Policy Formation Essay


Depression in Primary Care

Depression is a widespread, often chronic condition. Despite beingtreatable, research demonstrates that most depressed persons lackoptimal management and diagnosis of the condition, frequently gettingsub-therapeutic doses. According to the World Health Organizationprojection, it is anticipated that in 2020, depression will result inadditional lost disability-altered life years compared to otherconditions (Pomerantz, 2015). Close to, half of lost productivity inAmerica is due to major depression.

Depression is specifically a major cause of mental health challengeamid the old. Numerous stressors linked with aging like physicaldisease, social exclusion, numerous losses and collective lifestressing conditions, like those linked to poverty, add to the perilof depressive signs. Current epidemiological research has shown theprevalence of mental disease amid the old to be at 20 and 25%contrasted to 15 and 20% for other populations (Lyons, Lecca &ampValentine, 2013). Screening for depression in primary care settingshas become widespread as a method of detecting depression as oldpeople access primary care. The main challenge with screening is thelack of enough workers for screening sick persons. In addition,physicians lack ample time to screen sick individuals for psychiatricissues, except in instances when sick persons inform of concerns(Lyons, Lecca &amp Valentine, 2013).

This calls for the need of the implementation of a needed change instaffing. The policy change involves employing more individuals tospecialize in screening for depression as patients’ access primarycare. The first step in policy formation is certifying theunderstanding of the society to the issue of depression. It alsoentails deciding who takes part in solving the issue and evaluatesthe means present in attaining an alternative. Possible alternativesto hiring more staff in health care facilities to assist in screeningfor depression during primary health care involves, special screeningdays. Screening days happen on a yearly basis where hospital workersset a day and individuals volunteer to participate in screeningtests. Other alternatives are home-based health care, harmonized byhospitals or personalized care agencies. Last, is early interventionplans providing free and suitable education (Michalak, 2002).However, the alternative interventions have been ineffective as mostindividuals visit hospitals for depression treatment when the mentalcondition has become unmanageable. Thus, employing more staff willmake it possible for screening to happen at every hospital visit,enhancing the probability of early detection, when the depression isstill manageable.

Agenda setting follows determining the issue. The governmentintervenes during this phase. This is owing to the insight that anissue needs to be considered and government action taken. It isapparent that there are few health practitioners to provide screeningservices during every medical visit. Since the government isaccountable for hiring health care providers, the policy needs tomake way towards the concentration of public officials securing aplace as an agenda. An agenda is a group of issues for furtherdiscussion, either through an organized public agenda, or throughgovernment agenda. The third stage is formulating a policy. Itinvolves creating of suggested action courses for resolving theidentified issue. In the case of finding a solution to detectdepression during primary care, an analogous policy formulation ismore applicable. This is because it deals with advent problems viaborrowing from experience on similar previous challenges. Thealternatives available to hiring more staff to conduct screening actas the experience in this case. When detected early, it is possibleto deal with depression and avoid life-long complications arisingfrom mental problems.

After formulating the policy, the policy is ready for adoption. Theformal choosing of public policies happens via three branches. Policyadoption is the long procedure of making a policy. This is becausethe legislature ought to approve the policy prior to making anyaction. After the step, the policy becomes lawful. To secure therequired votes during the legislative procedure, a bill might bealtered during this step. Intricate legislation might needconsiderable time to become legal. The legislation enacted isfrequently incremental, with just marginal alterations in a currentpolicy. The fifth step is budgeting where resources are designatedtowards availing for the appropriate policy implementation. Thepolicy of hiring new staff requires funding. This is because the newemployees will have to be trained and paid once employed. Funding, inmost instances happens via the congressional budget procedure.Following budget approval, the policy shifts to the next step ofimplementation.

Administrative organizations have the authority to employ variousmethods in public policy implementation. Capacity methods areeffective by motivating the public to take part in desired actions.The methods include availing information, instruction and providingresources to the public. In this case, the individuals to be involvedare hospitals that provide primary care, as well as health carepractitioners. It is also important to inform patients on the need toundertake screening for depression. Sick persons need to be sentientthat it is possible to detect and manage depression during itsinitial stages. This can be achieved if they are open to screeningand health care practitioners are available to screen them. Last ispolicy evaluation. It is the determination of the policy’sachievements, aftermaths and drawbacks. The last step inpolicymaking, referred to evaluation is progressive. It entails aresearch on how efficient the advent policy has been in tackling theinitial problem, which frequently results in more public policyalterations. It also involves review of resources present in ensuringthe policy becomes real.

Possible drawback with hiring more staff as a move towards ensuringmore people are screened for depression is that, individuals only goto the hospital when the depression has escalated. The staff may beavailable, yet there may be no patients to screen. Another drawbackis that after the first screening, it is necessary to conduct followup screening, especially to the old persons. However, old peopleassess primary care more often, which makes it possible to providescreening as often as possible. Hence, more staff will meet theincrease in demand of the elderly that require screening. The overalloutcome is that it will become possible to manage depression amongthe elderly. The lack of enough staff to ensure that screeningbecomes a prerequisite for all individuals accessing primary care,has been a major contributor towards, low screening for depression inhealth care facilities. As noted by the World Health Organization,depression is possible to surpass other conditions (Pomerantz, 2015).This makes it important to consider fast implementation of thepolicy, as the government seeks other more effective approaches. Itis necessary to have a view of the figure of individuals thatdepression, and begin providing care to ensure the depression doesnot escalate to more grave mental problems.


Lyons, K., Lecca, P. J &amp Valentine, P. (2013). Allied Health:Practice Issues and Trends into the New Millennium. New York:Routledge.

Michalak, E et al. (2002). The management of depression in primarycare: Current state and a new team approach. BCMJ, 44(8),408-411.

Pomerantz, J. M. (2015). Screening for Depression in Primary Care.Medscape Multispecialty. Retrieved from:http://www.medscape.com/viewarticle/511167