ABSTRACT
The literature on primary care mental health has tended to focus on those with common mental health problems and those with psychosis, including bipolar disorder. This chapter addresses different ways of defining this complex group, consider deficits in care, and propose ways in which individual care and the organization of care can be enhanced, using a combination of inferences from the literature, case studies, personal experience and predictions. The 'three Ds definition' is useful for primary and community care because of its emphasis on significant but less severe disability. Several components of care are necessary for managing chronic diseases. These include patient involvement, collaboration with specialist services, an appropriate review function and service redesign to incorporate these features. The medical perspective is important in terms of managing an analysis of the problem with respect to diagnosis, assessing risk and providing medical treatments.
