Evidence Based Protocol: Improving Depression Assessments in Primary Care

Depression is a destructive condition that can have a profoundly negative impact on quality of life, wellbeing, and health (Thase, Stowell, Berry, Mencia & Blum, 2014). Worldwide, depression is the leading cause of medical disability costing the health care system over $210 billion annually (World Health Organization, 2014; Greenberg, Fournier, Sisitsky, Pike & Kessler, 2015). The World Health Organization (2016) estimates depression affects 350 million people of all ages globally. One and three adults in the U.S. will experience a major depressive episode during their lifetime (Kessler, Petukhova, Sampson, Zaslavsky & Wittchen, 2012; Rubin, Ciechanowski, Egede, Lin & Lustman, 2004). Although depression is one of the most prevalent and treatable mental health disorders presenting in primary care, it is sub-optimally managed and worse, often not even detected by medical professionals (Gilbody, Richards, Brealey & Hewitt, 2007). Despite decades of widespread interventions, public awareness and research, prevalence rates of major depressive disorder has not improved (Ferrari et al., 2013). Furthermore, less than half of patients with depression receive care based on national practice guidelines (Wittenborn, Rahmandad, Rick & Hosseinichimeh, 2016). Therefore the purpose of this paper is to describe a protocol on how to improve depression management, specifically the quality and consistency of depression assessments in a primary care clinic