Mental health services in primary health care: yet another era of disillusionment?
Amid the ruins of a mental health care delivery system chronically beleaguered by inadequate planning, financial support, or public consensus, efforts to integrate mental health services with the health services of primary care physicians are considered the best hope to improve access to mental health care. Despite a high prevalence of mental disorder in their patients, most primary care physicians do not recognize, formally diagnose, or treat emotional disorders. Significant personal, professional, and economic issues may compromise effective mental health care delivery in underserved areas, especially poor access to continued medical education and professional support resources. The thrust to provide primary care manpower is at the expense of core health professional training in other needed specialties, including psychiatry. Comprehensive planning for mental health services to underserved populations must consider the shortage and maldistribution of psychiatrists, requirements for professional team and liaison support for effective mental health care delivery by primary care physicians, access to continuing education, and reimbursement for appropriate mental health services. Increasing the mental health role of primary care physicians may otherwise amount to no more than a shift in the locus of expected care delivery.
D005194:Family Practice; D005544:Forecasting; D008605:Mental Health Services / Q000639:trends*; D010821:Physicians, Family; D011320:Primary Health Care / Q000639:trends*; D011570:Psychiatry / Q000639:trends; D014481:United States