J. van Londen: The psychiatrist and primary health care.
In Primary Health Care, the general practitioner follows increasingly the holistic —comprehensive— approach. This implies that he does not restrict himself to purely somatic problems, but takes into consideration the psycho-social problems as well. This means that mental health is part of the duties of the G.P., not on a specialist level of course, but in the generalist's scope.
The question is how to provide the necessary knowledge and skills in primary care. Should the deficiencies of primary care regarding mental health be catered for by psychologists or other disciplines, employed in the primary care system? Or should the primary care workers —i.e. the G.P., the home nurse, the social worker— themselves provide mental health care? Or should these deficiencies be catered by specialized staff from the mental health care system?
The present paper discuses the various ways in which mental health care specialists could assist the primary care workers. The author makes a distinction between medicine and health care and, consequently, between psychiatry and mental health care. It is stated that mental health care is lacking in acceptable theoretical scientific concepts. The description of the duties of the psychiatrist, as established by the Dutch Association for Psychiatry, is submitted to a critical review because of an insufficiently theoretical basis.