Background
The
World Health Organization (WHO) estimates that 350 million people in the world
suffer from mental health illnesses and 121 million people in the world suffer
from depressive disorders (2004). It is estimated that 1 in 4 people will
suffer from mental illness at some point in their lives (WHO, 2004).
Furthermore, it is estimated that about 15% of those with depressive disorders
commit suicide and 60% of those who die by suicide had a primary diagnosis of a
depressive disorder (WHO, 2004).
Drug
treatments have been utilized for the treatment of psychiatric illness for over
100 years. In the 1940’s, mental illness was viewed as irreversible and
individuals suffering from psychiatric illness feared potential for
institutionalized (Callahan & Berrios, 2004). The social stigma of mental
illness has since decreased overtime, however, many physicians still hold bias
towards those with mental illness, particularly depression, understanding it as
a character flaw rather than an illness (Olfson, Marcus & Druss, 2002). Due
to various factors, including the social stigma, an increasing number of
individuals with mental illness have been seeking care from their primary care
physicians. Today, in the United States, around 75% of individuals being
treated with psychotropic medications are being treated by primary care
physicians (Clarke, 2011).
Primary
Care Setting
Primary
care settings may include the following health care physicians: allopathic and
osteopathic physicians, general internists, pediatricians, obstetrician/gynecologists.
In addition, nurse practitioners and physician assistants may also serve as
primary care clinicians. In primary care, clinicians are expected to
comprehensively address the health needs of patients. In the setting, practitioners
often maintain a patient-clinician relationship, provide preventative care, and
address their patients’ health care needs as they arrive during any point of
their lives by either treating the issues themselves, or coordinating care with
specialists.
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