MN Community Measurement (MNCM), a nonprofit organization, has released a report titled “Depression Care in Minnesota.”
The report marks the first in MNCM's new report series and highlights progress that has been made in identifying and caring for depression among adults and adolescents in Minnesota. MNCM has been collecting and publishing data on depression outcomes since 2009.
Depression affects millions of individuals across the United States, regardless of geography, age, gender or race. The outcome measures in this report reflect more than 110,000 adult patients in Minnesota whose depression screening indicated the need for treatment. “Depression Care in Minnesota” helps to shine a light on the work that is being done to identify and treat depression and also illustrates the need for improvement in care. The full report can be viewed at www.mncm.org/depressionreport2018.
Key findings of the report reveal that depression remission and response rates remain relatively low, and improvement has been slow. Analysts point out that one reason for this is that many patients with depression aren’t receiving the necessary follow-up assessment, and missed follow-up affects the rates for all outcome measures.
Despite low statewide average rates of depression remission and response, there are noteworthy bright spots with several medical groups and clinics achieving significantly better outcomes. In using data to help improve their efforts and taking innovative approaches to make improvements in follow-up communication, a handful of medical groups received a top rating on the Depression Remission at 12 Months outcome measure. These medical groups are Entira Family Clinics, Essentia Health, Park Nicollet Health Services, HealthPartners Clinics, and Grand Itasca.
For adolescents, mental health and/or depression screening rates have significantly improved since 2015 and have shown considerable improvement every year. Most medical groups in Minnesota are now administering a depression screening tool to their adolescent patients at well-child visits. Because screening for depression and other mental health issues was not consistently occurring in the adolescent population previously, it was selected as a focus for measurement in Minnesota. Beginning in 2020, MNCM’s data collection for depression outcomes will be extended to include adolescents.
“There’s absolutely no question that the mental health of our community deserves our attention. We’ve collaborated with a range of stakeholders to develop measures that matter most to improve patient outcomes in depression care,” said president of MN Community Measurement, Julie Sonier. “Our outcome measures purposefully focus on the need for follow-up because depression is an isolating condition and our community strongly felt that it was through that follow-up that providers could have the most impact. While we’ve seen slow progress, the data is showing us what's possible and will inform us and motivate us to move forward and improve our systems of care.”
Depression is one of the most common mental disorders in the United States. According to a study conducted by MNCM in 2015, nearly 10 percent of Minnesota adolescents who were screened for depression or other mental health conditions, screened positively. The National Institute of Mental Health reported in 2016 that more than 16 million adults in the U.S. (7 percent), experienced at least one episode of major depression in the past year. The large number of adult patients with this chronic episodic condition has a widespread effect on the workplace. A survey conducted by Gallup-Sharecare Well-Being Index reports that annually, U.S. workers diagnosed with depression miss an additional 68 million days, or an additional 4.6 days per individual diagnosed with depression as compared to workers who have never been diagnosed with depression. This loss of productivity is estimated at more than $23 billion per year.
To provide depression care beyond a screening, health clinics and medical groups will need to adjust their procedures.
“Of all the metrics that we are being measured on through MNCM, the depression remission measure has had the greatest impact on changing our care delivery,” said Dr. Tim Hernandez, Entira Family Clinics. “In order to be successful, one has to develop strategies to reach out to patients between visits. People who are struggling with mental health problems need between visit care perhaps more than people with other medical conditions. Finally, as we begin to manage adolescents who suffer with depression, we have had to use different strategies, such as texting, to reach different generations. The care coordination program that we developed for the depression remission measure became the foundation for our Health Care Home.”