Screening for Symptoms

CARIN GORRELL TALKS WITH DOUGLAS GEORGE JACOBS, M.D., ABOUT
NATIONAL DEPRESSION SCREENING DAY.

Depression is a national epidemic, but very few sufferers are even
diagnosed with the disorder, the first step to receiving treatment.
That's why in 1991, Douglas Jacobs, an associate clinical psychiatry
professor at Harvard Medical School, instituted National Depression
Screening Day (NDSD). Occurring each October during Mental Illness
Awareness Week, Jacobs' program is cosponsored by several national
organizations including the National Institute of Mental Health (NIMH)
and provides free nationwide screenings and referrals to those seeking
relief.

CG: What inspired you to start NDSD?

DJ: In the late 1980s, the NIMH came out with studies indicating
that depression was a prevalent but under-diagnosed and under-treated
disorder. I thought, "Why not apply the principles of health screening to
a mental disorder?" So I designed a screening model consisting of a
self-test, educational information about depression, a lecture, a video
and a brief interview.

CG: What occurs during the interview?

DJ: It's a novel concept of screening in psychiatry; the person has
an opportunity to review their self-test with a clinician--it can be a
psychiatrist, psychologist, social worker, nurse or mental health worker.
We give the clinician instructions to go over test scores and then ask
some basic questions about depression. People are not told that they have
depression, but rather that they have symptoms consistent with
depression.

CG: And if symptoms are present?

DJ: The idea is to answer any questions and to try to get the
person to follow up with a referral. It's important that we link people
up co what's available in their community. We also address the reality
that there are insurance issues, and so make sure that every facility has
referrals to state-funded programs.

CG: Where are screenings held?

DJ: Just about every hospital and academic center in the country
has participated. We have the support of the major professional
associations and advocacy groups, and various sites around the country
have registered with us. Today, about 95 percent of the country is within
100 miles of one of our sites. [To find the screening site nearest you,
call 800-754-6700, or check out its Web site at
www.mentalhealthscreening.org.]

CG: Who should consider getting screened?

DJ: Any person who feels they may be suffering from symptoms of
depression. It's anonymous, they don't have to worry about getting an
appointment and there's no pressure. The most important point is that
family members should encourage loved ones to at least go to a screening.
Of the nearly 20 million Americans who experience depression each year,
we estimate that between only 4 and 8 million are in active treatment.
We've come a long way in our understanding of depression--it would be
nice if more people could benefit from what we've learned.

STATISTICS

Depression is the country's second leading cause of disability.
Still, a surprisingly small number of people actually get treated, and
among those who do, very few have faith that they will improve. If you're
questioning the benefits of undergoing treatment for depression, consider
these statistics:

18.8 MILLION : Number of American adults who have a depressive
disorder

12 : Percentage of women affected by depression

6.6 : Percentage of men affected by depression

55 : Percentage of depressed patients who believe treatment will
provide symptom relief

80 to 90 : Percentage of depressed patients who significantly
improve after receiving treatment