ABSTRACT
Encouraged by the work of Goldberg and empowered by having such a simple and useful measure as the General Health Questionnaire (Goldberg and Blackwell 1970) we embarked on a series of studies in general practice. We surveyed patients and doctors in a stratified sample of Sydney general practitioners to answer the first question ‘How many patients have which disorders?’ The general practitioners noted that 13 per cent of their patients came for emotional or social reasons that day (Chancellor et al. 1977). This figure surprised us, for it was lower than the prevalence of mental disorders in the community which we had established to be about 20 per cent (Andrews et al. 1977) and certainly much lower than the 47 per cent of the general practitioners’ patients who scored as positive cases on the GHQ completed in the waiting room prior to seeing their doctor. This led us to do a further survey to ask why psychiatric disorders are missed and of those that are recognised how are they managed (Brodaty et al. 1982a; Brodaty et al. 1982b). We decided that something needed to be done. Keen to improve the ability of general practitioners to identify and manage people with emotional disorders we conducted a controlled trial of brief psychotherapy in general practice (Brodaty and Andrews 1983) and began to provide some training for general practitioners in interviewing and counselling (Brodaty et al. 1981). The conclusions from this body of work were that we should establish a formal postgraduate training programme for general practitioners and that this should be informed by reliable data from a national survey that focused on prevalence, disability and health service utilisation of people with mental disorders. Both these goals have now been achieved.
