New Gov’t Task Force Calls For Screening Every Adult, Pregnant Women For Depression

Wednesday, January 27, 2016
By Paul Martin

By Brandon Turbeville
ActivistPost.com
JANUARY 27, 2016

A new recommendation has been released by the U.S. Preventive Services Task Force, a government advisory group that is now recommending all adults be routinely screened for depression as part of their healthcare.

The first part of the recommendation suggests that all adults be screened, but singles out pregnant women and new mothers as a target population. The second part of the recommendation mentions the need to ensure that systems are in place that will allow for the proper diagnosis and treatment of people who are singled out through this screening. The guidelines, which were published in the Journal of the American Medical Association, did not specify how often adults should be screened.

In regards to the implementation of these guidelines, the Task Force states:

The USPSTF recommends that screening be implemented with adequate systems in place. “Adequate systems in place” refers to having systems and clinical staff to ensure that patients are screened and, if they screen positive, are appropriately diagnosed and treated with evidence-based care or referred to a setting that can provide the necessary care. These essential functions can be provided through a wide range of different arrangements of clinician types and settings. In the available evidence, the lowest effective level of support consisted of a designated nurse who advised resident physicians of positive screening results and provided a protocol that facilitated referral to evidence-based behavioral treatment.1 At the highest level, support included screening; staff and clinician training (1- or 2-day workshops); clinician manuals; monthly training lectures; academic detailing; materials for clinicians, staff, and patients; an initial visit with a nurse specialist for assessment, education, and discussion of patient preferences and goals; a visit with a trained nurse specialist for follow-up assessment and ongoing support for medication adherence; a visit with a trained therapist for CBT; and a reduced copayment for patients referred for psychotherapy.2, 3

Multidisciplinary team–based primary care that includes self management support and care coordination has been shown to be effective in management of depression. These components of primary care are detailed in recommendations from the Community Preventive Services Task Force.4 It recommends collaborative care for the treatment of major depression in adults 18 years and older on the basis of strong evidence of effectiveness in improving short-term treatment outcomes. As defined, collaborative care and disease management of depressive disorders include a systematic, multicomponent, and team-based approach that “strengthens and supports self-care, while assuring that effective medical, preventive, and health maintenance interventions take place” to improve the quality and outcome of patient care.4

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