Depression is a costly and debilitating condition that profoundly influences a person’s quality of life. In 2020, more than 21 million adults in the U.S. reported having at least one major depressive episode in the previous year. Depression symptoms increased dramatically during the COVID-19 pandemic, and now affect nearly 1 in 3 American adults.
There are also many disparities in access to depression treatment. Clinicians are less likely to recognize and treat depressive symptoms in certain groups, including racial and ethnic minorities, men, older adults and people with language barriers. These disparities may be driven by poor patient-physician communication about mental health, cultural differences in discussing depressive symptoms, stigma around mental illness and limited available treatment options.
Limited time to discuss mental health symptoms in depth in primary care settings may also contribute to the depression treatment gap. As a researcher and primary care physician focused on improving access to mental health treatment, I have seen many patients struggle to have their depressive symptoms recognized by their clinicians and access quality care. Depression screening often only occurs when a clinician suspects the patient may have depression or when the patient specifically requests mental health care.
But making depression screening a routine practice could help reduce treatment disparities. In January 2016, the U.S. Preventive Services Task Force began recommending depression screening for all adults. In October 2022, given the mental health effects of the pandemic, it extended the recommendation to include screening all adolescents age 12 and up for depression and suicide risk during routine wellness checkups.
In our recent study, my team and I found that implementing universal, routine depression screening for adults in primary care is one way to make detection more equitable.