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Screened and Well Managed Behavioral Health

Identifying and Addressing Behavioral Health in Adults with Cardiovascular Health Conditions

Given the high rates of behavioral health concerns such as depression and substance use and the association between greater depressive symptoms and substance use with worse cardiovascular health outcomes, we encourage primary care teams to establish standardized protocols to identify and address these concerns. 

Description of Resources

We recommend using validated screening tools for depression annually in all patients and as needed when a patient may be experiencing depressive symptoms. If the 2-item PHQ-2 is “positive”, use the 9- item Patient Health Questionnaire (PHQ-9) for a more in-depth screening. Then, supplement the PHQ-2 and PHQ-9 screenings with a full clinical assessment to conclusively diagnose depression. Using electronic health record tools to assist care teams in remembering to screen for depression is critical to improving screening rates.
Resource 1: Instrument: Patient Health Questionnaire-2 (PHQ-2)
Resource 2: Instrument: Patient Health Questionnaire-9 (PHQ-9)

A recent Cardi-OH webinar discusses the integration of behavioral health into primary care along with successful Ohio primary care clinic examples.
Resource 3: Integrating behavioral health into primary care (Cardi-OH webinar)

A toolkit for implementing screening, brief intervention and referral to treatment (SBIRT) to assist primary care practices in screening and addressing alcohol and other substance use.
Resource 4: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment for Substance Use

A clinician’s pocket guide to motivational interviewing to assist care teams in discussion with patients around substance use.
Resource 5: Cardi-OH – Clinician’s pocket guide on motivational interviewing

Smoking cessation resources can be found on the Tobacco Cessation page