Depression is the commonest mental illness in old age. In 2001–02, there were 9.8 million visits by older people to office-based physicians in the USA for depression. 1 In the UK, one in six older medical inpatients are depressed (Geriatric Depression Score – GDS – of 7 or more out of 15). 2 The mean prevalence in over sixty-fives living at home is about 12%. In the UK, the National Service Framework (Standard 7) for Older People recognised that 10–15% of people over 65 have depression. It recommended that primary care trusts should ensure that every general practice uses an agreed protocol to diagnose, treat and care for patients with depression.