Psychologists and physicians help address barriers to improved primary health care

Primary care teams that include both psychologists and physicians would help address known barriers to improved primary health care, including missed diagnoses, a lack of attention to behavioral factors and limited patient access to needed care, according to health care experts writing in a special issue of American Psychologist, the flagship journal of the American Psychological Association.

"At the heart of the new primary care team is a partnership between a primary care clinician and a psychologist or other mental health professional. The team works together to produce a comprehensive, integrated personal care plan for each patient that includes attention to mental and medical disorders, addresses substance abuse issues and incorporates health behavior change," wrote Susan H. McDaniel, PhD, of the University of Rochester Medical Center, and Frank V. deGruy III, MD, of the University of Colorado Denver School of Medicine, in An Introduction to Primary Care and Psychology.

The special issue has 11 articles, co-authored by psychologists and primary care physicians, covering areas including pediatrics, obstetrics and gynecology, palliative care, military service members' and veterans' health services, and care for special needs groups such as people with serious mental illness, refugees and deaf people.

"Improving our national health care system requires strengthening primary care, which covers a large majority of health care needs for individuals and families," said Norman B. Anderson, PhD, APA chief executive officer and American Psychologist editor. "Research clearly shows that psychological, behavioral and social factors are key drivers of health problems seen in the primary care settings. This special issue highlights some opportunities, challenges and successes in incorporating psychology into collaborative integrated health care to achieve truly comprehensive, whole-person primary care."

"The majority of people in the United States receive care for mental disorders, substance use disorders and health behavior problems in the primary care setting," wrote McDaniel and deGruy, who served as the issue's scholarly leads. "Yet primary care professionals have up to this point been poorly equipped to address these behavioral concerns adequately - they diagnose less than one-third of patients so afflicted and provide acceptable treatment for less than half of those correctly identified."