Identification and Management of Depression in Australian Primary Care and Access to Specialist Mental Health Care

Objective: The authors evaluated management of illness, including access to specialist mental health care, among people identified by general practitioners as clinically depressed. Methods: Australian primary care practitioners recruited in 2009 completed case reports and collected self-report assessments from five to seven consecutively presenting patients whom they identified as having clinical depression. Results: Among 735 patients with clinical depression, 55% met criteria for major depressive syndrome, 86% reported clinically significant sleep disturbance, and 47% had been depressed for more than 12 months. Most (77%) were prescribed antidepressants, and 30% were prescribed anxiolytics or hypnotics. Patients under shared care with specialist mental health care providers (42%) had more severe, chronic, and recurrent conditions but no demographic advantages. Conclusions: Depressed patients of general practitioners often had chronic, recurrent, and moderately to severely disabling conditions, but fewer than half received specialist care. Access to specialist care, however, appeared to be based on clinical need, with little inequity in sociodemographic characteristics observed. (Psychiatric Services 63: 1247-1251,2012; doi: 10.1176/appi.ps.201200017)