THE RELATIONSHIP BETWEEN PRIMARY-CARE AND PSYCHIATRY - AN OPPORTUNITYFOR CHANGE

The past two decades have seen the development of a symbiotic relation ship between primary care and psychiatric services. The changes which have taken place, however, have been piecemeal and variable in their e xtent. With some exceptions, they have followed an empirical route, an d have come about largely because individual practitioners intuitively felt that they yielded positive results or attractive patterns of wor king. For the most part, they have not followed the elaboration of a s pecific theory and although a great deal of subsequent research has be en carried out in order to analyse their benefits and limitations rout ine practice has been slow to change. The recent reorganization of the health service has yet to exert an appreciable effect on the relation ship between the two disciplines. Owing to the newly developing struct ures and patterns of care, future change is inevitable and brings with it both opportunities and dangers. This paper sets out some of the ar guments in favour of a new contract between psychiatry and primary car e based on an equal partnership.