National Depression Screening Day, held annually on the Thursday of the first full week in October, is an education and screening event conducted by hospitals, clinics, colleges, and community groups nationwide. Much like the medical community screens for diabetes and high blood pressure, groups screening for mental health wanted to offer large-scale mood disorder screenings for the public. The program provides free, anonymous screenings for depression, generalized anxiety disorder, bipolar disorder, and post-traumatic stress disorder, as well as referral to treatment resources. Screenings are done both online and in-person and thousands of people participate each year.

This year, Depression Screening Day is focusing on the importance of seeking help. Depression is a common and treatable mood disorder, and spreading awareness about the different ways those dealing with it can get help could save lives. Please join us this National Depression Screening Day and help us spread the word to increase awareness of mental health.

BCBSRI supports and encourages use of the PHQ-9 for depression screening in primary care settings.

Why screen for depression in primary care?

• The USPS Task Force has issued guidelines for universal depression screenings and stated that 100% of patients should be screened annually for depression.
• Depression is one of the most common chronic conditions across the population. The National Alliance on Mental Illness (NAMI) estimates that one in four adults at any given point in time are living with depression.
• Screening all patients for depression in primary care can be very useful. Most providers are able to easily identify their patients with severe depression. However, those with mild or moderate depression often go undetected. If mild or moderate depression is identified and discussed during a primary care appointment, it can be a relief to the patient to be able to discuss their feelings openly with the primary care provider and be given treatment options. It can also help the patient create an action plan that may help them avoid more severe depression, and the need for more intensive medical care in the future.

What do I do if my patient screens positive for depression?

As a primary care provider, you have a relationship with the patient and have the opportunity to identify depression and facilitate relief. Work together with your patient to create a comprehensive treatment plan using shared decision making. Some examples of interventions may include providing the patient with resources regarding depression and/or chronic disease or providing the patient with resources regarding medication, if applicable. You may also consider offering problem solving treatment or brief supportive counseling services within your practice.

Provide patients with referrals for specialty care as needed. Not everyone with depression needs a referral for therapy. Some patients could benefit from brief interventions that could be done by a nurse case manager or other clinical staff already working in your practice. Consider options for providing supportive counseling to patients as needed, particularly as a patient is starting on a new antidepressant. It is important to stay in contact with patients as they are managing their depression and/or other chronic conditions. Frequent check-ins with patients to provide support and education as needed will help them stay on track with managing their depression. Behavioral health case management, provided through our behavioral health partner, Beacon Health Options, is also available to you as a resource for your patients. Please see below for additional information on Beacon’s program and other ways to connect your patients to behavioral health resources.

BCBSRI promotes integrated behavioral health in primary care settings

The Centers for Medicare and Medicaid Services (CMS) established a code set to cover the collaborative care model as well as integrated behavioral health services in primary care. In the final rules, CMS put forth specific requirements that must be met in order to submit for payment using these codes. The requirements are aligned with the foundational elements of the collaborative care model put forward by CMS. In order to ensure adherence to these requirements, primary care physicians must be able to demonstrate that they are providing services under the collaborative care model or in an integrated care setting by submitting a detailed program description to BCBSRI. After BCBSRI reviews and approves the program description, the provider will be reimbursed for services provided to BCBSRI Medicare Advantage members. Behavioral health integration is not separately reimbursed for commercial products. Please refer to BCBSRI’s Behavioral Health Integrated Services policy for additional information.

BCBSRI will inform the provider via email notification if their program description meets requirements. Providers will be able to submit claims 60 days after program approval. No retroactive payments will be made for services rendered. All program descriptions can be sent to BehavioralHealth@bcbsri.org.

How do I connect a patient to behavioral health services?

The behavioral health system can be confusing and overwhelming for your patients to navigate. As BCBSRI continues to expand our continuum of services for behavioral health, we realize that providers may have questions regarding the types of services available for their patients. There are several ways to learn more about behavioral health benefits and services:

• The Physician and Provider Call Center can answer questions regarding a member’s benefits, including member liability for services. They can also assist if you’re simply looking for a participating behavioral health provider. You can contact the Physician and Provider Call Center at (401) 274-4848. You can also search on the Find a Doctor tool at bcbsri.com if you are simply looking for a behavioral health provider.
• The Beacon Health Options (Beacon) Clinical Referral Line is available 24/7 and is answered by clinical behavioral health staff. The clinical referral line can assist you in identifying a behavioral health provider, as well as providing support and guidance. The clinical referral line should not be used if there is concern of imminent danger, but can be a first point of contact in non-emergency situations. The clinician, who may be a registered nurse, independently licensed social worker, or a mental health counselor, will ask questions to get a better understanding of your patient’s needs. The clinician will provide you with information about services that are available and will offer the names and contact information for providers who offer these services. You can contact the Clinical Referral Line at 1-800-274-2958. You may also share this number with your patients if they prefer to contact Beacon themselves.
• Beacon Health Options Intensive Case Management Program can assist your patients in effectively managing their behavioral health conditions. Independently licensed behavioral health clinicians will work with your patients to:
  • Help them understand barriers that prevent them from getting the most from their treatment or in obtaining recommended treatment.
  • Help them find and obtain services or resources needed to better manage their behavioral health condition.
  • Provide education and supports to help them better manage their condition.
  • Coordinate care with providers to ensure you and your patients have the necessary information to provide them with the best care and support.
  • Work with them to ensure they know the medications they should be taking and understand the instructions you’ve provided to them.

To refer a patient to Beacon Health Options Case Management Program, please call 1-800-274-2958, option 2. You may also use our automated referral form at bcbsri.com by following these easy steps:

                     1. Log on to the provider portal of bcbsri.com

2. Click on Tools and Resources

3. Click on Forms

4. Click on Case Management Request

5. Complete the required fields and click Go!

If your office is looking for more information regarding depression screening and follow up, please contact Sarah Fleury, LICSW, CPHQ, manager of behavioral health, at (401) 459-1384 or sarah.fleury@bcbsri.org.