The development of a new specialty of primary care provider, the primary care behaviorist (PCB), provides another possible solution. The primary care behaviorist would be a primary care physician with additional training and certification in diagnosing and treating behavioral health issues, bridging the gap between physical and mental health. But even standard primary care offices need to improve mental health screenings. Although studies have shown that depression screening does not substantially affect health (since simply discovering that a patient is depressed is of little help in a fragmented system of behavioral health care), a recent editorial in the Journal of the American Medical Association calls for regular depression screenings during primary care visits. Until a more efficient method of matching patients with effective types of treatment evolves, screening for depression can help clinicians better track their patients' responses to treatment, nonadherence, and lack of symptom improvement during early stages of therapy.
Andrea Segal is research coordinator at the Scattergood Program for Applied Ethics of Behavioral Health Care and an MPH candidate at the University of Pennsylvania Perelman School of Medicine.