title: Diverse voices, simple desires: a conceptual design for primary care to respond to depression and related disorders.
abstract: BACKGROUND
  The World Health Organization and the World Organization of Family Doctors have called for 'doable' and 'limited' tasks to integrate mental health into primary care. Little information is provided about tasks GPs can undertake outside of guidelines that suggest to prescribe medication and refer to specialists.
  
  
  OBJECTIVE
  The reorder study aimed to gather diverse patient and community perspectives to inform the development of an effective system of depression care.
  
  
  METHODS
  Five hundred and seventy-six patients completed computer-assisted telephone interviews. Two hundred and seventy-six community stakeholders completed a modified two round Delphi. Responses were analysed to identify tasks and these were synthesised into a conceptual design.
  
  
  RESULTS
  Fifteen core tasks were identified, 5 were agreed upon and a further 10 identified by each group but not agreed upon. Listen, understand and empathize, provide thorough and competent diagnosis and management, follow-up and monitor patients, be accessible and do not rush appointments and provide holistic approach and tailor care to individual needs were agreed on. Other tasks included: develop plans with patients, assess for severity and suicide risk, account for social factors, be well trained in depression care and offer a range of treatment options, appropriate and timely referral, support and reassurance, educate patients about depression, prescribe appropriately and manage medication and be positive and encouraging.
  
  
  CONCLUSIONS
  The tasks form the basis of a conceptual design for developing a primary care response to depression. They fit within three domains of care: the relational, competency and systems domains. This illustrates tasks for GPs beyond prescription and referral.
authors.affiliation: Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia. v.palmer@unimelb.edu.au
authors.forename: Victoria
authors.initials: V
authors.lastname: Palmer
authors.forename: Jane
authors.initials: J
authors.lastname: Gunn
authors.forename: Renata
authors.initials: R
authors.lastname: Kokanovic
authors.forename: Frances
authors.initials: F
authors.lastname: Griffiths
authors.forename: Bradley
authors.initials: B
authors.lastname: Shrimpton
authors.forename: Rosalind
authors.initials: R
authors.lastname: Hurworth
authors.forename: Helen
authors.initials: H
authors.lastname: Herrman
authors.forename: Caroline
authors.initials: C
authors.lastname: Johnson
authors.forename: Kelsey
authors.initials: K
authors.lastname: Hegarty
authors.forename: Grant
authors.initials: G
authors.lastname: Blashki
authors.forename: Ella
authors.initials: E
authors.lastname: Butler
authors.forename: Kate
authors.initials: K
authors.lastname: Johnston-Ata'ata
authors.forename: Christopher
authors.initials: C
authors.lastname: Dowrick
mesh_terms: D000328:Adult; D000368:Aged; D003697:Delphi Technique; D003866:Depressive Disorder / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation; D014739:Victoria