Recognition and response Approaches to late-life depression and mental health problems in primary care

The boundaries between what is a healthy response to stress and anxiety and what is abnormal are often difficult to determine, especially in primary care. Even symptoms of conditions such as psychoses and dementia can present as relatively normal behaviour. This paper considers depression in late life as an example of this tension. On the one hand, depressive symptoms may be viewed as an 'understandable' response to bereavement or physical illness, while, on the other, it can be a serious, disabling and life-threatening condition if left untreated. Primary care has a key role to play in supporting depressed older people, through improved pattern recognition and diagnosis, by tailoring effective treatments to fit the individual, and by providing or signposting the older person to information and advice. This is a pivotal role that primary care plays in relation to other mental health problems that older people experience.