More than 430,000 New Yorkers suffer from depression.
Depression Screening and Management in Primary Care
Almost one out of every six adults (one in four women and one in ten men) are affected by depression at some point during their lifetimes, but only 25% are adequately treated. In New York City, more than 430,000 adults suffer from depression and 200,000 have an anxiety disorder. Depression in half of these New Yorkers goes undiagnosed and three out of five New Yorkers do not receive treatment for their depression. Of even greater concern are the disparities that exist for African-Americans and Hispanics: Only a quarter are receiving treatment for depression.
Depression impacts many facets of an individual’s life including family relationships, friendships and the ability to work or go to school. Some 23% of New Yorkers with anxiety and 15% of those with depression say the condition limits their ability to work. Despite the seriousness of depression, many people believe they can shake off symptoms and do not seek treatment because of shame and stigma. Depression is one of the most common conditions in primary care settings, and because of comprehensive nature of doctor visits, addressing depression in primary care settings is a priority.
Primary care physicians and other non-psychiatrists can effectively screen for and manage depression; and a grant to the Fund for Public Health in New York (FPHNY) supported a NYC Health Department-led clinical improvement process to streamline screening and basic depression management in adult primary care practices. A Care Manager with a social work background worked at Lutheran Medical Center clinics in Brooklyn to support the treatment of depressed patients. The Care Manager strengthened treatment adherence by following up with patients diagnosed with depression, reminded patients of appointments, provided education on depression and anti-depressant medications and communicated with the physician regarding the patient’s progress.
At the conclusion of this grant, 80% of all patients who were seen during program implementation at the two participating clinics were screened for depression and 26% of patients receiving care management services showed improvement. According to Yar Pye, Medical Director at Lutheran Family Health Center, phone support and liaising with the Care Manager enhanced patient adherence. At the conclusion of this project, Lutheran Medical Center incorporated depression care management services into the routine care of patients at two of its primary care clinics. Though grant funding has ended, Lutheran Medical Center has hired an additional care manager and continues to utilize this new care management model.