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Depression Screenings: Taking “Universal Precautions” Against Depression

By Richard Juman, PsyD, Director of Behavioral Health Policy and Regulations, Co-Chair, Clinician Resiliency Core Group


As National Depression Screening Day approaches on October 7, it’s important to highlight the value of identifying depression. Both the World Health Organization and the United Nations Health Agency report that depression, on its own, is a leading cause of disability worldwide, with impacted individuals prone to poor functioning at work, in school and at home. In severe cases, depression can lead to suicide.

The COVID-19 pandemic has exacerbated many of these issues. In 2020, 40% of adults in the United States reported struggling with mental health or substance misuse.  Because of this, depression screenings are valuable tools to help gauge patients’ proclivity for depression.

Depression Screening

  1. How are you feeling these days? Over the past couple of weeks, have you found yourself with little or no interest or pleasure in doing things?
  2. Have you been feeling down, depressed or hopeless?

In answering these two simple questions, you have responded to a valid, evidence-based screening tool for depression. The tool, known as the PHQ-2, uses the first two questions from the more widely-known PHQ-9 as a quick and easy method for identifying depression.

Identifying Depression in Patients

From the standpoint of a primary care clinician, depression negatively impacts the effectiveness and increases the cost of treating other major medical conditions. In short, if your patient is depressed it will likely be harder, and more costly, to promote a good clinical outcome, even if you provide optimal medical care. Depression often goes unrecognized and untreated. So, it behooves all healthcare professionals to routinely screen for depression in their clinical practices. The PHQ-2 allows us to easily do just that. When patients do trigger for depression on the PHQ-2, clinicians can either explore the mood disorder more thoroughly or refer them for consultation with a mental health professional.

Traditionally, certain populations, like residents of skilled nursing facilities, are at higher risk for depression. However, given the extraordinary stressors we are all now confronted by from the COVID-19 pandemic and various other national and global concerns, it makes sense to take “universal precautions” against depression. This approach says all clinicians should operate under the assumption that ALL of our patients may be at risk for depression and screen for it accordingly. Given the ease of administration with the PHQ-2, clinicians can easily incorporate the screening tool into the routine approach to patient care.

Identifying Depression in Clinicians

Healthcare providers themselves are not immune to suffering from depression. Clinicians have been exposed to the same pandemic pressures as the rest of the population. But they then must go to work in COVID-19 epicenters where they encounter suffering and death daily. From that standpoint, clinicians may be more at risk for depression than the general population. Given that reality, TeamHealth has created a myriad of programs and tools designed to improve clinician wellness. If you feel that you or a colleague may be suffering from depression, please explore these options to obtain needed support.

If you or someone you know is struggling, please reach out for help. Reach the 24/7 National Suicide Prevention Lifeline: 800-273-8255 (Languages: English, Spanish).

  • National Suicide Prevention Hotline: 800.273.8255
  • National Alliance on Mental Health Help Line: 800.950-NAMI (6264)
  • Substance Abuse and Mental Health Services Administration National Helpline: 800.662.HELP (4357)
  • Crisis Text Line: Text HOME to 741741 to connect with a crisis counselor,