Depression is common and it can affect how people feel, think and function. But many people don’t bring it up during a routine visit, especially if they’re unsure how to describe what they’re experiencing. That’s why WellSpan primary care practices use routine depression screenings to help identify concerns early and connect patients with the right support.

During many primary care visits, patients age 12 and older are asked brief, standardized questions about mood and interest in activities. These screenings are part of preventive care, similar to checking blood pressure, because mental health is an important part of overall health.

WellSpan uses a two-step approach. The first step is a short, two-question screening (often called the PHQ-2) that helps flag whether someone may be experiencing symptoms of depression. If a patient’s responses indicate possible concern, the care team follows up with a nine-question tool (PHQ-9) to better understand symptom severity and how it may be affecting day-to-day life.

In one recent primary care visit, a teen completed the initial screening and scored in the mild-to-moderate range. It was a result that could have been easy to gloss over if the visit focused only on what was visible in the room.

But the screening result prompted Dr. Ridge Salter, WellSpan’s well-being medical director, to slow down and ask a few more questions. Creating a calm, supportive space, he invited the patient to share what was really going on.

The patient became more comfortable speaking honestly—moving from a practiced smile to a more direct conversation about how she’d been feeling.

As the conversation continued, the patient shared she had been having daily thoughts of self-harm and felt she didn’t have the support she needed. A family member was with her, but the screening helped open the door for the patient’s own voice—and helped the care team recognize the urgency of the situation.

“In primary care, it’s important that we pay attention to any cues patients give us and make space for them to share their story,” Salter said. “Taking a moment to pause and ask one more question can make all the difference.”

What happens after a depression screening?

Screenings are only useful if they lead to action. When a patient’s responses suggest depression, or any safety concern, WellSpan primary care teams take time to talk through symptoms, assess immediate risk and partner with the patient on next steps. That may include a same-day safety plan, more frequent follow-up, a referral to therapy or starting or adjusting medication when appropriate.

“Depression screenings help us create a consistent process, so the next step is clearer for patients and for clinicians,” Dr. Salter said. “When we use the tools and then follow up with thoughtful questions, we’re more likely to find people who need help but haven’t been able to say it out loud yet.”

In this visit, Dr. Salter discussed options with the patient and her family member, which can include counseling, medication, coping strategies and community resources. Together, they agreed on a plan and set clear expectations for when and how to reach out if symptoms worsened.

“Depression is common and treatable,” Dr. Salter said. “One of the most important messages we can offer is hope and share that you’re not alone, and help is available.”

Follow-up is a key part of care. Patients may be scheduled to return in the coming weeks to reassess symptoms, review treatment response and revisit safety. Care teams also help patients understand how to reach support between visits if concerns arise.

Primary care is built on ongoing relationships. Over time, that continuity can help patients feel safer sharing hard topics, especially when a screening tool provides a structured, stigma-reducing way to start the conversation.

“In primary care, we have a unique opportunity to build trust over years,” Salter added. “Even when we can’t solve everything in one visit, we can stay with patients, listen and help them take the next step.”

Across WellSpan primary care practices, routine depression screening is part of how teams identify needs early and respond quickly. With a goal of screening patients age 12 and older, results are documented in the medical record so clinicians can recognize patterns over time, coordinate support and connect patients to the care that fits them best.

If you or someone you know needs help now: Call or text 988 (Suicide & Crisis Lifeline). If you believe someone is in immediate danger, call 911 or go to the nearest emergency department.

Visit WellSpan.org/PrimaryCare to learn more.