ABSTRACT
Primary care has become the centrepiece of programmes for managing mental health problems. Recent studies have found that 10 per cent of the general population consult their general practitioner (GP) for a new illness, and that one out of five of such consultations can be attributed to the presence of mental illness. However, less than 50 per cent of psychiatric disorders are detected by the GP, and only a minority of patients is ever seen by a mental health specialist. In addition, it has been recently established that the disabilities generated by mental illness are as severe, or even more so, than those derived from major medical conditions (Murray and Lopez, 1997). These findings have contributed to a renewal of research interest in this field, and stimulated the development of epidemiological studies and programmes focusing on the management of mental illness by the GP. In order to explore how these aims are achieved, we will analyse the epidemiology of mental disorders in both the community and primary care, following Goldberg and Huxley’s innovative model (1980) which describes the extent and nature of mental illness in the community and in the different levels of care. We will, therefore, analyse in this chapter: the distribution of psychiatric morbidity in the general population; the process of establishing medical contact with the GP; the characteristics of mental illness in primary care services; and the detection and management of mental illness by the GP.
