Inclusion Criteria:  Age ≥ 19 years Prescribed at least one chronic medication for mental health which is considered pharmacogenomically actionable, as defined above (amitriptyline, doxepin, imipramine, nortriptyline, citalopram, escitalopram, fluvoxamine, paroxetine, sertraline, or venlafaxine). Diagnosis of major depressive disorder (MDD)  Exclusion Criteria:  Subject is a prisoner or is under a court order for treatment as part of a sentence or incarceration Persistent medication non-adherence for reasons not potentially linked to pharmacogenomic variation (e.g. inability to obtain medications due to cost; non-adherence due to cognitive impairment) Individuals receiving mental health treatment/care from a non-VA facility Individuals who are terminally ill Inability to communicate in and/or understand English