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Mental health moves into mainstream of primary care

February 18, 2016 | Patricia Harriman
UCI Health psychiatrist Dr. Jody Rawles

Dr. Jody Rawles

Don’t be surprised if your doctor asks you about depression at your next visit. The US Preventive Services Task Force, a federal government advisory group, recently issued a recommendation that general physicians screen all adults for depression. Dr. Jody Rawles, a physician with UCI Health Psychiatry Services, says this is a sign that mental health is moving to mainstream medicine in America.

“It has to,” he says. “Mental health issues are a major source of medical disability.”

The National Institute of Mental Health estimates that nearly 7 percent of the US population suffers a depressive episode every year, costing businesses more than $440 billion annually.

Mental health: making it a routine part of health care

Many of the physical complaints that people have can be signs of depression, such as:

Through the screening process, physicians can determine the cause. If depression is diagnosed, provide treatment or refer the patient to the appropriate level of care.

Rawles believes that integrating depression screening into the standard protocol of primary care physicians will begin to destigmatize the diagnosis, by helping patients understand that depression is a medical condition that affects the brain rather than the body. Depression can also interfere with the patient’s ability to comply with treatment for other conditions they may have, such as diabetes or high blood pressure.

“It is going to take time to convince people with symptoms that there is no shame, guilt or blame in experiencing depression," he says.

“The goal is to make people as comfortable in recognizing and getting treatment for their depression as they would for their diabetes. As with physical illnesses, early diagnosis and treatment are most effective in managing the condition.”

Challenges of treating depression

It is important to screen for depression, Rawles explains, because it is a pervasive, highly prevalent condition that has not been widely recognized.

The challenge is going to be ensuring that patients receive proper treatment and follow-up care. The extensive resources that have been allocated to establish the procedures and practices in place for physical illnesses have not been dedicated to mental health.

“When a patient goes to an emergency department complaining of chest pains, the staff will immediately know how to determine the cause and treat the condition, and where to transfer the patient if necessary,” he says.

“The systems are in place for that patient. We need to make sure that as patients for depression are screened, the services and people to care for them are in place.”

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