<h3>Purpose/Objective(s)</h3> Cancer patients frequently suffer from depression and psychosocial impairments due to their disease and treatment. Depression in cancer patients has been reported to decrease quality of life, increase morbidity, lengthen hospital stay, decrease motivation to obtain treatment, and reduce therapy adherence. Psychosocial services have been shown to help patients cope with treatment-related stress. However, there is currently very little data on the best way to identify patients who would benefit from these services. Resources are needed to screen for depressive symptoms among oncology outpatients. The aim of this study was to investigate the frequency of depression among radiation oncology patients and evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool to identify patients that may benefit from a referral to psychosocial services. <h3>Materials/Methods</h3> The PHQ-9 was incorporated into routine clinical evaluation of outpatient radiation oncology patients. Patients with a diagnosis of any cancer completed the PHQ-9. Patients with a score of 5 to 9 were given educational material on available support services and re-screened at their next appointment. Patients with a score equal to or greater than 10 were referred for further evaluation for psychotherapy by a psychologist. <h3>Results</h3> From January to December 2021, a total of 2457 patients underwent PHQ-9 screening. 19.4% were screened during their initial consult, 78.6% were screened during a follow-up appointment, 1.6% were screened during a re-consult, and 0.2% were screened while they were on treatment. PHQ-9 scores ranged from 0 to 24. The majority of patients (97.8%) who underwent screening, scored less than 10 (n = 2404) and 1.8% of patients scored equal to or greater than 10 (n = 45). Data were missing on 8 patients. A total of 57 referrals were made. Of the referrals made, 59.6% refused referral (n = 34) and 40.3% accepted a referral (n = 23). 21% of the patients who accepted a referral had scored less than 10 on the PHQ-9 and self-referred themselves (n = 12). Of the patients who were referred or self-referred to Psychology, the mean PHQ-9 score was 10.5 (SD = 4.7). <h3>Conclusion</h3> Cancer necessitates an enhanced continuum of care. With the significant burden of depression among cancer patients, the integration of mental health services, particularly mental health screenings, and psychosocial consultation and referral, is critically needed and should be scaled up in cancer treatment facilities. Clinic-based interventions provided by healthcare providers are imperative to address cancer patient mental health needs. These findings provide a practical means to incorporate protocols for depression screening enhancing mental health access among cancer patients.