Depression Still Undertreated

Depression is extremely common; more than 16 million U.S. adults experience major depression each year. The costs in lost productivity costs about $44 billion a year, according to the University of Michigan. Yet even with the stakes so high, only about a third of people diagnosed with depression go on to initiate treatment, according to a to a new study.

The study, conducted by Kaiser Permanente and published in the Journal of General Internal Medicine, looked at 240,000 patients who had been seen by their primary care doctors and received a diagnoses of depression. The study used electronic health records, insurance claims and demographic data, and covered patients from the years 2010 to 2013. According to the study, once the patients had been diagnosed by their doctors, only 35.7 percent initiated treatment, including psychotherapy or taking antidepressant medication, within 90 days of their diagnoses. The rate of action was higher among those who had been experiencing more severe depression, with about half starting treatment.

“Over the last decade, there has been a growing effort to raise awareness about mental health and to integrate mental health care into primary care,” wrote the study’s lead author, Beth Waitzfelder, Ph.D, who works with Kaiser Permanente in Honolulu, Hawaii. “This is a positive development, since most people receive care from primary care providers. However, our study shows there is a lot more work to do to understand why many depressed patients do not begin treatment.”

The study also found that there are some disparities among who seeks more treatment. For example, Asian, non-Hispanic blacks and Hispanics started treatment at a rate that was 30 percent lower than non-Hispanic whites. Older patients, classified in this study as over age 60, were only half as likely to seek treatment as patients aged 44 or younger.

Waitzfelder writers that some of the reasons may be stigmas associated with seeking mental-health care among some populations, or challenges accessing behavioral health care. The study underlies the point that while screening and detection are important, treatment and outcomes should also be considered. If you have preferences, such as preferring psychotherapy to medication or vice versa, be sure to discuss that with your doctor so that you can come up with a strategy that will work best for you.