Psychiatry and primary care: can a working relationship develop?

This article explores the relationship between psychiatrists and primary care physicians. Expectations and results of attempts to train nonpsychiatric physicians in the care of the mentally ill are reviewed. The failure of this effort, along with the stigma against psychiatry has led to poor treatment of disturbed patients by primary care physicians. Using other mental health professionals as both educators and clinicians in primary care training programs over the past 20 years has resulted in a different referral pattern system for the mentally ill than for any other group of patients. Although the gap between psychiatry and the rest of medicine has widened, there are models of interaction and cooperation that are explored. The development of consultation-liaison programs has been a most important effort. The need for all of medicine to recognize the relationship between mind and body is stressed.