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New pocket manual of psychiatry for primary care physicians

November 2, 2011 – A new manual from the Centre for Addiction and Mental Health provides up-to-date and rapidly accessible information in a Canadian context for those physicians and other primary care providers who are on the front lines of caring for people with mental illnesses and addictions.

Canadians with mental health problems and illnesses as well as substance use problems go to primary care clinicians more than to any other professionals. As the first point of contact, clinicians find that stigma, constraints on time, knowledge of available services and access to specialized referrals can all be barriers to care. Psychiatry in Primary Care helps mitigate these issues, focusing on practical approaches to improved understanding, reliable diagnosis and effective treatment .

“One crucial step is to work better with primary health care providers to close the gap between primary care and mental health services,” said Dr. David Goldbloom, Senior Medical Advisor at CAMH and co-editor of the pocket guide. “General practitioners and other primary care providers have an integral role to play in mental health treatment; the challenge has always been providing the resources and knowledge to help bring the two spheres of primary care and psychiatry closer together.

Goldbloom noted that open and honest communication between patients and primary care clinicians is also an important factor in receiving proper care. “We know that stigma and the fear of being discriminated against can prevent people from disclosing possible problems to their general practitioner,” added Dr. Goldbloom. 

“If family doctors are able to initiate the conversation, their patients may feel safer to seek help. The goal is a system where patients feel as comfortable going to their primary care physician for mental health concerns as they do for physical health issues.”

This manual was conceived and organized with the extensive input of an advisory group of family physicians. Accordingly, the book is short on theory and long on practicality and the reality of primary care. Chapters cover topics such as depression, anxiety, somatization, psychosis, substance abuse, eating disorders, personality disorder, dementia, sleep disorders and attention deficit disorder. They also address issues in dealing with suicide, child and adolescent psychiatry, perinatal disorders and parenting challenges, disability and insurance claims, and psychotherapy. Newer approaches to improving collaboration between primary care and psychiatry as well as the emerging role of supported self-management are also summarized.

The format of the manual is focused on practicality; it includes how to make a diagnosis in a reasonable period of time, how to initiate evidence-based treatment, what is reasonable to expect of a primary care clinician, and when to refer to a specialist.

The manual, co-edited by Dr. David Goldbloom, Senior Medical Advisor at CAMH and Dr. Jon Davine, psychiatrist at McMaster University, features contributions by leading psychiatrists and other mental health experts from across Canada. For more information about Psychiatry in Primary Care: A concise Canadian pocket guide or to order online, please visit the CAMH website.

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