Wellplace, Michigan functions as the Access Center for Detroit Wayne Mental Health Authority (DWMHA). As the Access Center, Wellplace serves as the front door for individuals seeking mental health or substance abuse information and services in Detroit-Wayne County.
Major Depressive Disorder (MDD)
Depression is a major cause of disability worldwide. Evidence for the effectiveness of various pharmacological and psychological treatments is abundant, yet outcomes are often disappointing. This may reflect poor patient understanding of the illness, poor adherence to treatment or inadequate systems to support high quality care.
Given the low detection and recognition rates, it is essential that primary care and mental health practitioners have the required skills to assess patients with depression, their social circumstances and relationships, and the risk they may pose to themselves and to others. This is especially important in view of the fact that depression is associated with an increased suicide rate, a strong tendency for recurrence and high personal and social costs. The effective assessment of a patient, including risk assessment, and the subsequent coordination of the patient’s care, is likely to improve outcomes and should therefore be comprehensive.
- Depression is a major cause of impaired quality of life, reduced productivity, and increased mortality.
- Social difficulties are common (e.g. social stigma, loss of employment, marital break-up).
- Associated problems, such as anxiety symptoms and substance misuse, may cause further disability.
- People with depression are at increased risk of suicide. Mortality from suicide is reported to be as high as 15% among people hospitalized for severe depression. In primary care populations, the prevalence of suicidal ideation is approximately 20-30% among depressed patients, but serious suicide attempts (7/10,000) and completed suicides (4/10,000 ) are relatively infrequent [Simon GE, 2006]
- Depression is a significant independent risk factor for both first myocardial infarction and cardiovascular mortality. In people with ischemic heart disease, depression has been found to be associated with a three- to fourfold increase in cardiovascular morbidity and mortality.
Major depressive disorder in the Veterans population, diagnosed by structured psychiatric interviews and specific diagnostic criteria, is present in 5-13% of patients seen by primary care physicians. The prevalence of this disorder in the general population is about 3-5%. The annual economic burden of depression in the U.S. (including direct care costs, mortality costs, and morbidity costs) has been estimated to total almost $83.1 billion in year 2000 dollars [Greenberg PE, 2003]. The suicide rate in depressed persons is at least 8 times higher than that of the general population. (VA Tech-manual 1999)
Management of Major Depressive Disorder, Department of Veterans Affairs, May 2009, pp 5-6