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Type:
Story
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Resolution: Done
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Priority:
Medium
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Affects Version/s: None
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HWC Sprint 18, HWC Sprint 19
As a healthcare provider I want the PHQ-9 depression screening to be automatically enabled and scored so that depression severity is accurately identified and appropriate counselling or referrals are triggered in a timely manner.
Acceptance Criteria
- Auto-enablement
PHQ-9 screening is automatically enabled when triggered from mental health screening or post-partum status (≤12 months after delivery via RMNCH+A).
- Mandatory Questionnaire
All 9 PHQ-9 questions must be answered using predefined radio options before submission.
- Auto Scoring
The system automatically calculates the total PHQ-9 score (0–27) as the sum of responses to questions 1–9.
- Severity Classification
Depression severity is auto-derived based on the total score and displayed to the user.
- System Action Trigger
Based on severity, the system recommends appropriate action (Psychoeducation, Counselling, or Referral).
- Referral Alerts
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- If PHQ-9 score ≥10, the system generates a referral to MO/PHC.
- If PHQ-9 score ≥15, an urgent referral alert is generated.
- If PHQ-9 score ≥20, an emergency referral alert is generated.
- Post-partum Rule
For post-partum women (≤12 months after delivery), PHQ-9 screening is mandatory regardless of the chief complaint.
Table 3: PHQ-9 Questions
| S. No. | PHQ-9 Question | Field Type | Response Options |
| 1 | Little interest or pleasure in doing things | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 2 | Feeling down, depressed, or hopeless | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 3 | Trouble falling or staying asleep, or sleeping too much | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 4 | Feeling tired or having little energy | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 5 | Poor appetite or overeating | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 6 | Feeling bad about yourself — or that you are a failure or have let yourself or your family down | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 7 | Trouble concentrating on things, such as reading the newspaper or watching television | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 8 | Moving or speaking so slowly that other people could have noticed, or being unusually restless | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
| 9 | Thoughts that you would be better off dead or of hurting yourself in some way | Radio Button | Not at all (0) / Several days (1) / More than half the days (2) / Nearly every day (3) |
Note: These must be individual radio-button questions, not a single composite field. Scoring Logic (Backend): PHQ9_TOTAL_SCORE = Q1 + Q2 + ... + Q9; Range: 0–27
