Cardiovascular disease, type 2 diabetes mellitus, cancer and chronic respiratory diseases are often referred to as the ‘big four’ chronic conditions, because in combination, they account for more deaths than any other. However, if one considers the global burden of chronic conditions in terms of disability rather than mortality, major depression is the second leading cause of disability (O’neil, Jacka, Quirk, Cocker and Taylor and Berk, 2015) preceded only by cardiovascular disease. In terms of disability, ‘the big four’ only account for only (54%) of all related disability adjusted life years (DALYs). Although, relative to physical health conditions, mental disorders are associated with greater disability, they are much less likely to receive treatment and this holds true across the world (Von Korff MR, Scott KM, Gureje, 2009).