“Open Wide and Say if You’re Depressed”

You might be used to sticking your tongue out for your primary care physician, but there are those who think you ought to be exposing a lot more than your tonsils.

The US Preventative Services Task Force (USPSTF) has issued a low-level recommendation that every single adult in the United States should be screened by their primary care physician for depression.  If you’re over 18 according to this group, you should take some surveys and questionnaires to determine if you might have depression and need further surveys and questionnaires and possibly counseling, talk-therapy, or prescription medication.

Their rationale is that the potential benefit of such screening outweighs the associated risks that might come with treatment – including prescription medication.  Frankly this seems like another means of making primary care physicians the portal to a much broader range of treatments – whether wanted or unwanted.  What happens if the screening says you might be depressed but you don’t want to pursue further analysis or treatment?  At what point is this information shared with the insurance companies and the government?  Primary care physicians – who already don’t have enough time to adequately get to know their patients – will have yet another battery of paperwork to deal with.  But hey, since we all have to have insurance anyways it can just get billed through them and nobody has to pay for anything still, right?  What a great deal!  Free billable items for doctors and patients alike!

Being helpful is a good thing, but it can take on ominous tones when it’s not requested and when the results of such good intentions are ill-defined.  I’m automatically suspicious of information-gathering programs despite the fact that they might be helpful to some people.  If you refuse the evaluations will your primary care physician refuse to see you?  Whenever something is pushed as mandatory, eventually there will be penalties to coerce cooperation from those of us who are not so cooperative.

It also makes me wonder how worried people are about depression.  Are rates of depression a lot higher than we tend to think or imagine?  Curious indeed.