Title: Should Mental Health Be a Primary-Care Doctor’s Job? | The New Yorker
Headings: Should Mental Health Be a Primary-Care Doctor’s Job?
Should Mental Health Be a Primary-Care Doctor’s Job?
Video From The New Yorker

Content: Or the businesswoman whose therapist told her to see me about starting an antidepressant? Or the civil servant trying to shake his Oxycontin addiction? They’ve all asked me to treat them because they don’t want or can’t easily access psychiatric care. This winter, I’ll see more patients with seasonal-affective disorder than the flu, and the tissues in my exam room will dry tears more often than they muffle sneezes. The problem is, I lack the time or training to diagnose and manage many psychiatric disorders. And some studies, such as this one about low rates of detection of anxiety and depression by primary-care doctors, show that I’m probably not all that great at doing so. Still, over a third of all mental-health care in the U.S. is now provided by primary-care doctors, nurse practitioners, pediatricians, and family practitioners. One reason is that there aren’t enough psychiatrists. I recall discussions, fifteen years ago, among members of my internal-medicine group about whether it was ethical for us to prescribe antidepressants when we practiced in a hospital with dozens of mental-health professionals on staff. We no longer have those discussions.