Psychiatric Diagnosis and Classification - ResearchGate

PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION IN PRIMARY CARE 243
[63], a structured diagnostic interview for DSM-IV and ICD-10 that includes
the Mini Mental State Examination [64], the Equivalent Diagnostic Interview
Schedule for Children [65] and the Child Behavior Checklist [66].
They should be able to administer the Wechsler Intelligence Scale for Children
[67] to any child who has a problem at school. In addition, the psychologist
should be familiar with a range of questionnaires used to identify
symptoms specific to the various mental disorders. Once such self-report
measures are established in a clinic, the practice nurse can administer
and score most of them. In fact, in many practices, clinical information
systems can be used to administer most of the tests used to assess mental
well-being.
Volunteers, NGO Staff and other Multipurpose Care Workers
These people, who often function with people at considerable risk of mental
abnormality, need ways of identifying people who should be referred to
a primary care physician for further assessment. Again, they should be
trained to administer and score the GHQ and the SF-12, and to recognize
when a person's score is above the accepted threshold. Furthermore, because
their clientele are underserviced, they may need some understanding of the
ways that people with the common mental disorders behave. The Management
of Mental Disorders is a very accessible workbook see www.crufad.
org/books) that is published in the UK, Australia, New Zealand and
Canada, with Italian and Chinese language versions in preparation. All
primary care staff, from doctors to care workers, should have access to
this resource.
CONCLUSIONS
We have shown that primary care needs to use a simplified system
of classification, aimed at choosing appropriate management for the individual
patient. The main problems in the development of the mental health
aspect of primary care are finding the time to deal with the sheer mass
of psychological problems in primary care, and training suitable staff in
the specific skills they need to deal with the various problems that are
of high prevalence in this setting. Across the world, many patients can
now be offered treatment where previously no help would have been
forthcoming, and there is a growing appreciation of the contribution
that can be made by other staff, with the doctor responsible for initial
triage.