Lewistown clinic joins others in introducing depression screening

LEWISTOWN – The Geisinger-Lewistown clinic, along with other Geisinger clinics across Pennsylvania, has launched a new screening program designed to increase patient access to mental health treatment.

Each regular appointment with a primary care physician now includes a voluntary depression screening survey. The survey serves to open lines of communication between doctors and patients and to provide treatment guidance where necessary, said Dr. John Pagnotto, primary care physician at Geisinger-Lewistown.

“Depression is the most common psychiatric disorder and few patients want to discuss it outright,” Pagnotto said. “So unless you address it directly and ask questions, it’s rarely identified.”

Patients are invited to take the electronic survey in private at the beginning of each appointment. Should the survey find a patient positive for depression, it then moves on to a second set of questions to determine if the condition is mild, moderate or severe.

“If a patient is found to be experiencing any level of depression, the physician is made aware and part of the appointment is used to discuss possible treatment,” Pagnotto said. “If there’s any sign of suicidal thoughts or tendencies, the patient is immediately transferred to the physician for immediate treatment or possible hospitalization.”

The program was first launched in April 2012 at the Dallas clinic, with a specific focus on adults 65 years of age or older, said Juli Molecavage, performance innovation consultant with the Center for Best Practices at Geisinger Health System.

“We found the program to be very successful and quickly rolled it out to 40 practice sites over the next 10 months,” Molecavage said. “It’s now designed to screen adults ages 18 to 50 and 65 or older, but by the end of October it will cover all age groups.”

The success of the survey, Molecavage said, is directly related to the way and environment in which it is given. Since patients are able to take the survey in private and discuss the results with a trusted physician, they are more likely to be honest and address the issue, she said.

“The patient is truly doing this by themselves without the embarrassment of answering to a nurse,” Molecavage said. “They are more likely to be non-biased when answering the questions. It’s a concrete way to start a conversation about depression, if needed.”

Of the 10,000 Geisinger patients who have participated in the depression screening survey, 20 percent have been diagnosed with mild depression, 3 percent with moderate depression, 3 percent with moderate to severe depression and 2 percent with severe depression.

“That’s a pretty whopping number of people with depression, especially when two-thirds of patients with psychiatric needs usually go undiagnosed or untreated,” said Mark Basinger, associate vice president with Geisinger Health System’s Division of Psychiatry.

It’s just as important, Basinger said, for a physician to address mental health concerns as it is to address physical health concerns. Since all parts of the body interact, it doesn’t make sense to treat them individually, he said.

For example, people with Type 2 Diabetes have double the chance of experiencing depression, and one-sixth of patients treated for heart attack are treated for depression, Basinger said.

“People with major depression average twice as many visits to the doctor, but rarely seek treatment for mental health,” Basinger said. “The screening process is a way to open up that conversation, figure out what seems to be behind the depression and determine how the patient would like to proceed. It’s a two way conversation.”

To schedule a primary care appointment or to discuss the depression screening further, contact the Geisinger-Lewistown clinic at 242-4200.