Vital Sign
Ongoing support keeps UT Southwestern at the forefront of depression diagnosis
Building on a long tradition of funding mental health initiatives, The Meadows Foundation has been an integral partner of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center. With its most recent gift of $750,000, the Dallas-based, private family foundation is helping the Center address gaps in identifying and treating depression and other mood disorders.
Evidence suggests 10%-14% of primary care patients have major depression. While these people regularly see a physician, less than half are diagnosed due to a lack of diagnostic training and screening capabilities.
“The high-quality standard of mental health care that patients deserve is often missing,” said Madhukar Trivedi, M.D., Director of the Center for Depression Research and Clinical Care.
Dr. Trivedi, who is also a Professor of Psychiatry and Chief of the Division of Mood Disorders, created the Mood Disorders Network to address that gap.
When patients visit their primary care doctor, it is common for them to have their vital signs measured. Blood pressure, pulse rate, respiration rate, pain, and temperature are the five most common measurements. In 2014, Dr. Trivedi decided it was time to add a sixth.
Through a program called VitalSign6, the Center has encouraged primary care physicians to make depression screening the sixth vital sign and a regular part of routine patient visits. Using web-based mental health questionnaires, a physician can make an initial diagnosis and access resources to support measurement-based care that include systematic assessment of depressive symptoms, treatment side effects, and treatment adherence.
Currently, 48 partner clinics across North Texas use VitalSign6. More than 63,000 patients have used the tool to date. According to the Center, patients who screen positive for depression and engage in follow-up visits with a physician experience a 38% remission rate, more than six times higher than the national rate of 6%.
“This new technology makes depression care available to more people by making it part of a routine medical exam,” Dr. Trivedi said.
Since the Center’s inception five years ago, The Meadows Foundation has supported Dr. Trivedi and UT Southwestern’s advances in offering mental health diagnostics to primary care clinics as well as to a wider network of hospitals.
“Funding practical, seamless ways to integrate mental and physical health care and scale it to benefit more Texans is a priority of the Foundation,” said Peter M. Miller, President and CEO of The Meadows Foundation.
For Bruce H. Esterline, the Foundation’s Senior Vice President for Strategy, the Mood Disorders Network’s development of breakthrough diagnostic tools such as VitalSign6 “makes UT Southwestern a leader in blending mental health care into the broader health care community.”
The Foundation has partnered with UT Southwestern to bring even more hospitals into the Mood Disorders Network.
“We were supporting the extraordinary mental health research and technological advances made by UT Southwestern – achievements you could not find anywhere else,” Mr. Miller said.
The significance of the Meadows Foundation’s ongoing support is not lost on the Center’s leader.
“The biggest impact from the Meadows gift,” Dr. Trivedi said, “is their clear support for expanding this technology to more primary care practices and major health systems across our state. This makes The Meadows Foundation’s goals and ours a very nice marriage, indeed.”
Opening New Doors
VitalSign6’s greatest asset is identifying patients with early signs of depression – people who often go undiagnosed.
“These are patients who could have easily flown under the radar,” said Kelli Triplett, Ph.D., a licensed Clinical Psychologist for the Solid Organ Transplant Team at Children’s Medical Center Dallas.
Since she began using VitalSign6, Dr. Triplett estimates 215 organ transplant patients between the ages of 11 and 21 have completed mental health screenings as part of their medical appointments – four times more than the number of patients screened prior to using the technology.
“With adolescent suicide rates skyrocketing, we are trying to normalize the discussion of mental health, and VitalSign6 makes it a key part of a patient’s medical workup,” said Dr. Triplett, who is also an Assistant Professor in UT Southwestern’s Department of Psychiatry.
VitalSign6 uses a nine-item depression survey that patients fill out on a tablet computer. Psychologists and physicians then use the patients’ responses to evaluate their current mental health and whether they are showing signs of depression or anxiety. The program’s diagnostic value comes from the opportunity to check in with patients at every visit, giving them a chance to describe their feelings.
“Before VitalSign6 came along, our team might ask a typical adolescent how they were doing, and they might smile and say they were fine,” Dr. Triplett said. “But when they complete the VitalSign6 program, we see they are able to more honestly select answers admitting they are not doing very well. VitalSign6 allows our team to identify patients who were not openly reporting depression but were experiencing symptoms. It opens the door to an infinitely more honest conversation with a patient.”
The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1‑800‑273‑8255.
Dr. Trivedi holds the Julie K. Hersh Chair for Depression Research and Clinical Care, and the Betty Jo Hay Distinguished Chair in Mental Health.
