The first purpose of this study was to examine the variables related to the diagnosis of a depressive disorder and associated with referral to a mental health clinician. The second purpose was to examine the level of agreement of the primary care provider's diagnosis of depression with that of the mental health clinician. The design was a retrospective, case-control study (n = 162). Data were analyzed with descriptive statistics and logistic regression. Referred patients tended to be Caucasian, middle-aged or older men who had a history of depression, were experiencing depressive symptoms and/or an acute or chronic stressor, had a diagnosis of cardiovascular disease or cerebrovascular accident, and were taking a greater number of medications. Mental health clinicians agreed with the primary care clinicians' diagnoses of depression 76% of the time. Primary care clinicians accurately diagnosed depression for the majority of patients and appropriately referred them for psychiatric care.