FeatureConditions That Influence a Primary Care Clinician's Decision to Refer Patients for Depression CareAnthony, Jean S. PhD RN1; Baik, Seong-yi PhD RN2; Bowers, Barbara J. PhD RN3; Tidjani, Bassirou PhD4; Jacobson, Jeffrey C. PhD5; Susman, Jeffrey MD6Author Information 1Jean S. Anthony, PhD RN, is a an assistant professor at University of Cincinnati College of Nursing in Cincinnati, OH. 2Seong-yi Baik, PhD RN, is an associate professor at the University of Louisville, College of Nursing, Louisville, KY. 3Barbara J. Bowers, PhD RN, is dean of research at the University of Wisconsin-Madison and faculty of health at the Australian Catholic University. 4Bassirou Tidjani, PhD, is an associate professor at the School of Business, University of Darkar—West Africa, and adjunct professor in the Department of African American Studies at the University of Cincinnati. 5C. Jeffrey Jacobson, PhD, is an assistant professor at the University of Cincinnati, College of Anthropology. 6Jeffrey Susman, MD, is chair of the Department of Family Medicine at the University of Cincinnati, College of Medicine. Assistant Professor Dean of Research Chair of the Department Address correspondence to her at[email protected]. Rehabilitation Nursing Journal: May 2010 - Volume 35 - Issue 3 - p 113-122 doi: 10.1002/j.2048-7940.2010.tb00286.x Buy Metrics Abstract The objective of this study was to identify conditions that influence primary care clinicians' referral decisions related to depression care. Forty primary care clinicians (15 general internists, 10 nurse practitioners, and 15 family practice physicians) were included in this study. The clinicians participated in semistructured interviews and completed two quantitative instruments (with 33 items on depression treatment decision making and 32 items on provider attitudes toward psychosocial care). Data analysis revealed that several conditions influence a clinician's decision to refer a depressed patient to a mental health specialist: the patient's resources, the clinician's comfort in prescribing antidepressants and counseling patients with depression, and familiarity with a mental health specialist and practice environment. The decision to refer a patient with depression to a mental health specialist is a complex process involving the clinician, patient, and practice-related issues. Understanding these relationships may provide strategies to improve depression care management and lead to the design of depression care quality-improvement interventions that accommodate primary care practice context. The findings from this study suggest a need to increase mental health training opportunities for primary care clinicians to strengthen their skills and comfort level in managing depressed patients and encourage the development of relationships between primary care clinicians and mental health specialists to facilitate timely and accessible mental health care for patients. © 2010 Association of Rehabilitation Nurses.