• Victoria Palmer, Jane Gunn, Renata Kokanovic, Frances Griffiths, Bradley Shrimpton, Rosalind Hurworth, Helen Herrman, Caroline Johnson, Kelsey Hegarty, Grant Blashki, Ella Butler, Kate Johnston-Ata'ata, and Christopher Dowrick.
• Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia. v.palmer@unimelb.edu.au
• Fam Pract. 2010 Aug 1; 27 (4): 447458447-58.

BackgroundThe World Health Organization and the World Organization of Family Doctors have called for 'doable' and 'limited' tasks to integrate mental health into primary care. Little information is provided about tasks GPs can undertake outside of guidelines that suggest to prescribe medication and refer to specialists.ObjectivesThe reorder study aimed to gather diverse patient and community perspectives to inform the development of an effective system of depression care.MethodFive hundred and seventy-six patients completed computer-assisted telephone interviews. Two hundred and seventy-six community stakeholders completed a modified two round Delphi. Responses were analysed to identify tasks and these were synthesised into a conceptual design.ResultsFifteen core tasks were identified, 5 were agreed upon and a further 10 identified by each group but not agreed upon. Listen, understand and empathize, provide thorough and competent diagnosis and management, follow-up and monitor patients, be accessible and do not rush appointments and provide holistic approach and tailor care to individual needs were agreed on. Other tasks included: develop plans with patients, assess for severity and suicide risk, account for social factors, be well trained in depression care and offer a range of treatment options, appropriate and timely referral, support and reassurance, educate patients about depression, prescribe appropriately and manage medication and be positive and encouraging.ConclusionsThe tasks form the basis of a conceptual design for developing a primary care response to depression. They fit within three domains of care: the relational, competency and systems domains. This illustrates tasks for GPs beyond prescription and referral.

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