by Pamela D. Knudson
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| Tom Arnold, M.D. ’84, clinical assistant professor of obstetrics-gynecology, Dickinson, ND, created a universal screening tool to detect depression in women. The screen is used by physicians throughout the state. |
In his Dickinson, ND, practice
Tom Arnold, M.D. ’84, has a patient who, once a year – at the same time of year, suffers from a period of depression. Her husband refuses to let her seek treatment, saying, she should “just get over it.”
On a daily basis, Arnold sees women of all ages and varying circumstances, all trying to find balance and cope with the challenges in their lives. Some are dealing with depression or are at risk of developing a mental illness.
“This is really unfortunate,” says Arnold, an obstetrician-gynecologist, because now there are very good medications and good counseling approaches that have proven to be effective in treating depression in women.
Depression and other mental illnesses are not adequately addressed by the American health care system, Arnold maintains. “We need to provide a pathway, from identification to diagnosis to treatment, to solve this problem and help women get the care they need.”
Persistent barriers block this path to wellness, however, Arnold adds. Among them, patients don’t want to admit they have a mental health problem, health care providers are sometimes uncomfortable with diagnosis, and often times there’s not adequate insurance reimbursement for these conditions.
Several years ago, Arnold took on the task of responding to this issue. He became involved in a Primary Care Health Policy Fellowship, a training program that included four intense weeks of working in Washington, D.C., with other professionals, including family physicians, pediatricians, nurse midwives and nurse practitioners.
“We were challenged to create health care policy and present it to Donna Shalala,” then-secretary of Health and Human Services, Arnold says.
His group developed a tool to universally screen for depression in women. Based on the DSM IV, the handbook which health care professionals use to diagnose mental illnesses, the tool provides the means to screen for depression “and the clinical guidelines on how to implement that screen,” he says. “We felt it was part of the review in treating patients.”
They made the screening tool “as easy as possible to implement,” he says. It shows who’s at risk for depression but may not have depression.
“For many people, it’s easier to admit they’re depressed on paper, rather than face-to-face,” he explains. For those who answer “yes” to five or more of nine questions, the screening tool identifies a referral path so the provider can recommend appropriate, seamless care for the patient.
