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Community individuals
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Primary care patients
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Medical inpatients
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Adults
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Children
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Depression affects between 1 in 5 and 1 in 6 people at some
point in their lives (Depression Alliance, 2003; MHF, 2003a).
Anyone can become depressed, people from all backgrounds, all
ages, all cultures. Depression is most common in people aged 25-44 years
of age (MHF, 2003). Click on
Prevalence of
Depression for a graphical display of the male and female prevalence of
depression between the ages of 16-74 years.
Community Individuals :
Primary Care Patients:
Medical Inpatients:
In each
of the above settings there are 2-3 times as many individuals with symptoms of
depression who fall short of major depression criteria (WHO, 2001).
Adults:
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20% women aged 16-65 years have significant mental health problems.
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14% men aged 16-65 years have significant mental health problems.
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15% people aged 65 years and over suffer depression severe enough to
require treatment.
Children:
Statistics taken from ONS (ONS, 1999; 2001),
MIND and the
Mental Health
Foundation (MHF, 2003)
Carers:
(Banks, 1999)
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1 in 8 adults is a carer.
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58% carers are women.
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29% of all young carers are providing care for someone with a mental
health problem.
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The average age of a young carer is 12 years of age.
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57% of young carers are girls, 43% are boys.
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20% young carers miss school.
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25% young carers and their families receive no outside support services.
Primary care:
(NICE, 2004; Tylee, 2001)
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60% of patients consult their GP each
year.
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33% of patients who present at the GP
surgery each year have mental health problems, this group of patients
accounts for at least 33% of GP time (Layard, 2005; Norwich Union, 2006)
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80-90% of patients with depression are cared for solely in primary care.
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The 'Rule of Halves' applies to
depression i.e. only half of depressed patients seek help from primary care,
only half are detected in primary care, only half receive treatment, only
half complete their treatment (Lepine, 1997).
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Of those who use secondary care
services, most, if not all, continue to receive much of their care from the
primary care team.
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The GP is traditionally the healthcare professional who
the patient seeks help from.
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However, the advent of skill mix and the
employment of Nurse Practitioners in primary care means that the Nurse
Practitioner is likely to regularly need to recognise and manage depression with
the patient.
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The whole Primary Healthcare Team (PHCT) has a responsibility
to be alert to recognising depression.
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Practice Nurses have regular
contact with patients suffering from chronic disease through the nurse-led
chronic disease clinics, they need to be alert to the possibility of signs of
depression in this high-risk group.
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Formalising the ongoing care of depression within the
concept of depression as a chronic disease means that Practice Nurses are
similarly well-placed to take on the responsibility of monitoring and educating
this group of patients.
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Follow-up does not necessarily need to be
face-to-face, telephone follow-up is a viable tool for follow-up of this group
of patients.
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The patients who suffer from the illness of
depression
are the people that can identify the important aspects of care.
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Depression
is an illness and all illnesses need their own evidence base.
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My current
research is
being undertaken as part of a PhD and is
attempting to develop an understanding of one aspect of the illness of
depression i.e. the fears and concerns patients may have when stopping
antidepressant medication when well:
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It represents a willingness and enthusiasm
to engage service users in developing an evidence-based quality primary care
health service for people with a depressive illness.
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It will provide a
useful basis for the review of current practice and the refining of research
questions for further study.
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The more that health professionals understand
patients’ views and concerns about their illness then the easier it is to
understand and manage the condition with the patient.
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