Common Mental Disorders Depression - New Zealand Doctor

Good practice points
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Recognition of common mental disorders in adults
Brief tools are optional aids for use by the primary care practitioner as
an adjunct to clinical assessment. Examples of brief tools include:
• the Kessler 10 (K10)
• the Patient Health Questionnaire for Depression (PHQ-9)
• the Generalised Anxiety Disorder Scale (GAD-7)
• the Alcohol Disorder Use Identification Test (AUDIT)
• the Case-finding and Help Assessment Tool (CHAT)
Practitioners should be aware of the cultural identity and health care
preferences of people in their care
Opinion of the Guideline Development Team, or feedback from consultation within New Zealand
where no evidence is available
5.1 Psychosocial assessment of adults/pakeke
It is good practice to enquire after the psychosocial wellbeing of every patient whatever
their reason for presentation. Every interaction with an adult in primary care should be
regarded as an opportunity to assess psychological wellbeing, taking into account both
strengths and difficulties. Establishing and maintaining a good therapeutic relationship
between the practitioner and the patient is also important and increases the likelihood
that mental disorders will be identified and addressed. 186,286 Depression, anxiety and
substance abuse are the most common mental disorders in New Zealand adults. 34
Good communication requires knowledge of the patient’s cultural background, and
it is standard good practice to ask every patient about their ethnicity. This also provides
an opportunity to discuss their cultural preferences with respect to health care. 151
Correct pronunciation of a person’s name is fundamental, and learning how to
pronounce Mäori names correctly has been suggested as ‘perhaps the single greatest
way to show respect to your Mäori patients’. 151
Culturally appropriate forms of greeting may help build a sense of familiarity. 287 For
both Mäori and Pacific patients it may be easier for practitioners of other ethnicities
to establish a rapport if they allow initial introductions to proceed at a relatively formal
and unhurried pace, and exchange some information about their background with
the patient. Long-term, allowing enough time at this stage in the process will improve
the patient-practitioner relationship, the information disclosed and the delivery of
services. 14,151,163 Family involvement at all stages is a priority for many Mäori and
Pacific patients: this may include biological or adopted family members, and nuclear
or extended family. 163 Face-to-face (kanohi ki te kanohi) consultation is generally
preferred, and often whänau members also attend the consultation for support. 17,151
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Identification of Common Mental Disorders and Management of Depression in Primary Care