The Major Depression Problem We Need To Address

Photographed by Alexandra Gavillet.
Depression is one of the most common mental-health issues in the United States, and it affects roughly twice as many women as men. Yet new research suggests that far too many people aren't getting the help they need — whether that's because they're getting too much treatment or not enough. For the study, published online this week in JAMA Internal Medicine, researchers looked at data from a large online health survey. Originally conducted between 2012 and 2013, the survey gathered 46,417 responses. This included a short screening questionnaire about participants' possible symptoms of depression in the past two weeks. Participants were also asked whether they had received any treatment for mental-health conditions. Results showed that 8.4% of respondents met the screening criteria for depression. But only 28.7% reported receiving any treatment, including different types of therapy and medications. On the flip side, only about 30% of those who were receiving treatment for depression actually screened positive for the disorder, suggesting that some people might be more likely to be overdiagnosed and get care they don't actually need. Those who were most likely to get treatment were women, between the ages of 35 and 64, white, had completed at least high school, and, of course, had health insurance. "These patterns suggest that more needs to be done to ensure that depression care is neither too intensive nor insufficient for each patient," the lead author of the study, Mark Olfson, MD, PhD, said in a press release. Part of that is already being implemented thanks to recent changes to the U.S. Preventive Service Task Force's guidelines, which now recommend that all adults be screened for depression as part of routine care.
But this study suggests that those screening tools still aren't being used often enough — or in the right way. "Although screening tools provide only a rough index of depression severity, increasing their use might nevertheless help align depression care with each patient's needs," Dr. Olfson said. That's especially important because we know depression treatment is often a combination of approaches unique to each patient. What works for one person won't necessarily work for someone else. And you don't have to have a diagnosable mental illness to get benefits from therapy — we've all got shit to work through. So these results suggest that using screenings as an opportunity not just to diagnose but to actually direct treatment is crucial, too.

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