The Southcentral Foundation depression collaborative.
OBJECTIVE
To describe a collaborative between a primary care clinic and a behavioral health clinic to treat depression among Alaska Native and American Indian patients.


METHODS
Cross-sectional study.


METHODS
Protocols for screening and intervention are described. The Patient Health Questionnaire identified individuals as negative or positive for DSM-IV depression. A computerized medical record was queried for descriptive data. Distribution of depression symptoms and diagnoses, antidepressant prescription, and service utilization highlight successes and weaknesses.


RESULTS
Of those screened (n = 14,648), 17.2% (n = 2,534) screened positive for depression. A little more than half (57%) of positives were prescribed antidepressant medications. Roughly 55% of patients who initially screened positive scored negative for depression after follow-up. Less than half (42%) of patients who initially screened positive had received specialty behavioral health care or a mood disorder diagnosis during the previous year.


CONCLUSIONS
This program successfully identified and treated the depressive symptoms of many Alaska Native and American Indian patients who had not presented for specialty care and had not previously been diagnosed as depressed. Implementing similar programs elsewhere may help address depression as a significant health concern in the Alaska Native and American Indian population. Recommendations for future investigation are delineated to guide program improvement efforts and add to the general health disparities literature.
D000413:Alaska / Q000453:epidemiology; D000928:Antidepressive Agents / Q000627:therapeutic use; D001524:Behavioral Medicine / Q000458:organization & administration*; D003156:Community Mental Health Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D007373:Interinstitutional Relations; D004930:Inuit / Q000523:psychology*; D008403:Mass Screening / Q000458:organization & administration; D010348:Patient Care Team; D011320:Primary Health Care / Q000458:organization & administration*; D012720:Severity of Illness Index
D000928:Antidepressive Agents