A significant part of being a primary care practitioner is dealing with people’s mental health. Approximately 15 to 50 percent of patients encountered in primary care have mental health problems that are either primary in nature or secondary to physical illness. Many of these patients are seen exclusively in the primary care setting and do not see mental health care specialists at all. This reality underlines the important role that primary care practitioners play in delivering mental health care to communities.
A unique role in delivering mental health care
Primary care practitioners are in an ideal position to get at mental health problems because they have a long-term relationship with their patients. Most people see a primary care practitioner at least once a year, and because of the established relationship and the trust that evolves, they may be more likely to share mental health concerns.
Unfortunately, detection rates of mental disorders in primary care remain low, for various reasons: Limited time is available for each appointment. Patients experiencing mental health problems often have a somatic presentation, and it is this presentation, not the mental health problems, that may be considered a valid “ticket of admission.” Detection is also hindered by the stigma of psychiatric illness, which can make patients reluctant to discuss their problems.
In The Art of the Brief Psychiatric Interview in Primary Care