FUTURE-DIRECTIONS IN PRIMARY CARE MENTAL HEALTH RESEARCH

The United States, unlike England, has made limited advances in investigating the mental health role of health care providers and in contrasting the mental health services delivered by other health care providers with those delivered by mental health specialists. This is not the result of lack of attention, but of a limited and unorganized focus. Although there has been an active tradition of research and work in psychosomatic medicine, until recently the lack of adequate data systems and the nonavailability of organized health services such as health maintenance organizations with registered populations have hindered such research. Methodological problems are still an issue in the study of nonorganized and private practice settings. Research studies and methodologies need to be developed to investigate the following major areas: (1) the prevalence - actual, identified, and treated - of mental disorder in the primary health sector; (2) the specific mental health services provided by PCPs in the primary health care sector; (3) the interface between primary health care services and services provided by the specialty mental health sector. The purposes of this paper are to identify research areas, to review briefly what has been learned to date, and to delineate further issues requiring investigation.