Integrating Mental Health into Primary Care

Article excerpt

Each year, the month of October brings the World Federation for Mental Health's World Mental Health Day, and this year's theme emphasizes enhancing treatment and promoting mental health by collaborating with primary care.

We know that few of those with mental illness receive even the most basic treatment. Mental illness affects hundreds of millions of people, and if left untreated, can cause deep suffering and economic loss. Considering the worldwide shortages of mental health professionals and the stigma our patients face, the only effective option is the integration of mental health into primary care.

This strategy was endorsed last year in a report by the World Health Organization (WHO) and World Organization of Family Doctors (Wonca).

Mental health must be connected with the network of services at different levels of care, complemented by broader health system development. The position of WHO and Wonca is that for every family, there should be a family doctor. For family doctors to be effective, they should have access to a full spectrum of specialist services in community and hospital settings.

Through primary care services, many objectives that we psychiatrists care about can be met, such as early identification of mental disorders, treatment of common mental disorders, management of stable psychiatric patients, referral to other specialists deemed appropriate by the primary care physician, attention to mental health needs of people with physical health problems, and mental health promotion and prevention.

Local hospitals would be a key part of this strategy and should adhere to clear policies and guidelines that support the treatment and management of mental disorders within a framework that promotes human rights and uses evidenced-based guidelines.

Community-based services such as day centers, rehabilitation services, hospital diversion programs, mobile crisis teams, therapeutic and residential supervised services, group homes, home help, and other support services can become a safety net by preventing relapses among those who have been discharged from hospitals. …

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