Caring for depressed patients in rural communities: general practitioners’ attitudes, needs and relationships with mental health services

OBJECTIVE: To examine the needs and practices of rural GPs and their relationships with local acute mental health services, particularly in the provision of care to depressed patients. DESIGN: Postal survey. SETTING: Rural general practices. SUBJECTS: Ninety-nine GPs (63 males, 36 females) from the Hunter Valley region of NSW, Australia. MAIN OUTCOME MEASURES: GPs' self-reported contact rates, confidence, needs and beliefs. RESULTS: Depression was the most commonly seen mental disorder, with an average of 1.44 patients per GP per month referred to local acute mental health services, most commonly for suicidality. The preferred form of feedback after the referral of a depressed patient was a follow-up letter, while the most requested type of patient management support was cognitive behavioural therapy (CBT) groups. GPs were most confident in recognising depression, compared to other mental disorders except anxiety, and they were most confident in treating depression, compared to all other mental disorders. The most common barrier to providing care for depressed patients was reported to be 'time constraints' on GPs. CONCLUSIONS: The challenge for mental health services is to develop ways to collaborate more effectively with GPs in the provision of psychological services for depressed patients in rural communities.