Depression and Suicide in the College Counseling Center: A Quality Improvement Project

Rationale and Significance
The American College Health Association’s (ACHA) 2012 assessment of college student’s mental health in the U.S. revealed 30% of students reported problems with significant depression that impacted functioning. While suicide is rare in college students, 7 % of the ACHA subjects reported considering it.

Purpose
The purpose of this quality improvement project was to improve the screening of depression in college students using the PHQ-9 screening tools and improve the documentation rate of suicide assessment.

Methodology
A pre and post group design was used with specific interventions to implement the PHQ-9 screening tool for depression as well as strategies for documenting suicide risk during a 6 month period. Screening tool usage data from 99 charts representing over 629 individual clinic appointments was collected. Data were analyzed using Chi square test as well as descriptive statistics.

Findings
Results were statistically significant for utilizing the PHQ-9 for monitoring illness severity, screening for depression and for documenting suicide ideation. Clinical significance was found in the practice changes for follow up on suicide ideation.

Implications for Practice
Use of the PHQ-9 improved the rate of depression screening as well as the monitoring of depression symptoms severity. Documentation of suicide risk and follow up was also improved. These improvements meet the standard of care outlined in the APAs clinical practice guideline on depression care.