Depression Screening at a Community Health Fair: Descriptives and Treatment Linkage (original) (raw)
Related papers
Effectiveness of community-based screening for depression
American Journal of Psychiatry, 1997
The effectiveness of a voluntary depression screening program was assessed by determining 1) whether participants in the 1994 National Depression Screening Day went for recommended follow-up examinations and 2) the characteristics that differentiated those who did and did not return. Method: Randomly selected participants (N=1,169) from 99 facilities completed a follow-up telephone survey. Results: Of 805 people for whom follow-up was recommended, 56.5% (N=455) went for an appointment. The severity of depressive symptoms in these subjects ranged from severe (33.4%, N=152) and marked (41.3%, N=188) to minimal (17.1%, N=78) and normal (8.1%, N=37). Subjects with marked or severe depression were more likely to respond to the screening recommendation than were those with minimal depressive symptoms. However, at each level of symptom severity, subjects who had received previous treatment were more likely to adhere to the screening recommendation than were those with no previous treatment. Of those who returned for a recommended follow-up, 72.1% were diagnosed with depression. Of those who did not return, 29.5% cited lack of insurance, underinsurance, or inadequate finances, and 38.0% felt they could "handle" depression on their own. Conclusions: Voluntary screening for depression is an effective way to bring certain untreated depressed individuals to treatment. Inadequate insurance and the belief that individuals can manage depression on their own continue to be barriers to seeking treatment among some depressed individuals who attend a depression screening program.
2018
Author(s): Ames, Angharad | Abstract: Major depression is one of the most common, debilitating, and treatable psychiatric disorders in America, yet depression is significantly under-identified among low-income and uninsured populations. The USPSTF recommends routine depression screening in the setting of primary care when mental health support resources are available. The purpose of this project was to implement a universal depression screening in Student-Run Free Clinics (SRFCs) to improve identification and treatment of depression in patients receiving primary care
International Journal of Geriatric Psychiatry, 2009
Background Mental illness is highly prevalent and disabling, but is under-treated. Outreach services attempt to overcome system and personal barriers to care, but there are few reports of their effects in improving access and use of mental health services. In the Community-based Early Psychiatric Interventional Strategy (CEPIS) programme in Singapore, community nurses routinely screened seniors for depressive symptoms, and provided psychoeducation and referral for primary care treatment. We evaluated the impact of the outreach programme and the extent to which determinants of treatment-seeking were altered by removing socioeconomic, physical and cognitive barriers to care. Methods Participants were screened using the geriatric depression scale (GDS) and independently assessed using structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis. Treatment-seeking at 1 month post-outreach was compared retrospectively to pre-outreach spontaneous treatment-seeking in the previous 1 year. Results Among 4633 participants, 370 (8%) with depressive symptoms included 214 (57.8%) with diagnosed mental disorder(s). Pre-outreach treatment-seeking was 10.3%. The programme resulted in 73.8% being successfully referred to GP treatment. Pre-outreach treatment-seeking was significantly associated with a diagnosed mental disorder (OR ¼ 2.22), fair or poor self-reported mental health (OR ¼ 3.26), 10 depressive symptoms (OR ¼ 3.18), perceived need for professional help (OR ¼ 3.58), 3 medical comorbidities (OR ¼ 2.67), younger age <70 (OR ¼ 2.55), female gender (OR ¼ 3.58) and at least primary education (OR ¼ 3.06). All but a few of these predisposing and enabling variables were not associated with postoutreach treatment-seeking. Conclusion By eliminating socioeconomic, physical and cognitive barriers, equitable care provided in an outreach programme vastly increased referrals for primary care treatment for depression.
Depression Screening Patterns for Women in Rural Health Clinics
The Journal of Rural Health, 2010
Context: Rates and types of screening for depression in rural primary care practices are unknown. Purpose: To identify rates of depression screening among rural women in a sample of rural health clinics (RHCs). Methods: A chart review of 759 women's charts in 19 randomly selected RHCs across the nation. Data were collected from charts of female patients of rural primary care providers, using trained data collectors (inter-rater reliability .88 to .93). The Women's Primary Care Screening Form, designed by the authors, was used to collect demographic, health, and screening data. Data describing the characteristics of the clinics were collected using the National Rural Health Clinic Survey. Data regarding formal screening (validated instrument used) or informal (documentation of specific questions and answers regarding depression) in the previous 5 years were recorded. Findings: Characteristics of participating clinics and demographics of the women were similar to published data. Formal screening was documented in 2.4% of patients' charts. Informal screening was documented in 33.2% of charts. Patients with a history of anxiety were more likely to be screened (P < .001), and younger women were more likely to be screened than older women (P < .001). Conclusions: Primary care providers in RHCs use more informal than formal depression screening with their female patients. Providers are more likely to screen younger patients or patients with a diagnosis of anxiety.
