Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process
Abstract
The assessment of undifferentiated psychological distress is a daily aspect of primary care practice. Primary care practitioners' underlying values influence the priorities, process and content of assessment. Currently there is a lack of definition of these values in primary care clinical mental health assessment. This paper presents the case for adopting the philosophical values and principles of holistic transdisciplinary generalism to influence practice worldwide. Furthermore, it raises awareness of current constraints on practice, including an overreliance on the psychiatric paradigm of care and resulting criteria-based diagnoses. Finally, the paper seeks to promote discussion among primary care practitioners and researchers globally about how to define primary care clinical mental health assessment priorities, process and content.
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GPs are well versed in supporting people through life's common stressors, empowering patients to adapt and grow from adversity through long-term therapeutic relationships.
“GPs are well versed in supporting people through life's common stressors, empowering patients to adapt and grow from adversity through long-term therapeutic relationships. 25”
From Understanding and managing psychological distress due to climate change (2023) · cites this paper as [25]
Cites
Handbook of Posttraumatic Growth
(2014) · Routledge · doi:10.4324/9781315805597 · Cited by 1,078 · cited 1× · see citing works
“In all of these areas, generalist primary care would do well to look for strengths and resilience and growth as well as disorder (e.g., Blanch, 2007; Calhoun & Tedeschi, 2006; Haggerty et al., 2009; Mikulincer, 1995; Neimeyer, Herrero, & Botella, 2006; Schore, 2003).”
BackgroundViolence in the family as a disorder of the attachment and caregiving systems
Bowlby, J. (1984) · The American Journal of Psychoanalysis · doi:10.1007/bf01255416 · Cited by 262 · see citing works
The survival of psychiatric diagnosis
Pilgrim, D. (2007) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.03.054 · Cited by 156 · cited 1× · see citing works
“Despite all this debate, use of the psychiatric diagnosis as gold standard has persisted (Pilgrim, 2007), and the practice of those primary care practitioners who do not adhere to this standard is declared not conventionally evidence based (Small, 2003).”
BackgroundAdjustment disorders: Fault line in the psychiatric glossary
Casey, P., Dowrick, C., & Wilkinson, G. (2001) · British Journal of Psychiatry · doi:10.1192/bjp.179.6.479 · Cited by 153 · see citing works
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Understanding and managing psychological distress due to climate change
Seth, A., Maxwell, J., Dey, C., Le Feuvre, C., & Patrick, R. (2023) · Australian Journal of General Practice · doi:10.31128/ajgp-09-22-6556 · Cited by 20 · see citing works
- Authors
- Lynch, J. M., Askew, D. A., Mitchell, G. K., & Hegarty, K. L.
- Affiliations
- The University of Queensland (AU)
- The University of Melbourne (AU)
- Corresponding author
- Lynch, Johanna M.
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 74
- Issue
- 2
- Pages
- 143-149
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2164773706
- Cited by
- 23
- References
- 4
- Citations by year
- 2025: 2 · 2023: 2 · 2021: 3 · 2020: 3 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 4 · 2012: 1
- FWCI
- 2.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Australian Government
- University of Queensland
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- primary care mental health, clinical evaluation, psychological distress, psychiatric paradigm, diagnostic criteria, assessment process
- MeSH terms
- Communication, Health Priorities, Humans, Mental Health, Physician-Patient Relations, Primary Health Care, Quality of Health Care, Stress, Psychological, Time Factors
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