Citation

Blake C. Workplace Health Saf. 2022; 70(12): 543-550.

Copyright

(Copyright © 2022, American Association of Occupational Health Nurses, Publisher SAGE Publications)

DOI

10.1177/21650799221119147

PMID

36214536

Abstract

BACKGROUND: Depression in the U.S. population affects approximately 17.5 million people, with an approximate annual economic cost of US$326 billion. The overall objective of this quality improvement program was implementation of a standardized screening protocol using a validated screening instrument to identify depression in first responders in a primary care setting.

METHODS: This program applied the Knowledge-to-Action framework utilizing the 9-question Patient Health Questionnaire (PHQ-9) screening tool. The outcome measure was screening completion with a process measure of depression questionnaires provided to patients, and balance measures of time of visit and referral rate. In a pre-/postintervention project design, clinic staff were trained on depression screening. PHQ-9 questionnaires were placed in all exam rooms for patients and providers to discuss. Referrals were made to the staff psychologist or to medical providers based on evaluations.

FINDINGS: From pre- to postintervention, screening increased from less than 1% to a screening rate of 92%. Appointments for depression intervention increased to 50%, 44 patients for counseling and 12 for medical therapy.

CONCLUSIONS/APPLICATIONS TO PRACTICE: A standardized screening protocol using a validated self-assessment tool improved depression surveillance and increased referrals for treatment. A training program with an accompanying policy was designed to sustain this program and may serve as a model for other programs serving first responders.

Language: en

Keywords

Humans; suicide; depression; substance abuse; first responders; firefighters; *Emergency Responders; *Quality Improvement; Depression/diagnosis/therapy; emergency medical personnel; Mass Screening/methods; mental health screening or depression screening; posttraumatic stress disorder or PTSD; Primary Health Care/methods