Abstract Background Depression is a significant public health concern and deeply affects both the depressed person’s life and the lives of their family members. The purpose of this project is to improve the monitoring of patients with major depressive disorders while they are receiving treatment, in order to prevent harm to them and to reduce their current depressive symptoms. Methods  This project introduced improved provision of care by monitoring the response to treatment of major depression in a psychiatric outpatient clinic using the patient health questionnaire (PHQ-9). A convenience sample of 22 people who presented for psychiatric services were asked if they would be willing to participate in the project. Each patient consented and was given PHQ-9 forms to fill out. The scores of the initial and final PHQ-9 were compared for each patient to evaluate changes of major depression symptoms as response to patient treatment. The project duration was three months. Results             A paired-samples t test was calculated to compare the mean initial PHQ-9 scores to the mean final PHQ-9 scores. The mean on the initial PHQ-9 was 13.27 (sd = 5.522), and the mean on the final PHQ-9 was 3.50 (sd = 2.445). A significant decrease from the initial to final PHQ-9 scores was found t(21) = 12.981, p   Discussion The use of PHQ-9 forms at the outpatient clinic for the monitoring of patients with major depression resulted in reduction of the symptoms of major depression in all the study participants as observed on the PHQ-9 final scores. The PHQ-9 instrument helped clinicians to pinpoint the most worsening symptoms of depression to adjust the treatment. The use of the PHQ-9 during patients follow up showed improvements of targeted symptoms as response to treatment....