Professor Jane Gunn Project: Department of General Practice, University of Melbourne Funding: Australian Primary Health Care, Research Institute Stream Funding

Depression is the single largest cause of disability burden in Australia, and GPs provide a great deal of first contact and management for patients. Yet general practice depression care has not been well designed or resourced, and the current evidence base is mostly unrelated to Australian primary care.

The re-organising care for depression and related disorders in the Australian primary health care setting (re-order) study conducted consultations with 576 patients and 310 non-patient stakeholders about their views on exemplary depression care, and worked directly with six general practices and their 55 staff to document how depression care occurs.

The first study of its kind in terms of subject matter and methodology, ‘re-order’ developed an outstanding and original evidence base. The project developed ground-up, practice-driven interventions and principles to understand and reach agreement about: who is depressed and who is not (including the techniques to decide on this); shared sets of techniques to deal with depressed patients; agreement on who does depression work, how depression work is allocated and organised; and, how practices will know they are doing good work.

The ‘re-order’ data confirmed that patients rely heavily on GPs for their mental health care. This is particularly relevant for mental health and primary care policy and the education and training of GPs in the future. The impact of ‘re-order’ at the practice level has been profound with participants acknowledging that the study was in most cases the first time ever that groups had met to discuss depression care management.

View the project abstract on ROAR