The extent to which the noise of silence pierce the fabric of our society is but a reminder for "We the People" to take action to stop this noise. Depression is just one of the problems inherent in a society where the voiceless can not be heard because we fail to find adequate solutions. The health care crisis creates unprecedented opportunities for the people of faith to be major providers of preventive education and a site for an expanded role for primary health care.
The new prevention and wellness programs provided for in the Affordable Care Act (ACA) in opposition to the advocates of the free market system often celebrated as a mechanism, unabashedly driven by self interest, that lets us exchange goods and services without the need for redemption. Healing is more than treating diseases; health care more than a commodity; and huge corporations not the vehicle of choice for the delivery of appropriate health care. What we need is a comprehensive and accessible health care system that is available for all U.S. citizens.
The Center for Medicare and Medicaid (CMS) now covers annual screening for depression for Medicare beneficiaries in primary care settings that have staff-assisted depression care supports in place to assure accurate diagnosis, effective treatment, and follow-up. The decision to use a specific tool is at the discretion of the clinician in the primary care setting. However, coverage is limited to screening services and does not include treatment options for depression or any diseases, complications, or chronic conditions resulting from depression.
Choices in treatment will be influenced by one's value system, and recovery may be linked to one's personal faith. The "faith factor" is significant in a patient's recovery from a wide variety of illnesses. It appears that the faith itself rather than the object of the faith is of primary importance. The first element of faith is expectancy of improvement which may actually produce improvement. Suggestion is another powerful force. If one expects to improve, one will. Cultivating a sense of hope about oneself and the course of one's illness is central to recovery. Hopelessness creates a sense of futility.
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