Unmet need in depression: varying perspectives on need

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Abstract
Major depression is a common illness with a significant morbidity. The focus for health care has been widened to include definitions and determinants of outcomes and the cost-effectiveness of defined interventions. This chapter outlines the issues and areas of concern from the perspective of five groups of 'stakeholders': clinicians in primary care; clinicians in secondary and tertiary care; depressed individuals and their families; the general community; and the fundholders. Primary care is affected by a number of problems to do with treatment and awareness of depression. There are many different groups concerned with mental health, all of whom have their own particular perspectives of depression. This may lead to conflicts of interest and need. The working definition of unmet need can be defined in the context of areas of dysfunction for which there are potential remedies or interventions, and the chapter proposes four areas to tackle unmet need.

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