Lancaster to study ways depression screening and treatment can be improved in primary care practices
Dr. Blake Lancaster was just awarded the U-M Depression Center’s inaugural Frances and Kenneth Eisenberg Collaborative Innovations Fund award. Dr. Lancaster, an assistant professor of pediatrics and communicable diseases at U-M, will study, “The Screening to Address Depression (SAD) Task Force: Improving Depression Screening and Treatment Practices in Pediatric Primary Care.”
The National Institute of Mental Health estimates 1 in 5 adolescents will suffer from a mental illness before age 18, and depression is one of the most commonly identified mental health problems among the pediatric population. Due to a lack of access to mental health services, only 25 percent of adolescents who need clinical services ever receive treatment for mental health issues such as depression. Significant burden is placed on primary care pediatricians (PCPs), as it is estimated that 80 percent of adolescents with mental health issues will seek treatment in the primary care setting.
Pediatricians consistently report that they are not comfortable treating mental health issues such as depression because they do not have the flexibility or the requisite training to deliver evidence-based treatments during the course of a typical primary care visit.
The goal of Dr. Lancaster’s project is to provide universal screening for depression in primary care and to ensure pediatricians are trained to deliver a brief component of Cognitive Behavior Therapy (CBT), the most widely recognized evidence-based treatment for depression. By training pediatricians to deliver brief Behavior Activation Therapy (BAT), the team hopes to increase access to evidence-based treatment for adolescents with depression by providing pediatricians with a treatment that can be feasibly delivered within a regular primary care visit. Behavior Activation Therapy is a brief intervention that can be delivered flexibly and is particularly well suited for children and adolescents in the primary care setting.
The goal of BAT is to increase the patient’s engagement in daily pleasurable activities. As engagement in pleasurable activities increases, mood improves, increasing motivation and desire to continue to participate pleasurable activities in the future. A primary characteristic of depression is lack of engagement or withdrawal from previously enjoyed activities. Behavioral Activation Therapy breaks the withdrawal cycle that many who suffer from depression experience. Throughout the course of the project the team will disseminate research findings regarding the prevalence of depression found within the Michigan Medicine General Pediatrics Clinics, tracking pediatrician use of the protocol, and monitoring the impact of this initiative on patient outcomes.
“Most children and adolescents with depression never receive any assessment or treatment services,” said Dr. Lancaster. “This generous funding from the Eisenberg’s allows us to address the unmet mental health needs of our patients in the place most children receive their mental healthcare – the primary care clinic. The project represents yet another example of the innovation possible when Michigan Medicine pairs with donors like the Eisenberg’s, truly putting us on the cutting-edge of collaborative behavioral healthcare.”
“The earlier we can treat depression and its related illnesses, the better,” said John Greden, M.D., executive director of the U-M Depression Center. “By providing primary care practitioners and pediatricians with the skills needed to screen for depression, we are better serving our at-risk youth. The more people who have the skills to identify depression and its symptoms, the more adolescents we will help and the more lives we will save. We are looking forward to helping Dr. Lancaster implement this program.”