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Young men with mental health problems often do not present to traditional primary care services. Novel methods to engage this population need to be explored. Between April and July 2005, Croydon Primary Care Trust developed a depression service for men aged 18 to 35 years. Part of this service was a mail-shot to all men in this age group registered with two general practices. The mail-shot informed them of the symptoms of depression, the importance of seeking help and where to obtain help. The objective of this research was to determine whether this mail-shot influenced the number of young men presenting to primary care with depression. Method: This was a before and after study. The quarterly incidences of depression in men aged 18 to 35 years was calculated from January 2000 to June 2005. Incidence risk ratios were calculated to compare pre-mail-shot incidence with the post mail-shot incidence. The cost of the mail-shot was calculated. Results: There were 148 new cases of depression diagnosed between January 2000 and June 2005 across the practices. There was a statistically significant increase in depressed young men contacting the two participating general practices in the quarter after the mail-shot compared with previous quarters (IRR 2.57; 95% CI 1.59-4.17; p < 0.001). The cost of the mail-shot was £1.00 per registered man aged between 18 and 35 years, or £297 (450 ) per case of depression detected. Conclusion: Mail-shots may be a cost-effective way to encourage this traditionally 'hard-to-reach' group to consult primary care professionals for depression treatment.
