The Introduction of a mental health component into primary health care

Abstract

Outlines a new approach to both the promotion of mental health and the diagnosis and management of psychological disorders. Citing abundant evidence linking psychosocial factors to the causes and symptoms of disease, the book argues for an approach to treatment and prevention that recognizes mental health care as a part of general health care and treats patients with psychosocial problems within the same facilities as those suffering from physical complaints. The book opens with an explanation of reasons why most systems of health care have neglected the emotional needs of patients and ignored the demonstrated impact of psychosocial factors on health and disease. The second chapter defines the scope of mental health care, noting the need to develop skills that can enhance the quality of life as well as aid in the control of disease. Readers are also given a list of the types of mental disorders that are best managed by general health workers. These include such severe disorders as senile dementia and schizophrenia, as well as the more common psychological and emotional disturbances, drug and alcohol abuse, and psychological complications of physical disease or injury. The second and most extensive part of the book outlines the practical steps needed to decentralize mental health care and place the responsibility for prevention within the general health services. Of particular practical value is a chapter, concerned with the infrastructure for decentralization, which defines the specific mental health tasks that can be performed by clinic-based health workers, by specialized medical personnel, and by psychiatrists working in hospitals and institutions. The remaining chapters cover principles for training disease-related and psychosocial skills, the priority conditions that should be handled at the primary level whenever possible, the essential drugs required for treatment at the primary level, methods of data collection to support programme development, and the financial savings that can be expected when mental health services are decentralized