Major depressive disorders (MDD) affect 5 - 10% of patients in the primary care setting. The U.S. Preventative Services Task Force (USPSTF) recommends screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment and follow-up. Our Depression Care Program will utilize the PHQ-9 (Patient Health Questionnaire 9) screening tool for identifying patients who are depressed, track and follow-up patients who screen positive for severe depression. We also offer an in-clinic option for psychotherapy conducted by a licensed clinical social worker (LCSW). The Depression Care Program is coordinated by an LCSW, who will work closely with the patient's provider to coordinate care for patients with depression.
The Depression Program assists patient and providers in various ways:
- Prompting nurses and providers to administer and assess depression screens (PHQ-9) on the Visit Planner
- Tracking results of depression screens
- Follow-up phone calls for patients with severe depression
- Offering in-clinic pyschotherapy option with an LCSW focused on concrete problem-solving techniques
In-clinic psychotherapy appointments. Referral criteria in order of priority are:
- Patients with severe depression who refuse medication but are willing to go for counseling
- Patients with moderate depression who are willing to go for counseling
- Patients with severe depression who are taking medication and are willing to go for counseling
A referral can be made to the Internal Medicine Counseling Program by circling counseling on the encounter form. At check-out a copy of the patient's insurance card will be made in order to request pre-authorization for insurance to cover mental health services. This must be completed before the first appointment can be scheduled.
Currently, we have a wait list for patients interested in pursuing psychotherapy in clinic. We recommend referring elsewhere for the following:
- PHQ score less than 10 - consider local mental health referral
- Active substance abuse - consider local Alcholics Anonymous, Narcotics Anonymous, outpatient substance abuse programs or inpatient detoxification programs
- Patients with biploar disorder, personality disorder, active hallucinations/delusion or active suicidality - consider UNC Psychiatry for patients in Orange, Person or Chatham Counties or local county, psychiatric services or emergency department