Depression And Primary Care - Expanding The Evidence Base For Diagnosis And Treatment

Main Category: Depression
Also Included In: Primary Care / General Practice
Article Date: 16 Jun 2008 - 2:00 PST

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Primary care has the lead role in easing the burden of common mental disorders in Australia, according to an editorial in the supplement to the latest issue of the Medical Journal of Australia.

The MJA's 48-page supplement, funded by a grant from beyondblue: the national depression initiative, adds to the evidence base needed to achieve it.

Professor Harvey Whiteford, from the Queensland Centre for Mental Health Research at the University of Queensland, says specialist mental health services play a supporting but not a central role in reducing mental health problems in Australia.

"A longstanding concern has been whether GPs are able to detect common mental disorders in their patients," he said.

"[In this supplement, researchers have] examined the way distress and depression are perceived by GPs … and [others] discuss the value of screening tools to increase recognition of patients with mental disorders."

The National Survey of Mental Health and Wellbeing, conducted by the Australian Bureau of Statistics in 1997, and the Australian Burden of Disease Study, conducted by the Australian Institute of Health and Welfare in 1998-99, greatly influenced mental health policy in Australia.

Professor Whiteford says that, until that time, the major focus of the National Mental Health Strategy had been on providing services for those individuals discharged from psychiatric hospitals.

"While the service reforms for such individuals remain incomplete, the information provided by the ABS and AIHW studies significantly expanded the mental health policy agenda.

"Ensuring the primary mental health care sector can reduce the burden of common mental disorders by increasing the number of patients receiving evidence-based interventions remains the challenge."

Even when common mental health problems such as depression are detected and treated, there is still a need to address relapse prevention. The supplement includes a report of a depression relapse prevention program that was trialled with some success in South Australia.

Professor Whiteford says primary care is an ideal setting in which to address the high co-morbidity between mental and physical disorders.

"This emphasises the importance of integrated clinical care for these people," he said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

Medical Journal of Australia