Dealing with Depression
Three quarters of mental illnesses occur by the time individuals reach university age, amplifying the pre-existing stress of university life (Kessler, 2005).
Depression is one of the most common psychiatric disorders diagnosed in students at the McMaster Student Wellness Centre.
SYMPTOMS OF DEPRESSION INCLUDE:
- Little interest or pleasure in doing any activity
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling badly about yourself or feeling that you are a failure or have let yourself or your family down
- Trouble concentrating
- Moving or speaking so slowly that other people notice or being so fidgety or restless that other people notice
- Suicidal thoughts or thoughts of harming yourself
Ultimately, in a university setting, depression can lead to lower marks, higher drop out rates, and a greater risk of suicide.
McMASTER’S COLLABORATIVE CARE MODEL
Collaborative care involves medical and counselling services working together in order to create patient focused individualized care. Collaborative care is a proven method to not only decrease symptoms of depression, but also improve patient quality of life and increase patient satisfaction (Archer, et al., 2012; Katon, 2009; Richards, et al., 2013).
The National College Depression Partnership (NCDP) is an initiative based out of New York University aiming to implement collaborative care into schools. The McMaster Student Wellness Centre is the first Canadian school to implement the NCDP initiative!
THE MAIN GOALS OF THE PROGRAM ARE TO:
1. Improve identification of students who are experiencing depression
2. Improve treatment and follow-up care for these students
a. By 4 weeks, the aim is to create an individualized management plan. This could include:
i. Individual counselling
ii. Group counselling
iv. Self Care (e.g. Exercise)
b. By 8 weeks, the goal is to see a significant reduction in depressive symptoms. At this point, since the student should be feeling a bit better help the student take control of their mental health through a self-care goal (see below).
c. By 12 weeks, the aim is to see students in remission, meaning the student is not (at this time) experiencing any debilitating depressive symptoms.
What tools do we use?
THE PERSONAL HEALTH QUESTIONNAIRE 9 (PHQ-9)
The PHQ-9 is a 9-question depression-screening tool used to identify the severity of depressive symptoms. The PHQ-9 is used to identify students having difficulties and subsequently track their progress throughout treatment. This questionnaire identifies any areas of concern and allows the mental health team to make changes to care.
TAKING CONTROL THROUGH SELF-CARE
The initiative helps student’s create a self-care goal. The self-care goal engages the student in their care and enables them to take control of their mental health. The self-care goal is created by the student, and is essentially anything that the individual believes will improve their mental health. Examples could include goals related to exercise, healthy eating, sleeping, socializing, etc. This goal demonstrates that what you do for yourself has a big impact on how you feel.
Many students with depression get lost in follow-up especially due to busy class schedules. The NCDP initiative has created a care manager role. The care manager is a nurse who ensures that students are getting the help they need. The care manager proactively reaches out to students who have not returned for follow-up to help them book a follow-up or to simply remind the student that the staff at the McMaster Student Wellness Centre are here whenever they need help and they are welcome back anytime.
- Collaborative care for depression and anxiety problems
- Collaborative Care: Evidence-Based Models that Improve Primary Care Depressive Outcomes
- Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication
- Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial