Depression Screening Just the First Step: Why Follow‑Up Matters – Laura Levine, MD, Neighborhood Health

Depression Screening Is Just the First Step: Why Follow‑Up Care Matters

By Laura Levine, M.D., Behavioral Health Medical Director at Neighborhood Health Plan of Rhode Island

Depression screenings are becoming more common in the office of primary care providers, in schools and in community settings across Rhode Island. This is encouraging. Depression is one of the most common and treatable mental health conditions, and screening helps bring symptoms to light. But screening alone is not enough. It is only the beginning. Real impact happens when screening results are followed by timely, appropriate diagnostic assessment and care.

In Rhode Island, depression affects many individuals and families. According to the National Association on Mental Illness (NAMI), more than one in five adults in the state, or about 216,000 people, are living with a mental health condition, with depression among the most common diagnoses. Yet many people who screen positive for depression face delays or barriers when trying to access follow‑up care.

Why Depression Screening Matters

Depression screenings usually involve a brief questionnaire that asks about mood, energy levels, sleep, appetite and interest in daily activities. It’s a valuable tool since it opens the door to a conversation that might otherwise be difficult to start. For many people, screening is the first time they realize their symptoms may be linked to depression.

However, a positive screening result is not a diagnosis. It is a signal that further evaluation or support may be needed. Without follow‑up care, people may continue to struggle, and symptoms can worsen over time. Missed follow‑up means missed opportunities for early treatment, when care is often most effective.

This is particularly important in Rhode Island, where, according to the Centers for Disease Control and Prevention (CDC), about 24.9% of adults report having been diagnosed with depression at some point in their lives, which is slightly higher than the national average. These numbers remind us that depression is common, but also that it is highly treatable when people receive ongoing care beyond an initial screening.

The Importance of Timely Follow‑Up and Potential Treatment After a Positive Screening

If you’ve had a positive screening, follow-up care is critical. That care can include a longer visit with your primary care provider, referral to a mental health professional, talk therapy, medication or a combination of approaches. What matters most is that the next step happens quickly and matches your mental health needs.

Timely follow-up care can lessen depression, shorten symptoms, and help prevent crises like emergency visits or hospitalization. For people with severe symptoms, early follow-up can save lives. According to the CDC, 105 Rhode Islanders died by suicide in 2024, a rate of 8.9 deaths per 100,000 residents. Many suicides are associated with untreated or under-treated depression. Regular follow‑up care after a positive screening plays a critical role in identifying risk, adjusting treatment and supporting recovery.

Barriers to Depression Follow‑Up Care in Rhode Island

Even when someone wants help after screening positive for depression, getting care is not always easy. More than 390,000 Rhode Islanders live in areas with a shortage of mental health professionals, according to NAMI. Long wait times, transportation challenges, cost concerns and stigma can all prevent people from following through on referrals.

Adolescents face additional challenges. In Rhode Island, 16,000 adolescents (aged 12 to 17) experience a major depressive episode each year. Screening helps identify young people who may be struggling, but without consistent follow‑up and family support, symptoms can persist into adulthood. This makes coordinated, ongoing care especially important for children and teens.

What You Can Do After a Depression Screening

If you or someone you care about completes a depression screening, these steps can help ensure it leads to meaningful care:

• Ask questions. Make sure you understand the screening results and what symptoms they reflect.
• Schedule the follow‑up appointment. Whether it’s with a primary care provider, therapist,  psychiatrist, or mental health professional, the next visit is a key step.
• Identifying a mental health provider can feel daunting. Referrals can be identified through a primary care office or by calling your health plan for in-network providers or other resources that are available to you.
• Monitor symptoms over time. Depression symptoms can change. If they worsen or do not improve, let a provider know.
• Use available supports. Rhode Island offers community resources and crisis services, including the 988 Suicide & Crisis Lifeline (988lifeline.org), available 24 hours a day, 7 days a week. BH Link (bhlink.org) is a walk-in, 24/7 community-based facility where clinicians connect people to immediate, stabilizing emergency behavioral health services, and long-term care and recovery supports.

Treatment for depression works best when it’s regular, personalized and responsive. A one-time check-in is not enough.

A Message of Hope

Depression is a medical condition, not a personal failure, and effective treatment is available. Screening helps start the conversation, but follow‑up care helps people heal, regain stability and reconnect with their lives.

Mental Health Awareness Month is a reminder that addressing depression requires more than awareness alone. With early screening, timely follow‑up and compassionate support, individuals and families across Rhode Island can move toward recovery and hope.

If you or someone you know is struggling, reaching out for follow‑up care may be the most important next step.

Laura Levine, M.D., is the Behavioral Health Medical Director at Neighborhood Health Plan of Rhode Island