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Interpreting scores from a screening tool like the PHQ relies on comparing an individual’s results to reference data from a similar population. If there are no Australian norms, clinicians don’t have local benchmarks to judge how a person’s score fits within the Australian population, which makes it harder to determine depression severity accurately or track changes over time for Australian patients.

That’s why the listed drawback is the absence of Australian norms. The PHQ-9 is designed to be quick to administer, so the idea that it takes too long isn’t accurate. Having Australian norms would be helpful (not a drawback), and copyright status isn’t typically cited as a primary limiting factor in practice.