Ensuring consistent care for those with Major Depressive Disorder

Date: 02/01/2024

Acadia Hospital creates clinical pathway to guide primary care providers and ensure consistent outcomes for patients seen throughout the Northern Light Health system.

What is major depressive disorder (also known as clinical depression)?
Symptoms of major depressive disorder can range from mild to severe, but they typically last most of the day, nearly every day, for at least two weeks.

A few of the more common symptoms include:
  • Feeling very sad, empty, or hopeless
  • Loss of interest in things and activities that used to bring joy
  • Trouble sleeping, or sleeping too much
  • Difficulty concentrating

Major Depressive Disorder is common
According to the Cleveland Clinic, the prevalence of Major Depressive Disorder (Clinical Depression) is common, affecting 8.3% of people at any given point in time. In Maine, with a population of 973,685 Maine citizens aged 18 or greater, there were up to 80,815 Major Depressive Disorder cases in 2020, with 186 suicides. 

(Source: Explore Suicide in Maine | 2020 Annual Report | Americas Health Rankings – americashealthrankings.org I www.nimh.nih.gov/health/statistics/major-depression).

A Focus on Consistent, Evidence-based Care
Acadia Hospital serves is the Behavioral Health Center of Excellence for Northern Light Health. One of the major tenets for a Center of Excellence is to provide the best possible clinical outcomes. A proven method to do so is to standardize care by using evidence-based decision making. This eliminates unnecessary variation in practice as well as in clinical outcomes.

Two years ago, Acadia clinical leaders assembled a team of stakeholders with the goal of creating an “evidence-based pathway” for Northern Light Health primary care and pediatric providers that would offer diagnostic and treatment algorithms, all based on the most current information pertaining to diagnosing and treating Major Depressive Disorder.

This tool has been adopted by many Northern Light Health providers since early 2022, with impressive results (used on average over 100 times a month by physicians system-wide) and grateful providers.

One provider who has found the pathway to be invaluable to her practice is Ja’Nette Bowden, FNP, primary care provider at Northern Light Maine Coast Hospital. “I use it (Major Depressive Disorder Clinical Pathway) all the time. I find it super helpful with both depression and anxiety and gives good check points on the medications while providing support for patients. The two-week check in gives them comfort that someone is going to call and make sure they are doing ok in the adjustment phase. Because of this, we’ve caught some potentially negative side effects and have been able to make changes when needed even before the next visit. It also helps by suggesting the labs and helping us normalize the process."

"Behavioral health issues used to carry such a stigma," she continues, "but honestly right now depression and anxiety are the most common visit reasons. People need to hear that they aren’t alone. Having a clinical pathway, I believe helps providers and patients navigate those conversations.”