STUDY PROTOCOL Developing stepped care

Full list of author information is available at the end of the articleBackground Prevalence, impact and access Depression is a long-term and relapsing condition and set to become the third biggest cause of the global burden of disease by 2030 [1]. Over three-quarters of all people who recover from one episode will go on to have at least one more [2]. Lifetime prevalence has been estimated at 16.2% and rates of co-morbidity are high [3-5]. In the UK, de-pression and anxiety are estimated to cost the economy £17 billion in lost output and direct healthcare costs annu-ally, with a £9 billion impact on the Exchequer through benefit payments and lost tax receipts [6]. Whilst there is a clear need for effective depression treatment, access to treatment is poor: results from th