Improving the psychiatric knowledge, skills, and attitudes of primary carephysicians, 1950-2000: A review

Objective: The authors reviewed the literature on mental health education f or primary care physicians and made recommendations for the design of educa tional programs and research. Method: They searched the MEDLINE and PsycLIT databases from 1950 to 2000 b y using a variety of key words and subjects. Results: More than 400 articles were identified, ranging from empirical stu dies to philosophical articles. Many identified a perceptual gap between pr imary care and psychiatry as the basis for problems of contextual relevance in psychiatric education for primary care practitioners. There were few em pirical studies; most reported only results of satisfaction surveys or simp le tests of knowledge. Longterm outcomes were less positive; there were imp ortant negative findings. Conclusions: An extensive literature published over five decades identified a strong need for ongoing mental health training for primary care physicia ns. Helpful recommendations exist related to objectives, methods, and evalu ation. However, there are organizational and attitudinal issues that may be equally or more important for educators to consider than the selection of educational methods.