending on the size of your practice, you may want to include a mental health professional as an integral part of your staff, or you may prefer to hire a part-time consultant. Another alternative is to establish an ongoing, collaborative relationship with a mental health provider in private practice. In some instances, working with a patient’s employee assistance program may be the best way to ensure that he or she receives treatment and follow-up. Primary care practices serving disadvantaged or impoverished communities may need to develop partnerships with public-sector community mental health centers.

Whatever setup works best for you, the goal is to make sure that your patients with depression have access to ongoing screening, diagnostic, and treatment services. That goal is worthy of your best efforts.

CORRESPONDENCE
Michele Surricchio, MPH, American College of Preventive Medicine, 1307 New York Ave., NW, Suite 200, Washington, DC 20005; msurricchio@acpm.org