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: 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. Demand by patients for mental-health care has increased such that if primary-care doctors didn’t offer it, many people would go without it. It’s estimated that seventy per cent of a primary-care doctor’s practice now involves management of psychosocial issues ranging from marriage counselling to treatment of anxiety and depression. Some argue that the increased demand is artificial, driven by overdiagnosis of mental illness and overuse of psychiatric medications. With one in four adults and one in five children currently carrying a psychiatric diagnosis—and one in five Americans taking psychiatric medications regularly, such skepticism seems warranted. Regardless, access to psychiatric care is nowhere near large enough to meet the growing demand.