Implications of the World Health Organization study of mental illness in general health care for training primary care staff.

A substantial international study of mental disorders seen in primary care settings has shown that there are marked differences in prevalence between centres. Detection of mental disorders is better in centres using a 'personal' style of clinical service, and where there has been close collaboration between psychiatrists and general practitioners. However, even in the better centres, substantial numbers of mental disorders are missed and treatment often appears to be given regardless of diagnosis. It is argued that changes need to be made to the way in which both undergraduates and vocational trainees are taught about mental disorders, so that teaching emphasizes the psychological syndromes that general practitioners are likely to meet in their everyday work. Training packages need to be developed for primary care staff in the detection and management of mental disorders.