PLOS ONE, 2015
Physical health screenings were conducted by researchers and peer wellness specialists for adults attending publicly-funded community mental health programs. A total of 457 adults with serious mental illnesses attended health fairs in 4 U.S. states and were screened for 8 common medical co-morbidities and health risk factors. Also assessed were self-reported health competencies, medical conditions, and health service utilization. Compared to non-institutionalized U.S. adults, markedly higher proportions screened positive for obesity (60%), hypertension (32%), diabetes (14%), smoking (44%), nicotine dependence (62%), alcohol abuse (17%), drug abuse (11%), and coronary heart disease (10%). A lower proportion screened positive for hyperlipidemia (7%). Multivariable random regression analysis found significant pre-to post-screening increases in participants' self-rated abilities for health practices, competence for health maintenance, and health locus of control. Screening identified 82 instances of undiagnosed diabetes, hypertension or hyperlipidemia, and 76 instances where these disorders were treated but uncontrolled. These results are discussed in the context of how this global public health approach holds promise for furthering the goal of integrating health and mental health care. this manuscript. Data come from four community mental health centers whose identity and location are identified. The data set includes selfreported demographic and behavioral data from interviews, results of medical tests, and findings of health risk assessments. Sensitive information includes: 1) illegal substance use; 2) substance use disorders; 3) mental health disorders; and 4) HIV status. Even though the data set has been stripped of identifiers, we believe that there remains the program in which physical health screenings were conducted for clients of community mental health programs located in four U.S. states .
Assessment and management of depression: An imperative for community-based practice
Archives of Psychiatric Nursing, 1990
The purpose of this mental health training program was to increase primary care nurses' knowledge and skills about depression. The program emphasized criteria for assessing depression, presented psychopharmacological and psychotherapeutic content, discussed care coordination among multiple agencies and providers, and addressed referral resources. Highlighted were cultural and developmental issues for Native Americans, Mexican-Americans, the elderly. and adolescents. The training program successfully increased primary care nurses' knowledge about depression and their abilities to use this knowledge in clinical practice.
Depression, service need, and use in vulnerable populations
Archives of Psychiatric Nursing, 2000
Health care reform has created opportunities for mental health nurses to develop innovative health care delivery models to provide integrated behavioral health and primary health care. A community health analysis is one method to ensure appropriate services are planned. This study examined the health care services most needed and those used by depressed and nondepressed participants (N ؍ 231), and their satisfaction with these services. Individual and system characteristics were examined using a framework developed by Anderson and Aday. Significant differences were found between the 2 groups for predisposing characteristics, enabling characteristics, need for care, service use, and satisfaction with services.
Journal of Affective Disorders, 2016
Objective. There is considerable uncertainty about whether depression screening programs in primary care may improve outcomes and what specific features of such programs may contribute to success. We tested the effectiveness of a program involving substantial commitment from local mental health services. Methods. Prospective, randomised, patient-and evaluator-masked, parallel-group, controlled study. Participants were recruited in several urban primary care practices where they completed the PC-SAD screener and WHOQOL-Bref. Those who screened positive and did not report suicidal ideation (N=115) were randomised to an intervention group (communication of the result and offer of psychiatric evaluation and treatment free of charge; N=56) or a control group (no feedback on test result for 3 months; N=59). After 3 months, 100 patients agreed to a follow-up telephone interview including the administration of the PC-SAD5 and WHOQOL-Bref. Results. Depression severity and quality of life improved significantly in both groups. Intent-totreat analysis showed no effect of the intervention. As only 37% of patients randomised to the intervention group actually contacted the study outpatient clinic, we performed a per-protocol analysis to determine whether the intervention, if delivered as planned, had been effective. This analysis revealed a significant positive effect of the intervention on severity of depressive symptoms, and on response and remission rate. Complier average causal effect analysis yielded similar results. Conclusion. Due to the relatively small sample size, our findings should be regarded as preliminary and have limited generalizability. They suggest that there are considerable barriers on the part of many patients to the implementation of depression screening programs in primary care. While such programs can be effective, they should be designed based on the understanding of patients' perspectives.
The Limited Effect of Screening for Depressive Symptoms With the PHQ-9 in Rural Family Practices
The Journal of Rural Health, 2005
Context: Previous studies have found that routine screening for depression does not improve patient outcome unless it is combined with case management. However, these studies were conducted before the widespread use of SSRIs or in settings other than traditional primary care. Purpose: This study investigated whether screening for depressive symptoms improves outcomes for depressed patients seen in rural fee-for-service primary care offices. Methods: Depression screening was conducted at 2 private rural clinics in Iowa using the PHQ-9. Patients with depressive symptoms were randomized to the control group or the intervention group, where providers were given completed PHQ-9 questionnaires at the baseline visit. The outcome PHQ-9 scores were assessed by telephone at 4, 10, and 24 weeks after the index visit. Findings: A total of 861 patients were screened for depressive symptoms; 51 subjects enrolled in the trial. The intervention and control groups did not significantly differ with respect to changes in PHQ-9 scores at any of the 3 follow-up times. They also did not differ with respect to the proportion of subjects who were actively managed with medication or by referral to a mental health specialist: 46% vs 33% (P ¼.38) for all subjects and 50% vs 50% (P ¼.96) for subjects with major depression at baseline. Conclusions: Screening for depressive symptoms with the PHQ-9 in 2 rural medical clinics did not significantly increase physicians' active management of depression or lead to improved patient outcomes.
Review of a health fair screening program in mid-michigan
Journal of Community Health, 1989
Using sociodemographic data and findings from an evaluation survey, a Mid-Michigan health fair screening program is reviewed over a seven year period (1981)(1982)(1983)(1984)(1985)(1986)(1987). Most participants were older adults, and nearly two-thirds were women. Very few participants named the media as a reason for attending the health fairs at which the screenings were given. Many had seen a physician within the past two years, yet very few reported that they had had a complete checkup. The implications of these findings and a rationale for health fairs as a mechanism for screening are discussed.