Care for Adults and Adolescents
Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.
See below for a summary of the quality standard or download it for more detailed statements.
Download the Quality Standard
Quality Statement 1: Comprehensive Assessment
People suspected to have major depression have timely access to a comprehensive assessment.
Quality Statement 2: Suicide Risk Assessment and Intervention
People with major depression who are at considerable risk to themselves or others, including those who experience psychotic symptoms, receive immediate access to suicide risk assessment and preventive intervention.
Quality Statement 3: Shared Decision-Making
People with major depression jointly decide with clinicians on the most appropriate treatment for them, based on their values, preferences, and goals for recovery. They have access to a decision aid in a language they understand that provides information on the expected treatment effects, side effects, risks, costs, and anticipated waiting times for treatment options.
Quality Statement 4: Treatment After Initial Diagnosis
People with major depression have timely access to either pharmacotherapy or evidence-based psychotherapy based on their preference, the severity of symptoms, and their ability to tolerate treatment. People with moderate to severe or persistent depression are offered a combination of both treatments.
Quality Statement 5: Adjunct Therapies and Self-Management
People with major depression are advised about adjunct therapies and self-management strategies that can complement pharmacotherapy or psychotherapy.
Quality Statement 6: Monitoring for Treatment Adherence and Response
People with major depression are monitored for the onset of, or an increase in, suicidal thinking following initiation of any treatment. People with major depression have a follow-up appointment with their clinician at least every 2 weeks for at least 6 weeks or until treatment adherence and response have been achieved. After this, they have a follow-up appointment at least every 4 weeks until they enter remission.
Quality Statement 7: Optimizing, Switching, or Adding Therapies
People with major depression who are prescribed medication are monitored for 2 weeks for the onset of effects; after this time, dosage adjustment or switching medications may be considered. People with major depression who do not experience a response to their medication after 8 weeks are offered a different or additional medication, psychotherapy, or a combination of both.
Quality Statement 8: Continuation of Medication
People taking medication who enter into remission from their first episode of major depression are advised to continue their medication for at least 6 months after remission. People with recurrent episodes of major depression who are taking medication and enter into remission are advised to continue their medication for at least 2 years after remission.
Quality Statement 9: Electroconvulsive Therapy
People with severe major depression and those with difficult-to-treat depression have access to electroconvulsive therapy.
Quality Statement 10: Assessment and Treatment for Recurrent Episodes
People with major depression who have reached full remission but are experiencing recurrent episodes have timely access to reassessment and treatment.
Quality Statement 11: Education and Support
People with major depression and their family members and care partners are offered education on major depression and information regarding community supports and crisis services.
Quality Statement 12: Transitions in Care
People with major depression who transition from one clinician to another have a documented care plan that is made available to them and their receiving clinician within 7 days of the transition, with a specific timeline for follow-up. People with major depression who are discharged from acute care have a scheduled follow-up appointment with a clinician within 7 days.