Evaluation of primary care mental health integration and screening of anxiety and depression symptoms in Qatar from 2018 to 2023

This study examines the development of the Primary Health Care Corporation's (PHCC) mental health integration programs in Qatar, focusing on their impact on access to care and management of prevalent mental health conditions, and estimating their burden within primary care. We conducted a longitudinal retrospective analysis using de-identified, routinely collected data for all adult patients (≥ 18 years) who attended PHCC health centers from January 2018 to December 2023. The dataset includes scores from the 9-item Patient Health Questionnaire (PHQ-9) for depression and the 7-item Generalized Anxiety Disorder scale (GAD-7) for anxiety. Over this period, screening for both anxiety and depression symptoms increased significantly, with anxiety screenings rising from 199,465 in 2018 to 1,119,006 in 2023 and depression screenings from 187,653 to 1,107,551. Internal referrals to PHCC mental health clinics rose between 2018 and 2023, though they recently declined, especially within the Integrated Psychiatry Clinic. No-show rates for appointments improved from 2018 to 2021 but increased again in recent years, suggesting areas for improvement in patient follow-up. In 2023, we observed prevalence rates of 5.21% for depressive symptoms and 5.48% for anxiety symptoms, based on cut-off scores of ≥ 10. The expansion of PHCC's screening and management programs from 2018 to 2023 has enhanced early identification and care for mental health conditions. These findings provide insights for optimizing mental health screening and addressing challenges in patient engagement and appointment adherence.