UC Irvine

Background: Depression is a prevalent and leading issue among college students, which became worsened by the global pandemic of COVID-19. The Student Health Clinic in one of the tertiary public universities in Southern California also proved to be impacted with mental health complaints, depression being one of the most common diagnoses. The early treatment of depression is critical to avoid possible complications including suicidal ideation from untreated depression. Objectives: The primary objective was to implement a new workflow (Fast-Track) to treat students with uncomplicated depression as early as possible. Method: This project used a pre- and post-intervention design. The Fast-Track has three components: 1) reserving appointment slots from primary care providers’ clinic schedules for the Fast-Track patients, 2) sending an education material about depression treatment options to the patients to read before an initial visit, 3) providing two follow-up visits at weeks 2, and 5 or 6. A descriptive analysis was performed for demographic data and secondary outcome (PHQ-9 score), Paired two sample t-Test was used for the primary outcome (time to treatment in days). Data from the participants who completed the two follow-up visits were included in the analysis. Results: A total of 24 patients met the criteria for uncomplicated depression. 16 patients completed the two follow-up visits. Time to treatment in days reduced from 19.2 days (SD 4.6) to 2.5 days (SD 1.8) (p < 0.05). The mean PHQ-9 score at the baseline visit was 13.6 (SD 4.1) and 11.4 (SD 2.5) at the second follow-up visit with a mean change of -2. 2. 81.3% (n=13) of the 16 patients reported improvement at week 5 or 6 and 18.6 % (n=3) reported worsening of their depression symptoms. Conclusion: Opening up access to provider schedules greatly improved the patient’s time to treatment. Utilizing primary care providers, including APRN's, in the management of simple, uncomplicated depression for college students was safe and successful. The outcomes seen in this project offer some insight into how the pharmacological treatment for simple, uncomplicated depression can be safely initiated sooner among college students.