Abstract
Beyond Blue is an organization aimed at helping to detect and treat depression. Though it can be seen as destigmatizing depression, it can also be seen as having limitations which may contribute to suboptimal assessment and treatment. This paper investigates its underlying assumptions.
DSM IV is viewed in its historical context and its “ontological values” and the process of diagnosis are analyzed. Some specific issues in the diagnosis of depression are examined, in particular “border disputes”. “Drivers to diagnosis” are discussed including commercial, professional and cultural aspects.
Some philosophical and political difficulties of evidence based practice are considered as are methodological problems in particular in relation to psychological treatment. The evidence base for treatments of depression, especially CBT, is reviewed. There will also be some discussion about the gap between evidence and practice and the limitations of the RANZCP clinical practice guidelines for depression.
In conclusion it is argued that Beyond Blue follows an over-inclusive yet narrow DSM illness model of depression and uses the rhetoric of evidence based medicine to oversell drug and CBT treatments of depression.