Last week @JAMA published the recommendation to screen for depression in the general adult population, including pregnant and postpartum women. You can see the write-up here. Now this is nothing new to many of us as PTs as we have become direct access providers. However, this piece resonated with me for several reasons.
1. As direct access providers, this reinforced that we should be screening for depression. One should be utilizing the Patient Health Questionnaire (PHQ). This comes in the more familiar 2 question depression screen seen here (also known as the PHQ-2) or the JAMA recommended PHQ-9, which can be found here. These tools have been shown to be highly sensitive, thus helping us rule out depression–which will serve as a great screening tool if you are not already using. More information on the pyschometric properties can be seen here and here.
2. PTs have the ability to create strong connections with patients due to the inherent length of time they spend working with us and our staff. We can get a glimpse of their struggles, mood and behaviors as we develop relationships with our patients. We also see folks with chronic conditions that can contribute to the onset of depression. Through our interactions we can help us see signs and symptoms of this condition.
3. We should have a mental health professional that we can refer to when needed. This is essential. I have had interactions with several mental health professionals that have been a huge help in addressing depression, which allowed the patient to maximize physical function gains.
Here are my recommendations for PTs who are reading this:
- Utilize the PHQ-2. This is a simple addition to an intake sheet–I know many clinics that are currently doing this and I am sure it helps when starting off the examination process. I can also appreciate, though, that many intake sheets are lengthy or if in a large health system environment, changing intake forms is like trying to get Donald Trump to support Hilary Clinton. That being said, this can be verbally administered with ease.
- Utilize the PHQ-9 to gain more specifics on intensity of depression. This may be useful if you are in need for referral as this can help increase the urgency of referral as well as provide more information to a mental health professional.
- Let’s also remember the benefit of exercise for those that are suffering from depression. We are movement experts…it is time to get these folks moving!