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Depression Screening Tool and Clinical Guidelines for Non-Mental Health Providers

ValueOptions, EmblemHealth's Behavioral Health partner, recommends the following screening tool and clinical guidelines for depression.

Please see the member's identification card for information regarding the appropriate number to contact for a referral for behavioral health and/or substance abuse treatment services.

Screening Tool: PHQ-9*

The PHQ-9 (Patient Health Questionnaire-9) is a screening tool for depression.

Scoring:

• Mild Depression: Greater than or equal to 5
• Moderate Depression: Greater than or equal to 10
• Moderately Severe Depression: Greater than or equal to 15
• Severe Depression: Greater than or equal to 20

In addition, "significant" change can be attributed to any interventions that result in a decrease of 5 or more points on the PHQ-9. A member is considered to be in complete "remission" if his/her score falls below 5.

The PHQ-9 is especially sensitive to measuring change over time, and guidelines for intervention have been established based on its scores, as follows:

• 0 - 4: No action necessary (community norms)
• 5 - 9: Watchful waiting/monitoring for most members
• 10 - 14: Education, counseling, or active treatment, based on diagnosis, duration of symptoms, and level of impairment
• 15 - 19: Active treatment required for most members
• 20+ May need combination of medications and specialist treatment

Download (PDF): PHQ-9 Depression Identification Test

* PHQ-9 is adapted from PRIME_MD Today, developed by Spitzer, Williams, Kroenke and colleagues, Copyright 1999, by Pfizer, Inc. All rights reserved. Reproduction permitted for the purposes of clinical care and research only.