Implementation of Depression Screening Tools for Patients with Substance Use Disorder in an Outpatient Psychiatric Clinic
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Authors
Graham, Cheryl
Issue Date
2024-03-01
Type
Thesis
Language
en_US
Keywords
Mental Health--Depression , Mental Health--Screening Tools , Substance Use Disorder (SUD)
Alternative Title
Abstract
Background: Substance use disorder (SUD) is a major public health crisis in the United States (US). SUD is one of the primary causes of morbidity and mortality, accounting for nearly 92,000 overdose deaths in the US in 2020. About 43% of people with SUD have mental illnesses, with depression the most common diagnosis. Identifying depression in persons with SUD is critical to treatment and optimal patient outcomes (McGovern et al., 2023).
Purpose: This quality improvement project aims to implement and evaluate evidence-based depression screening tools (PHQ-2, PHQ-9) to identify adult patients with depression who present to the outpatient clinic for SUD treatment.
Methods: The project was conducted at an outpatient psychiatric clinic in the Midwest that specializes in treating patients with SUD and mental illnesses. A before-and-after study design was used to determine the rate of depression screening and treatment prior to and following project implementation. A two-step screening process was used at check-in. Patients with a positive PHQ-2 screen were administered a PHQ-9 questionnaire. Patients with positive PHQ-9 were treated with medication, referred for counseling, referred to psychiatry, or wait and see.
Results: Ten clinical staff members participated in the project: six FNPs, three MAs, and one physician. All ten clinical staff members completed the knowledge assessment survey and the educational training. Of the 45 charts audited pre-implementation, zero had a depression screening. 38 of 45 post-implementation charts audited had a PHQ-2, and 31 had a PHQ-9. Depression diagnoses and treatment increased from 20% to 60%, and from 16% to 47 % respectively.
Description
DNP Project
Citation
Publisher
Washburn University