Social psychiatry

, Volume 17, Issue 2, pp 89–94 | Cite as

Primary care and psychiatry

  • Donald G. Langsley
Psychiatry and Primary Care


Primary care has become the hope of this decade for more effective and less expensive personal health care. The primary care physician may be a general internist, general pediatrician or family practitioner but the concept often focuses on the new specialty of family practice. There has been an impressive increase in the number of young physicians entering this field. A large proportion (20–40%) of patients of the primary care physician have diagnosable psychiatric illness. Recent surveys found that 58% of all visits for mental disorder were made to primary care physicians instead of psychiatrists. Family practitioners do not refer most of these patients to psychiatrists because of dissatisfaction with the lack of collaboration, slow responsiveness in terms of seeing the patients, failure to receive reports and lack of demonstrated effectiveness of psychiatric treatment. Often the family practitioner will treat psychiatric problems himself or will refer to a non-psychiatric mental health practitioner (psychologist or social worker). This paper reviews the interaction of psychiatrists with primary care physicians. It suggests a curriculum for post-graduate and continued medical education about psychiatric illness and discusses styles of more effective collaboration between primary care doctors the psychiatrists. It describes the present and potential difficulties caused by the diversion of hopes for behavioral medicine to become a discipline wherein physicians treat those behavioral disorders which influence physical health. Instead the behavioral scientist may see this new field as a pathway into the hospital from which to seek active medical staff membership and independent admission and treatment privileges. Hopefully, these “turf” and economic issues will get worked out as psychiatrists reaffirm their medical identities, participate with other physicians in hospital staff activities and alter their practice styles so as to contribute to the overall health care of our total society. To do otherwise would deprive patients of needed psychiatric skills.


Primary Care Primary Care Physician Psychiatric Illness Behavioral Medicine Continue Medical Education 
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Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • Donald G. Langsley
    • 1
    • 2
    • 3
  1. 1.Departments of PsychiatryUniversity of CaliforniaUSA
  2. 2.University of CincinnatiUSA
  3. 3.EvanstonUSA

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