In primary care, anxiety and depression, often occurring together, are the most prevalent mental disorders in the general population. The National institute for health and clinical excellence (NICE) guidelines on anxiety and depression outline how to manage these mental health disorders in primary and secondary care. In order to manage these patients effectively, good communication between GPs and community mental health teams is a key and that everyone follows the same framework.

To assess appropriateness of GP referrals to community mental health services of patients with anxiety/depression in line with NICE guidelines.

This study looks at the current practice in a town area especially in relation to primary care management of anxiety and depression, specifically looking at stepped care approach of NICE guidelines so that improvements can be made to patients care in the future.

We looked at all GP referrals during the period of June 2008-March 2009 and monitored standard of stepped care approach designed by NICE guidelines for patients suffering from anxiety and depression.

We received in total 204 referrals from GPs and included 64 referrals that mentioned problems such as anxiety and depression. Only half of the referrals followed the steeped care approach recommended by NICE guidelines.

There seemed to be a definite lack of counselling and CBT services for patients falling into the category of mild-moderate anxiety/depression. Not all practices had an internal practice counsellor and even if they did there was often a long waiting list.