Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Danielle Gunter



Background: Depression has been one of the most common mental health disorders that our population fact but is underdiagnosed and undertreated. Primary care providers are often the first line of defense in detecting depression. Because of this, implementing a depression screening tool in a primary care setting will improve holistic management of care and improve quality of life.

Project Aim: The aim of this project was to increase the number of clients who are evaluated for depression by using the PHQ-9 screening tool during their annual wellness exam and initiate treatment according to the Veteran’s Affairs/Department of Defense Depression Treatment Guidelines.

Methods: The project took place at a concierge medicine family practice with no current depression assessment tool in place. It involved the clients, medical assistant performing the screening and the provider. The provider reviewed the PHQ-9 score and implemented the appropriate treatment based on the guideline for each of the five categories ranging from continued reassessment to medication initiation or adjustment and referral to a specialist.

Results: Out of a total of 47 patients screened, 10 of them (21%) required at least a follow-up, and 2 out of these 10 were referred for a higher level of treatment with a counselor.

Implications: The implication for practice is to ensure all clients are screened for depression as part of the holistic management of care. Use of the PHQ-9 tool in primary care can lead to early identification and treatment for this overwhelming condition which can improve health outcomes overall.