Introduction

Depression is often reported to be undetected and inappropriately treated in primary care. Up to half of patients prescribed antidepressants either do not take them as instructed, or fail to take them altogether. Professional medical wisdom ascribes this deviant behaviour to lack of information and the influence of common misconceptions among the public concerning antidepressants. The solution is often formulated in terms of a need for effective educational campaigns and materials to improve the public's 'mental health literacy', and bring their understanding of depression and its treatments in line with that of professionals. However, patients' present knowledge and attitudes concerning antidepressants and, more importantly, their experience of depression and its treatment has not been well researched. It is important to establish patients' information needs, their use and evaluation of available information materials, and the extent to which their understanding of depression and its treatment accords with that of the professionals involved in their care.

Method

This paper presents findings of qualitative interviews with 30 members of the Depression Alliance (DA) and compares their understanding and experience of depression and antidepressants with that of the orthodox biomedical view presented in a range of DA information leaflets, and an ABPI booklet produced in association with the organisation. Members of a leading patient self help organisation such as the Depression Alliance were assumed to have accessed such information materials, and to tend towards the higher end of the 'mental health literacy' scale.

Findings

Many DA respondents had incorporated the biochemical model of depression portrayed in information materials and often found this helpful. However, the narrowly technical explanatory framework did not satisfactorily resolve the issue of what caused particular individuals to become depressed. The biomedical emphasis on depression as a functionally autonomous disorder of brain chemistry writes out the reality of the wider social and personal problems often underlying patients' experience of depression and from which they cannot easily disentangle themselves. In addition, being diagnosed with depression and taking antidepressants conferred an identity of sufferer from mental illness. This had consequences for the way respondents thought about themselves which were not addressed in the leaflets.

Conclusion

The narrow technical focus of professionally informed information misses the complex concerns that depression sufferers face when taking antidepressants. This is one reason why conventional efforts to improve 'mental health literacy' among the public will continue to miss their mark.