title: Identification and management of depression in Australian primary care and access to specialist mental health care.
abstract: 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.
authors.affiliation: Brain and Mind Research Institute, Sydney Medical School, University of Sydney, 94 Mallett St., Camperdown, New South Wales 2050, Australia. nick.glozier@sydney.edu.au
authors.forename: Nicholas
authors.initials: N
authors.lastname: Glozier
authors.forename: Tracey
authors.initials: T
authors.lastname: Davenport
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D058006:General Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011320:Primary Health Care; D012017:Referral and Consultation; D057566:Self Report; D013038:Specialization; D055815:Young Adult