The extent and course of psychological distress were examined in a representative sample of patients attending a primary health care practice in metropolitan Adelaide where general practitioner (GP) and clinical psychologist services are co-located. Scores for psychological distress were similar to national norms. Approximately one in six patients expressed a wish to discuss their feelings with a GP and/or psychologist, but the association between distress scores and wish to discuss feelings was only moderate. At follow-up 5 months later, average distress scores had fallen. Half of those who had expressed a wish for discussion had done so, and they had significantly lower scores for anxiety and stress. The results provide a context within which subsequent national mental health initiatives can be interpreted. (Contains 3 tables.)