Primary Mental Health Care

Although psychological science has contributed enormously to our understanding of the development of psychopathology and to interventions to treat psychiatric disorders, it has not successfully reduced the burden of mental illness in American communities. Factors include the lack of a mandate of population impact, stigma attached to mental health intervention, difficulty scaling up interventions, and problems in financing prevention. The concept of primary mental health care is introduced as a possible solution; components could include universal reach, universal brief interventions, screening and referral, ongoing support to all individuals, an infrastructure of specialized services, and an integrated data system. Promising examples of the primary mental health care approach are described, including PROSPER, Communities That Care, Triple P, Family Check-Up, HealthySteps, Family Connects, and Community Navigation. For these efforts to succeed, challenges must be overcome in labor force participation, reaching the full population, novel approaches to delivery of interventions, cultural adaptation, community-level interventions, financing, and scientific inquiry.