Integrating Mental Health Into Primary Care. A Global Perspective

Abstract

Integrating Mental Health Into Primary Care. A Global Perspective WHO and Wonca (World Organization of Family Doctors) (2008) Geneva, Switzerland: WHO Press. vii + 206 pp. Softcover $40.00. The integration of mental health and primary care services has persisted as a goal of governmental health systems, despite a record of spotty achievement, for well over half a century. In the United States for example this was a hoped for outcome of the community mental health center movement with its emphasis on mental health consultation aimed at avoiding unnecessary hospitalization. The appearance of this multiauthored volume presenting “the justification and advantages of providing mental health services in primary care” has, therefore, a somewhat nostalgic and dated tone. Its relevance to the still developing world, however, is worth re-emphasizing. The book notes the numbers of untreated mentally disordered patients who present in primary care settings, the clinical and economic advantages of care close to home rather than in isolated mental hospitals (where patients’ human rights may be violated), the importance of incorporating mental health into health policy and legislative frameworks, and of coordination with a network of services at different levels. Despite the bureaucratic presentation the clinician reader will be informed about recently planned, and sometimes seemingly idealized integrated services in 12 countries covering all regions of the globe. Several case histories suggesting remarkable improvements in seriously ill individuals bear careful reading. The opportunity for outpatient care with an empathic therapist, often a consequence of integrating mental health and medical services, seems to be the key ingredient in many such integrated services.