The introduction of a mental health component into primary health care.
Despite the interplay of physical symptoms and psychosocial distress, both the training of health personnel and the delivery of health care have failed to attend to mental health problems. The introduction of a mental health component into primary health care can reduce patient dissatisfaction, chronicity, and wastage of resources. With appropriate supervision, health personnel can detect and treat drug and alcohol abuse, chronic mental illness, acute emotional stress arising from life crises, and developmental disorders of childhood and adolescence, for example. To ensure coordinated action by governmental bodies and nongovernmental organizations, a statement of national mental health policy should be issued and a coordinating group established. Also essential is community involvement in the identification of local mental health and psychosocial problems. Training programs should emphasize practical skills such as counseling techniques, empathic listening, simple methods of assessment, and referral. Although not all priority mental health conditions require drugs, antiepileptic, antiparkinson, and psychotherapeutic agents should be available at health centers. In the short-term, additional expenditures will be required for staff training, essential drugs, and establishment of a national coordinating unit; however, these costs will be balanced by savings incurred through the rapid detection of mental disorders that underlie physical complaints and the transfer of mental patients from specialty hospitals back to the community.