What the Wall Street Journal Got Wrong About Mental Health Care

Primary care doctors can play a key role in helping people find the help they need

In a recent piece in the Wall Street Journal, Gurpreet Dhaliwal, MD, argues that generalist physicians are so pressed for time they should not be called upon to consider the mental health of their patients. His position that there "isn't enough time in the current system for generalist physicians to address complex psychiatric conditions" is true, but it misses a critical opportunity.

In the 12 minutes most primary care doctors spend with a patient at each appointment, they would be remiss if they neglected to screen for health risk factors, such as smoking or high blood pressure, even though doing so might require specialist care that's beyond a generalist's scope. Screening for mental illness is just as significant.

Depression is more common than AIDS, cancer, and diabetes combined, and nearly 400,000 people attempt suicide in the United States every year.

A dichotomy between mental and physical health stigmatizes those suffering from mental health issues, when in fact a simple screening and referral from a trusted generalist might be the very key to providing necessary care and relief.

We completely agree with Dr. Dhaliwal that the key to quality mental health care is an abundance of well-trained providers. But even if referral options are not as robust as they should be, primary care providers must not wait to ask about a patient's mental health until that ideal becomes a reality.

In fact, there has been an increasing awareness of the value of primary care screening for mental health issues; a number of states have recently passed mental health screening legislation compelling, for instance, OBGYN and pediatricians to screen new mothers for postpartum depression.

No one is asking generalists to be psychiatrists, just as we do not expect them to be oncologists or cardiologists. But what we need is a willingness to undertake the same screening “first steps” to safeguard the health of our community.

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