Dr Danielle Esler Project: GP and public health registrar, Danila Dilba Health Service, Flinders University and Monash University Funding: National Health and Medical Research Council Primary Care Project Grant; Primary Health Care Research, Evaluation and Development Northern Territory grant; and a General Practice Education and Training Registrar Research Grant

Ischaemic heart disease (IHD) is a major health problem among Indigenous people and depression is a significant risk factor for it. Yet grassroots clinicians wishing to screen Indigenous patients for depression have had a scant evidence base from which to draw upon.

This study assessed the reliability and validity of a depression screening tool – the PHQ-9©Pfi zer Inc. – which was modified for use with Aboriginal and Torres Strait Islander people. An Aboriginal Health Worker administered the tool to 34 IHD patients attending an Aboriginal Community Controlled Health Service in Darwin. The results were compared with the outcomes of psychiatric diagnostic interviews.

The complete tool and a subsequent ‘mini’ tool showed great promise, with 80% and 100% sensitivity respectively in assessing major depression.

The study found the prevalence of major depression in the patient sample was high at 15.4%.

The study’s ‘participatory action’ research method involved Health Service staff, clients and the community in all phases of the project, significantly strengthening the capacity of both the Health Service and the research project.

The project demonstrates the ability of a small study to address an important evidence gap. The research was initially fed back to the Health Service to use with its IHD patients, and the screening tool is performing well in a larger scale assessment of its use. Revealing the high prevalence of depression  among IHD patients has also provided important evidence for Indigenous, cardiology and mental health policy and program planning.