The Quality of Mental Health Services in an Organized Primary Health Care Setting

摘要

This study provided an estimate of the prevalence of specific mental disorders among patients in an organized health care setting (the Marshfield Clinic in Wisconsin) using different methods of assessment including primary care physician (PCP) diagnosis, a general health questionnaire (GHO) and a standardized psychiatric interview (SADS-L) employing research diagnostic criteria; assessed the validity of the PCP diagnoses; assessed patient functional status; and assessed the use of services in relation to presence or absence of diagnosed mental disorder. One of the study's most striking findings was the discrepancy between the point prevalence of mental disorder based on the standardized psychiatric interview (about 27%), compared with that based on primary care physician recorded diagnosis (2%) or based on the PCP recorded diagnosis in conjunction with other information recorded in the medical record (5%).