ABSTRACT
This chapter focuses on the potential of the primary health-care clinic, where most people who are experiencing depression will make contact with the health-care system, to play an important role in managing depression as it presents in the community. The role of the primary health-care clinic is not a new one. Depression is more common in primary care settings than in the general population. A major international study on mental illness in general health care screened 25 916 people aged below 65 years, from 15 primary care centres across the world, using the General Health Questionnaire (GHQ). The primary care clinic is well placed to play an integral role in meeting this challenge. The stress-vulnerability hypothesis provides an explanatory model that is of particular relevance to primary care. The prescriber must be aware of the risk of cardiotoxicity and death in overdose and be especially careful to assess each patient for their risk of self-harm.
