Background: Depression is one of the most common mental health disorders addressed in primary care with a lifetime prevalence of 12.2%. Current depression screening rates are low, with only 2.0% of primary care visits having depression screening suggesting that the vast majority of older adult patients suffering from depression do not receive adequate treatment. Methods: The goal of this quality improvement project was to increase depression screening rates in an outpatient primary care setting in Upstate New York. This was accomplished by implementing the PHQ-2 screening tool for depression screening in adults over the age of 65. The goal was for providers to screen at least 30 to 40 patients within a three-month period. Results: At the end of the 12-week time period, a total of 212 patients were screened for depression. Providers were interviewed on their use of the tool, and the number of patients screened, treated or referred, were reported. Nineteen patients were referred to a mental health provider or prescribed an antidepressant. Twenty seven were referred for counseling, and sixty four were given a follow-up appointment for further evaluation. The theoretical framework was used to optimize primary care, and assist the primary care clinic, in merging towards an integrated behavioral health care model. Conclusion: Screening for depression in primary care, helps to increase access to quality health care and services. Implementing the project led to the integration of a depression screening program that will be used in the medical clinic to improve the outcomes of patients with depression. Increasing the number of patients screened for depression, will decrease the incidence of suicide among older adults, and help ensure all older adults who are at risk are identified and offered treatment. Keywords: depression, depression screening, primary health care, mental health, quality indicators, quality of health care, older adults.