Appendix 5 - Depression -PHQ

Depression can be screened for with the help of the Patient Health Questionnaire (PHQ-9). https://www.integration.samhsa.gov/images/res/PHQ%20-%20Questions.pdf Patient Health Questionnaire (PHQ-9)

Interpreting the PHQ

Scores within these ranges on the PHQ suggest the potential presence of depression to the following levels:

1-4 / Normal range - Minimal depression 5-9 / Mild depression 10-14 / Moderate depression 15-19 / Moderately severe depression 20-27 / Severe depression

Where a player scores 1 or above on question 9 you must enquire about current thoughts or plans to harm self or other. Even where this item is not endorsed it is important you ask directly about any thoughts or plans to harm self or other, should the player appear to present with symptoms of depression. It is vital that the risk to self and other is comprehensively assessed and managed. This may involve you liaising with mental health professionals and emergency services.

Information from the PHQ should be integrated with information from your general screen to decide on next steps:

• Where the screen suggests minimal to mild depression (and your general screen did not indicate high intensity or prolonged symptoms or additional concerns) psychoeducation including sleep hygiene are indicated, as well as active monitoring.
• Where the screen suggests moderate depression or in cases of prolonged minimal to mild depressive symptoms, low intensity psychosocial interventions (e.g. Computerised cognitive behavioural therapy (CBT), guided self-help, non-facilitated self-help, psychoeducational groups) or group CBT are indicated. Where symptoms persist psychological interventions such as CBT are indicated.
• Where moderately severe or severe depression are indicated, or mild to moderate symptoms that have not responded to psychosocial interventions / CBT, consider drug treatment (often alongside psychological intervention) and refer to psychiatry. Where symptoms are particularly severe and functioning is impacted to a significant degree, often with high risk of suicide, inpatient referral may be indicated. Seek guidance from psychiatry.