A health services perspective on delivery of psychiatry services in primary care including internal medicine

There exists a tremendous need for integrated medical and psychiatric services in our health care delivery system. Primary care services have forged an important link in the mental health care system in our country; yet, serious problems persist in the rt cognition and treatment of psychiatric problems in primary care despite multiple interventions directed at correcting these problems. To be embraced by primary care providers, psychiatric screening instruments directed at recognition need to be streamlined tremendously. Publication of evidence-based guidelines and physician education, although important, are probably insufficient to implement guidelines-based care. Broad-based changes in health service delivery will be required to bring out meaningful, effective change.