IS THE LABELLING OF COMMON MENTAL DISORDERS AS PSYCHIATRIC ILLNESS CLINICALLY USEFUL IN PRIMARY CARE?

The present study has been carried out to examine the concepts of Common Mental Disorders held by primary health care providers in Goa. Ethnographic interviews and focus group discussions with primary health care (PHC) staff (n=33) and traditional healers (n=12) were done. Responses relating to the recognition and nature of case vignettes of depression, panic and agoraphobic disorder and multiple unexplained somatic symptoms and open-ended questions about mental illness were elicited. PHC staff recognised the somatic vignette frequently while the phobic vignette was rarely recognised. Both the somatic and the depression vignettes were related to non-somatic aetiologies frequently; Hindu spiritual healers used supernatural explanations while Catholic priests used psychological and cognitive models. Treatment was either religious/spiritual or psychological respectively. Implications for training and service included closer links between psychiatry and community medicine and avoiding the use of complex classification systems in primary care.