Screening for Depression, Anxiety, and Suicidality: Insights From Electronic Health Record Data in an Academic Medical Center

INTRODUCTION: In 2023, 14.6 million adult Americans had serious mental illness, including Major Depressive Disorder (MDD) and anxiety disorders. Further, 12.3 million adult Americans had serious suicidal thoughts and behaviors. This report examined mental health screening in non-psychiatry clinics to identify gaps in screening practices using electronic health record (EHR) data. METHODS: De-identified data were accessed from the Epic EHR from 2016 to 2022. All participants with a recorded encounter with a mental health screening within 5 years of the first encounter date were included. The screening tools included Patient Health Questionnaire - 9 (PHQ-9), Generalized Anxiety Disorder - 7 (GAD-7), and Concise Health Risk Tracking Self-Report (CHRT-SR₇). RESULTS: The frequency of self-report use (% of total encounters) increased from 2016 to 2022. During this period, the internal medicine department consistently screened for anxiety using the GAD-7 scale in over 35% of total encounters and for suicidality using the CHRT-SR₇ scale in over 20% of total encounters. Other non-psychiatry departments used these scales less frequently. CONCLUSIONS: This report highlights the increase in the use of key mental health questionnaires by non-psychiatric practitioners over time after implementation. EHR data enables the identification of gaps in screening for depression, anxiety, and suicidality across departments in a medical center.