Optimizing the care of patients with depression in primary care: the views of general practitioners.

Depression is a very common mental illness within the general population and in-patients consulting in general practice. General practitioners are well placed to provide care for patients with mental health problems, as these disorders are often connected with family and social problems, and GPs can provide their patients with long-term follow-up and support. While there are theoretical reasons for the important role of the family doctor, there is limited evidence about how general practitioners view their roles and their capacity to cope with the mental health needs of their patients. This paper explores the experience of 15 general practitioners from Scotland, who were interviewed during the spring of 1998, about how they approached the care of patients with depression in relation to their skills, knowledge and attitudes. The following four key categories of interest are presented which underpin the emergent themes of the study: (1) organizational issues; (2) referral and the use of other professionals; (3) treatment and management issues; (4) stigma. These themes reveal some interesting issues in relation to GPs' recognition and management of depression and it is also clear that the perception of collaboration within primary care and between primary and secondary care is an integral part of the process. The implications of what has been learned from this study may include the development of educational opportunities for GP trainees and established principals, in addition to brief multidisciplinary training opportunities and shared learning events between primary and secondary care.