The treatment of mental health and psychological problems in primary care

Mental health concerns have significantly increased worldwide as they impact on individuals and families, society and public health costs, which are very common in the Primary Care sector. The aim of this study is to determine the general practitioner's perceptions in the prevalence of such disorders in Primary Health Care Centres (PHCC), and to explore the features of the treatments administered. Finally, we aim to evaluate the quality of the interventions and the level of implementation of key strategies and national and international recommendations. It is a single group ex post facto retrospective design. To carry out the research, we developed an ad-hoc self-administered survey including the World Health Organization Assessment Instrument for Mental Health Systems and official health documents indicators. This survey was applied to 77 general practitioners in PHCC in Cordoba, Spain. The most relevant results highlighted minor mental health problems (anxiety/depression and psychosocial problems) with a higher prevalence (79.6%) than formal mental health disorders (22.7%). The 43% of the consultations related to demands are directly or indirectly connected with mental disorders. The 23.4% of prescriptions in a typical day at work are psychotropics (sedatives/antidepressants). According to the general practitioners surveyed, 39% of patients treated with psychotropic drugs could solve their problems without taking them. With regard to the interventions, 80% of general practitioners did not work in teams or implement psychoeducational techniques and they did not make any interconsultations from the second level to deal with these problems. The 97.4% of them pointed out that the integration of psychologists in primary care centres would increase the quality of services. In this study, we find there is a contradiction between the treatments offered (based primarily on the administration of psychotropic drugs) and the recommendations made by national and international organizations. We consider that it is also necessary to revise the characteristics and quality of them and to reconsider professionals' profiles, competences and strategies.