Mitch a community member in West Dundee arrives for his appointment at the Aunt Martha's Carpentersville Community Health Center while at the same time staff in Chicago Heights take Tatiana, a young woman from a residential home to the Aunt Martha's Women's Health Center.  Registration clerks at both health centers greet the patients and provide them with the medical registration forms and the patient health questionnaire.  Both are called back to the exam rooms where they are greeted by the doctor who reviewed the forms.  In providing the doctor with answers on the patient health questionnaire and having a conversation during the exam, Mitch and Tatiana are receiving quality integrated health care.  They are helping the physician diagnose and provide treatment for depression.

In understanding the vital need to screen for depression, Aunt Martha's Youth Service Center participated with the Federal Bureau of Primary Healthcare's Health Disparities Collaborative on Depression, which was established to train and teach primary care doctors to be familiar with depression.  To develop a depression screening tool Aunt Martha's partnered with Columbia University and the patient health questionnaire was established.  This questionnaire is now a nationally recognized tool for screening depression in both adults and youth.  The tool is both sensitive and specific and assists the physician in understanding the emotional needs of each patient.  The information is reviewed by the primary care physician who may then treat or refer the patient to a counselor or psychiatrist depending on the responses and discussion.

Depression is quite common but is not typically screened for at a private physicians' office or medical center.  Depression often manifests itself as aches and other complaints which is what brings individuals to see the doctor.  At Aunt Martha's we have increased the primary doctor's awareness, comfort and ability to screen & treat depression.  As a result, we have enhanced the treatment our patients receive.  Our health centers are treating a greater number of patients for depression because we are asking the right questions.

Depression in youth is often an undetected illness.  Imagine a young woman at the health care center with complaints of stomach aches and trouble eating.  She is asked to complete the patient forms and the patient health questionnaire.  As she sits in the reception area she completes a form that asks if she has been feeling irritable, has no pleasure in doing things, has trouble concentrating, eating and sleeping.  In answering the questions, she has provided the primary care doctor with vital information to best treat her.  The patient health questionnaire, applied to every youth visit at each of the 12 health centers has helped Aunt Martha's in treating the complaints but also in identifying depression in young adults.  According to Dr. Jennifer Byrd, Aunt Martha's Medical Director, "this screening is the key to getting help to depressed youth as soon as possible."

This approach in integrating primary health care and behavioral health is unique to Aunt Martha's Healthcare Network.  Patients like Mitch & Tatiana are not sent somewhere for counseling, they are seen right in the health center, often immediately.  The medical and behavioral health specialists work together in providing the best possible treatment for our patients.  With five full-time Licensed Clinical Social Workers and nine part-time Psychiatrists, every patient at the Aurora, Chicago Heights, Harvey, Hazel Crest, Women's Health and Kankakee Community Health Centers is screened at every visit except at the Danville and Carpentersville Health Centers, adults are screened only at the initial visit.

As we utilize this important screening, we recognize the need to allocate additional resources and provide additional time during each exam to effectively communicate with the patients.  Aunt Martha's strives to provide translation when necessary so that each patient's needs are addressed.  Utilization of the patient health questionnaire is a non-threatening and caring first line of defense in meeting the needs of all our patients, adult and teen.  It addresses both the physical and behavioral health needs.  It helps us to fulfill our mission in treating the whole patient.