Prevention and management of depression in primary care in Europe: A holistic model of care and interventions-Position paper of the European Forum for Primary Care

This position paper emphasises a more holistic approach to the management of depression and depression-related conditions (as reflecting the majority of common mental health problems) in primary care. This approach takes account of the physical, psychological/ emotional and social needs of patients and the position that attention to more than the diagnosis and treatment of symptoms is required. This also includes the role for primary care in engaging with promotion and prevention activities and working in partnership with other public services and voluntary agencies to address the needs of patients and enhance their general wellbeing. We leave our wide target audience for this paper with a fairly typical scenario of a patient presenting in primary care: George is a divorced single male in his 50s. He lives in an area of high deprivation and is unemployed. He quit his low-income job after becoming concerned it was aggravating his heart condition, and subsequently went into debt while waiting to become eligible for state support. During this time he was briefly homeless. He currently lives in state housing on a low income (from state benefits) and struggles to meet debt repayments. He has come to his GP as he feels his heart condition is deteriorating and he is becoming more depressed. He is already on an anti-depressant. What would be the current pattern of care for George and how might this be changed to better meet such needs in the future?