Primary care patients with anxiety and depression: need for care from the patient's perspective

Many anxiety and depression patients receive no care, resulting in unnecessary suffering and high costs. Specific beliefs and the absence of a perceived need for care are major reasons for not receiving care. This study aims to determine the specific perceived need for care in primary care patients with anxiety and depression, and examine to what extent these different needs are met.

Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety (NESDA). In 622 primary care patients with a current (6-month recency) diagnosis of depression and/or anxiety disorder who recognised their mental health problem themselves, the perceived need for mental health care was measured by the Perceived Need for Care Questionnaire (PNCQ). Possible determinants were measured in the same interview by means of a questionnaire.

Most patients with anxiety or depression expressed a need for counselling or information. Medication, practical support, skills training and a referral were less often perceived to be needed. Multiple logistic regression analyses revealed that after controlling for age, clinical status and disability, patients' confidence in professional help and their evaluation of received care positively influenced their perception of a need for medication and counselling.

Although no conclusions can be made about what type of care was specifically not wanted, patients with anxiety or depression mostly want to receive information and counselling. Health professionals should be aware of the fact that there are differences in perceived need for care between subgroups of patients, based on their beliefs and their evaluation of care.