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Head To Head

Should Google offer an online screening test for depression?

BMJ 2017; 358 doi: (Published 13 September 2017) Cite this as: BMJ 2017;358:j4144
  1. Ken Duckworth, medical director1 2,
  2. Simon Gilbody, professor of psychological medicine, and health services research4
  1. 1National Alliance on Mental Illness, Arlington, VA 22203, USA
  2. 2Department of Psychiatry, Harvard Medical School, USA
  3. 4Mental Health and Addictions Research Group, Department of Health Sciences, University of York and Hull York Medical School, York, UK
  1. Correspondence to: K Duckworth ken{at}, S Gilbody simon.gilbody{at}

It could raise awareness to improve identification and treatment of depression, says Ken Duckworth, but Simon Gilbody worries that screening for depression is not recommended because it could cause harm

Yes— Ken Duckworth

Until recently, patients had to see a doctor to learn their blood pressure and blood sugar levels. Now, measurement tools are readily available at home, and raised public awareness of cardiac risk has contributed to a huge reduction in heart disease.

Contrast this with suicide, which, in America, is increasing in almost all population groups.1 In the UK, suicide rates among women are the highest in a decade.2 While many people know what 120/80 mm Hg means, few know their PHQ-9 (patient health questionnaire 9) score. A common language for measuring depression could advance conversations among the public and with professionals.

PHQ-9 is a test validated for use in primary care to monitor the severity of depression and response to treatment. It is designed for patients to read and answer on their own. The result is a total of scores for each of nine DSM-5 criteria, each rated from 0 to 3 in terms of frequency of occurrence.3 The test is quick to do and used in many clinical settings.

Attitudinal barriers

Nearly a fifth of Americans experience clinical depression at some time.4 However, about half of these people do not receive any treatment, and the rest wait an average six to eight years.5 A key reason may be that people with mental health conditions perceive that they do not need treatment.6 Studies show that they report attitudinal barriers to seeking care much more often than structural or financial barriers.6

Google and the US advocacy organisation the National Alliance on Mental Illness (NAMI) want to help by …

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