OASIS-Central

Q: What is the score in which a patient can be considered depressed and what should be done if the patient attains such a score?

A: If a homecare agency chooses to use the PHQ-2 scale for level-one screening of depression, a response is selected for each row and the points added together. If the patient scores three points or more, then further evaluation for depression (level-two screening) is indicated. Level-two screening may include administration of the PHQ-9 scale, or another applicable screening tool. If the PHQ-9 scale is used, the tool identifies whether the patient has signs of a minor or major depressive syndrome. An agency’s best practice should define its actions based on the patient’s score. Minor depression may be able to be effectively managed by the home health interdisciplinary team; although major depressive syndrome typically requires more aggressive interventions. This may involve a referral to the agency’s mental health team or psychiatric team, if those services are available, or the patient may need to be referred to resources external to the agency.