In an effort to identify and treat patients with undiagnosed depression, Cedars-Sinai nurses are screening each hospitalized patient for signs of the illness and for risk factors that could make recoveries harder and longer.
The new initiative is believed to be one of the broadest depression screening of patients in a U.S. medical center, according to a news release.
Although many illnesses are associated with feelings of anxiety, stress and fear, the new screening process is designed specifically to help detect symptoms of clinical depression characterized by a severely disheartened mood, lowered activity level and persistent negative thoughts lasting longer than two weeks. More than 18 million Americans, about 7% of the adult population, experience major depression each year, according to the release.
Stigma against those with depression
Societys stigma against those who have a mental illness often prevents people from seeking treatment when they start feeling depressed, Itai Danovitch, MD, MBA, chairman of the Cedars-Sinai Department of Psychiatry, said in the release. If they develop a physical condition that requires hospitalization, it can cause depression to worsen, affecting the patients ability to bounce back from a physical illness. Instituting comprehensive screening will help us recognize underlying mental health issues and offer effective treatments more readily.
Depression affects many patients who enter hospitals and is thought to be caused by a combination of genetic, biological, psychological and environmental factors.
We know, based on multiple medical studies over several years, that addressing depression improves all aspects of patient health, Linda Burnes Bolton, RN, DrPH, FAAN, vice president for nursing, CNO and director of nursing research, said in the release. By routinely screening our patients for depression upon admission, we can ensure that they receive the appropriate treatment and protocol.
An RN will interview each patient within 24 hours of admission, Danovitch said, and ask two questions about mood and energy level. If the patients answers indicate a possible diagnosis of depression, the nurse immediately will use a standardized, detailed questionnaire to assess concentration, appetite, sleep patterns and the presence of any thoughts of suicide. Cedars-Sinai social workers, partnering with physicians, will help determine appropriate interventions.
If the questionnaire reveals a patient is suicidal, the nursing department will notify the patients physician and institute safeguards designed to protect a patient from self-harm.