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Tips for Conducting PHQ-9 & GAD-7 Screenings
You and your team have made amazing progress in increasing screening rates for anxiety and depression. We also know that for some, discussing mental health can feel uncomfortable! It can be helpful to think of these screens as a medical tool and remind yourself that you serve a vital role in identifying patients who need treatment. It gets easier with practice, and patients often appreciate being asked.
See below for some Screening tips and remember your COMPASS+ Care Manager is always available to answer any questions you may have!
- Normalize the Process
- “We ask all patients these questions as part of routine care, just like we check blood pressure. Mental health is a part of overall health, especially during pregnancy.”
- Keep a neutral, nonjudgmental tone to help patients feel at ease.
- Use Culturally Sensitive Language
- Be mindful of language preferences and offer interpreters when needed.
- Explain mental health concerns in ways that align with the patient’s values or beliefs. For example:
- “Some moms feel extra worried or sad during pregnancy. These questions help us understand how you’re feeling.”
- “Your body is going through a lot of changes, and sometimes those changes can also affect sleep, energy, or emotions. These questions help us understand how to support you.
- Pregnancy affects the whole body, including mood and stress levels. We check in on all aspects of your health to make sure you feel your best.”
- Build Rapport Before Screening
- A few minutes of engagement can help ease discomfort.
- Simple check-ins like, “How are you feeling today?” can help patients feel heard.
- Use Trauma-Informed Care Principles
- Some patients may have past trauma or fear judgment. Approach the screening with:
- Choice: “You can skip any question you don’t feel comfortable answering.”
- Empowerment: “These questions help us support you better.”
- Compassion: “If anything is concerning, we have a great team to help.”
- Some patients may have past trauma or fear judgment. Approach the screening with:
What to Do If a Patient Endorses SI (Suicidal Ideation)
- Make Sure We Don’t Miss It: If patients are completing the PHQ-9 on their own, always review their answer to question 9 before they leave the exam room.
- Stay Calm & Nonjudgmental
- Respond with a calm, neutral tone:
- “Thank you for sharing that with me. You’re not alone, and we have a team to support you.”
- Respond with a calm, neutral tone:
- Clarify Without Leading
- Ask in a gentle, non-alarming way:
- “Can you tell me more about what you mean?”
- “Have you had any thoughts about wanting to harm yourself?”
- “Do you have a plan to hurt yourself?”
- Ask in a gentle, non-alarming way:
- Follow Clinic Protocol
- Immediately inform the provider or COMPASS+ Care Manager.
- If there is imminent risk (specific plan, intent, means), stay with the patient until they can be evaluated by the provider or Care Manager
- Emphasize Support
- “It’s really brave to share this. You deserve support, and we’re here to help.”
- Use the Collaborative Team Approach
- Remember, you don’t have to manage this alone—you are part of a care team with the Care Manager and other mental health professionals available.
- If you aren’t comfortable asking follow up questions, let the provider or another team member know.
Final Takeaways
✅ Screenings are standard medical care, not intrusive questions.
✅ Patients appreciate being asked—they may not bring it up otherwise.
✅ If someone endorses SI, follow protocol, stay calm, and get the team involved.