Psychosocial
General practitioners play an important role in the detection and management of mental illness, especially high prevalence conditions such as depression and anxiety. The lifetime incidence of major depression is up to 30% and is twice as common in women than men. The prevalence in the community of major depression is 3–5%.424
The likelihood of depression among low SES persons is almost double that of high SES persons (most marked for persistent depression).425 Anxiety and affective disorders are more common in unemployed people; they are also less likely to seek help from their GP.426 In patients with chronic disease, lower educational level and unemployment are predictive of depression.427 Practices in disadvantaged areas have a higher prevalence of depression to identify and manage in their patients.428 Being aware of this is important for opportunistic screening for depression. Other general strategies to increase screening in this group are outlined in other chapters and are also discussed in the ‘green book’. Suicide and attempted suicide are consistently associated with markers of socioeconomic disadvantage,429-432 including low SES, limited educational achievement, and homelessness. These markers are more prevalent in Aboriginal people and Torres Strait Islanders.433 Refer to the National guide to a preventive health assessment in Aboriginal and Torres Strait Islander peoples.
Epidemiological studies have consistently shown a link between suicide and social disadvantage434,435 including low SES, limited educational achievement and homelessness.436
© The Royal Australian College of General Practitioners
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