New research shows the demand for mental health support in primary care

Primary can and mental health demand: ©Raymondorton - stock.adobe.com

In primary care, physicians are important to treating all common health conditions, providing preventive care, health education to patients, and even referrals to specialist treatment. However, many primary care physicians (PCPs) feel inadequate in terms of delivering care for patients in need of psychiatric services, even though they are often the first point of contact for navigating mental-health care.

Currently, many efforts are being made to strengthen primary care aim to address mental health and make physical and psychiatric care a reality for all patients. In order to find new ways to integrate this care into health care systems around the world, researchers from Nature Mental Health recently analyzed Norway’s nationwide administrative primary care records, pulling all doctor-patient encounters over 14 years from 2006 to 2019.

In Norway, cost barriers do not generate bias of individuals who seek care, with all residents being assigned a PCP. Researchers believe this is the only nationwide source of data about primary care settings with complete coverage of the entire population of a nation.

The data used allowed researchers to estimate how much of a PCP’s work is devoted to addressing mental health, the volume of the different types of mental health conditions that PCPs are asked to address, the volume of mental health conditions that PCPs work with at different stages of their patients’ lifespan, and to compare estimates of PCPs’ mental health encounters against estimates of encounters for other medical conditions.

Results showed that nearly half of the 4,875,722 people registered with a PCP between 2006 and 2019 came to a PCP for a mental health condition, which was recorded by their PCPs. Patients experienced psychological difficulties, such as depression and irritability and anger. Additionally, children were most likely to go to primary care for sleep disturbances and continence issues and ADHD, while young and middle-aged adults went for depression. Older adults sought treatment for memory difficulties and sleep disturbances.

Of all primary care encounters, 11.7% had a mental health condition. Interestingly, 1 out of every 11 mental health visits were unspecified and coded by PCPs as psychological symptoms or complaints or “other” disorders. PCPs also experienced two to nine times more mental health encounters than encounters for conditions in every other body system and for common disorders ranging from circulatory disorders to cancer.

Overall, this research had three main takeaways. First, the volume of mental health encounters in primary care practices in Norway is large, with one out of every eight or nine encounters with a PCP being for a mental health concern. Second, mental health encounters in primary care are not only limited to a few of the most common mental health conditions. Third, mental health encounters are generated by patients at every stage of the lifespan.

Researchers hope the results of this study will further normalize mental health help-seeking in primary care outside of Norway, as it is becoming a critical area of concern as more PCPs are in demand to help combat and provide resources for patients with mental health conditions.