Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

Abstract

Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between January and April 2006. Methods: A standardized 2-tiered screening approach for an inception cohort of students utilizing primary services. Primary care providers were trained to triage students with depressive symptoms. Results: Six percent of participants had clinically significant depressive symptoms (CSD). Severe depressive symptoms were found in less than 1.0% of participants. Male rates of severe depressive symptoms were more than double that of females. Only 35.7% of untreated depressed participants started treatment within 30 days following identification. Conclusions: Systematic primary care depression screening in a college health center is a promising approach to identify untreated students with depression. More study is needed to improve rates of treatment engagement.

Keywords:

• community health
• counseling
• gender
• mental health

ACKNOWLEDGMENTS

Michael C. Klein and Henry Chung were generously supported in this work by the Charles Engelhard Foundation, the Aetna Foundation, the New York Community Trust, the New York City Department of Health and Mental Hygiene, and the New York State Office of Mental Health. The authors appreciate the guidance and work provided by Karen Cheal, MPH, our statistics consultant. The authors would also like to thank Frank Kurdyla, Cynthia Cunningham, Francis Toro, Alexandr Azarov, Jennifer Crossdale, and Christine Diaz for essential review of health records.

Notes

^a All a priori p values set at .05.

*Significant differences between undergraduate and graduate and professional students.