In the years prior to publication, primary health care had been gaining in significance as a setting both for research on mental illness in the general population and for the development of new preventive approaches in this field. The growing need for research had received impetus from the escalating costs of hospital-based health care, the re-structuring of health services in a number of countries, with an increased emphasis on community care and prevention, and the World Health Organization’s ‘Health for All’ campaign, in response to which a growing number of national planning documents had been published. These developments had already stimulated a new interest in the scope for epidemiological and evaluative investigations based on general medical practice. This book, originally published in 1992, consists of selected contributions to the first international scientific meeting on this topic, held in Toronto in 1989. It is made up of five sections, dealing respectively with: the growth and development of a new research field; findings of psychiatric surveys in general practice in a number of different countries; specialist and generalist medical care for mental illness – issues of selection and referral; and specialist aspects of late-life mental disorders encountered in such research. The inclusion of reports from groups of workers in the USA, the UK, the Netherlands, Germany, Spain, Italy, Finland, Canada, Australia and other countries testifies to the rapid spread of interest in these questions. With the exception of the first two chapters, which sketch the background of public-health and general-practice epidemiology, all the contributions are focused on general practice as a field laboratory for study of the occurrence, distribution, diagnostic composition and risk factors of psychiatric illness in unselected populations, and present data, largely unpublished, from the authors’ own projects. These findings confirm the importance of research in general practice as a major growing-point of social psychiatry and provide guidelines for further progress in the years ahead. This book will still be an invaluable source of reference to all psychiatrists, psychologists, general practitioners and health care professionals concerned with mental disorders in the wider community.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

This book is a practical resource that will support the delivery of holistic mental health interventions in the primary and community care setting for older people. Primary care delivery is discussed in relation to both functional mental health problems, such as anxiety, depression, and psychotic and personality disorders, and acquired organic mental disorders of old age, such as dementia, cognitive impairments, and delirium. Careful consideration is paid to the complex relationship between mental and somatic health problems, as well as the impacts of multimorbidity and polypharmacy. Further topics include, for example, epidemiology, wider determinants of health, different care models, history taking, neurocognitive and capacity assessment, and pharmacological, psychological, and physical interventions. The wider goals of the book are to support the development of community resilience and self-care in older people; to promote universal access and equity for older people in order to enable them to achieve or recover the highest attainable standard of health, regardless of age, gender, or social position; and to promote pathways to care for older people with mental health problems respecting their autonomy, independence, human rights, and the importance of the life-course approach. This book will be an invaluable resource for all professionals who work with older adults with mental health problems and those training in these fields including physicians, psychiatrists, family doctors, geriatricians, general practitioners, nurses, psychologists, neurologists, occupational therapists, social workers, support workers and community health and social care workers.

A comprehensive guide to this emerging field, fully updated to cover clinical, policy, and practical issues with a user-centred approach.

An integrated, collaborative model for more comprehensivepatient care Creating Effective Mental and Primary Health Care Teamsprovides the practical information, skills, and clinical approachesneeded to implement an integrated collaborative care program andsupport the members of the care team as they learn this new,evidence-based, legislatively mandated care delivery system. Uniquein presenting information specifically designed to be used in anintegrated, collaborative care workflow, this book providesspecific guidance for each member of the team. Care managers,consulting psychiatrists, primary care providers, andadministrators alike can finally get on the same page in regard topatient care by referring to the same resource and employing acommon framework. Written by recognized experts with broadresearch, clinical, implementation, and training experience, thisbook provides a complete solution to the problem of fragmentedcare. Escalating costs and federal legislation expanding access tohealthcare are forcing the industry to transition to a new model ofhealth care delivery. This book provides guidance on navigating thechanges as a team to provide the best possible patient care. Integrate physical and behavioral care Use evidence-based treatments for both Exploit leading-edge technology for patient management Support each member of the collaborative care team Strong evidence has demonstrated the efficacy of a collaborativecare approach for delivering mental health care to patients in aprimary care setting. The field is rapidly growing, but fewresources are available and working models are limited. This bookprovides a roadmap for transitioning from traditional methods ofhealth care to the new integrated model. Providers ready to move tothe next level of care will find Creating Effective Mental andPrimary Health Care Teams an invaluable resource.

This timely and important work looks at the collaborative health care model for the delivery of mental health care in a primary care setting. This has become the ideal model for the treatment of comorbid medical and psychiatric or psychological disorders. There is also an increased awareness that pharmacological intervention, the most frequently delivered intervention for psychological disorders, is often of limited effectiveness without concurrent specific psychological intervention. The book includes more than two dozen case studies, co-written by clinical psychologists and primary care physicians. It is essential reading for any psychology practitioner in a clinical setting, as well as for health care administrators.

An innovative psychiatry textbook that presents behavioral disorders from the perspective of what is seen in medical settings The goal of Essentials of Psychiatry in Primary Care is not to make psychiatrists out of medical clinicians, but rather, to help clinicians manage common behavioral conditions that most often present in a medical setting. Essentials of Psychiatry in Primary Care seeks to integrate medicine and psychiatry --- as the authors’ systems-based biopsychosocial model proposes. The book identifies physical symptoms as a common mode of presentation of mental health problems and describes how to integrate them with psychological symptoms to make diagnoses of mental disorders. Essentials of Psychiatry in Primary Care also details a behaviorally defined, evidence-based mental healthcare model that can be effectively used in a medical setting. The combined experiences in primary care of the authors --- who specialize in both general internal medicine and psychiatry --- provide the perfect background for a book of this nature. Having trained medical students, as well as internal and family medicine residents since 1986, their experience and research demonstrates the information they outline is effective and associated with improved mental and physical health outcomes.