Depression screening in a VA primary care clinic.

Area of Science:

• Health Services Research
• Clinical Practice Guidelines
• Mental Health Services

Background:

• The U.S. Department of Veterans Affairs (VA) mandated annual depression screening in primary care settings in 1998.
• The VA Medical Center in New Orleans implemented a specific four-item depression screening tool.

Purpose of the Study:

• To evaluate the implementation and effectiveness of the VA's mandated annual depression screening program.
• To establish benchmarks for screening administration and follow-through on positive depression screens.

Main Methods:

• Evaluation of a depression screening program at a VA primary care clinic.
• Analysis of screening data for 1,100 patients over a one-month period.
• Assessment of follow-through on positive depression screens, including treatment or referral.

Main Results:

• 97% of 1,100 patients were screened either during the visit or within the previous 12 months.
• Of 70 patients who screened positive for depression, 71% were offered treatment or psychiatric referral.
• The study identified successful implementation strategies, including leveraging electronic medical record features.

Conclusions:

• The VA's depression screening program demonstrated high screening rates and significant follow-through on positive results.
• The findings provide valuable benchmarks for the administration of depression screening and subsequent patient management.
• Electronic medical record functionalities were key to the successful implementation of this healthcare best practice.