The Role Of Depression In Primary Care

The monthly quality improvement report comes across the desk of the primary care providers, and eyes immediately shift to the numbers of the disease that is at the forefront today, hypertension and diabetes. Although it may be these disease states that catch the providers’ attention, depression scores are equally as important. Chronic medical conditions and depressive disorder frequently occur together, so, what if the key to successful management of all disease processes was ensuring depression was adequately treated? An individual who is depressed may be less likely to check their blood sugars, eat a healthy diet and get exercise, or be compliant with blood pressure medications. In order to manage depression, it needs to be followed closely,
According to Greenberg et. al (2015), between the years 2005 and 2010, there was an increase of 21.5% (173.5 billion to 210.5 billion dollars) in direct care costs of depression. The direct cost of depression which is driving this, includes things like medication, hospital stays and the care of physicians. Of the 210 billion dollars, only forty percent was directly related to the treatment of depression alone. Moreover, for every one dollar spent on the treatment, an additional $4.70 is spent on the indirect costs, with an additional $1.90 spent on workplace related costs, and economic expenses linked with suicides. The indirect costs of depression are mostly associated with the persons affected by depression, and include things like a loss of productivity and missed work (Greenberg et. al, 2015). Depressive disorder also increases the cost of healthcare by carrying the largest medical plan costs of all behavioral health diagnoses (Conti & Burton, 1994). Essentially, the cost of depression extends far beyond the direct treatment as its implications can be seen in our economy as a
One primary resource expected to worsen in the coming years are the shortage of mental health care providers. Today, fifty-nine percent of psychiatrists are fifty-five years of age or older, and in the past nineteen years, there has been only a twelve percent increase of psychiatrists entering the workforce (Sederer, 2015), ensuring a shortage of providers. Another significant barrier to diagnosing and treating depression is the stigma associated with the condition. Social stigma can often deter those battling with depression from accessing the help they need for fear of judgment or discrimination. In some countries, social stigma of depression may be worse, in part due to religious and traditional beliefs (Goldsmith, Pellmar, Kleinman, & Bunney, 2002). Developing countries experience the same barriers the U.S. faces, but can be worse, as access to even a primary care provider is limited, and finding a psychiatrist is near impossible. Care is often provided in community centers and providers may have minimal education (Goldsmith et. al, 2002). All of these constraints make it more difficult for a patient to get the initial and ongoing treatment necessary for