Wednesday, October 21, 2009

Mental disorders treatable by your family doctor

The World Health Organization's Mental Health Gap Action Programme highlighted through World Mental Health Day recently that mental disorders are treatable and most of them can be treated in primary care, meaning in your family doctor's office or community clinic.

The report says that treatment does not always mean medication and that many mental disorders can be treated using psychosocial methods. A study carried out in China confirmed that epilepsy could be treated with an inexpensive anti-convulsant medicine by health professionals who had undergone basic training.

The catch here is that treating mental disorders in primary care settings is what WHO recommends for developing countries. Why can't the same be true for developed countries? Dr. Abram Hoffer said years ago that schizophrenia could be treated by family doctors. Three years ago I asked our family doctor to take over Chris's care in conjunction with his psychiatrist, and the answer was "no." The answer will still be "no."

If schizophrenia could be treated in primary care settings bolstered with psychosocial interventions it would go a long way to taking away the fear and stigma surrounding this label. I suspect more people would get better because it would "normalize" the situation. The WHO has already reported that the incidence of recovery from mental illness is much greater in the developing world. While it is not the premise of this latest WHO report to analyze why recovery from mental illness in the developing world is more likely than in the developed world, the report confirms why it will continue to be so.

The report can viewed at http://www.who.int/mental_health/mhgap_final_english.pdf

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