Only 48% of American adults in the general population were assessed for depression, whether through screening or as part of treatment for depression, and despite the U.S. Preventive Services Task Force recommendations encouraging clinicians do so, according to findings recently published in the Journal of the American Board of Family Medicine.
“Making sure that health care encompasses both physical and mental health has always been important to me in both my professional and personal work,” Amanda Borsky, DrPH, MPP, of the Agency for Healthcare Research and Quality, told Healio Family Medicine. “My father started out as a social worker and I remember hearing stories about the heartbreaking effects of what happens when people’s mental health needs are not assessed and treated adequately. Now, as a health services researcher by training, I have tried to examine how best to improve mental and behavioral health services.”
“There is still a lot of work to be done to improve the delivery of mental and behavioral health care, and looking at whether Americans are being properly assessed for depression is one step in this direction,” she continued.
Borsky and colleagues evaluated 1,852 responses from the Agency for Healthcare Research and Quality Medical Expenditure Panel Survey to determine if adults 35 years and older were being assessed for depression by their health care providers. The adults’ age, chronic conditions, education, insurance, perceived health and poverty status, race, sex and where they resided was also noted.
Researchers found that 48.6% (95% CI, 45.5-51.6) of respondents were assessed for depression. Specifically, men were less likely to be assessed vs. women (OR = 0.58; 95% CI, 0.46-0.72), adults older than 75 years of age vs. those 50 to 64 years old (OR = 0.47; 95% CI, 0.32-0.69), adults without recognized depressive symptoms vs. those with recognized symptoms (OR = 0.39; 95% CI, 0.24-0.63) and uninsured vs. private insurance holders (OR = 0.3; 95% CI, 0.18-0.51). In addition, Asians (OR = 0.35; 95% CI, 0.19-0.67), African Americans (OR = 0.42; 95% CI, 0.27-0.67) and Hispanics (OR = 0.47; 95% CI, 0.29-0.75), were less likely to be assessed vs. non-Hispanic whites.
“Somewhat surprisingly, we found some of the populations that were less likely to have been assessed for depression included: adults who believe they are in good health, do not have symptoms of depression and have fewer chronic conditions. This suggests that, contrary to concerns that depression will be overlooked in patients with multiple comorbidities, it is patients without chronic health issues, and who are less likely to go to the doctor, that do not have the opportunity to be assessed,” Borsky said in the interview.
"Prior research has shown that minorities, the elderly, and those with less education and access to health care are more likely to suffer from depression, and our study’s results show they are also less likely to have their depression needs assessed. Much remains to be done to achieve universal screening for depression,” she continued.
Borsky added that the studies that led to the USPSTF recommendations indicated PCPs can improve their patient’s depressive symptoms by screening and then, if appropriate, prescribe treatment such as antidepressants and/or psychotherapy either themselves or by referring the patient to a qualified professional. - by Janel Miller
The authors declare no relevant financial disclosures.