Improving the psychiatric knowledge, skills, and attitudes of primary care physicians, 1950-2000: a review.

OBJECTIVE The authors reviewed the literature on mental health education for primary care physicians and made recommendations for the design of educational programs and research. METHOD They searched the MEDLINE and PsycLIT databases from 1950 to 2000 by using a variety of key words and subjects. RESULTS More than 400 articles were identified, ranging from empirical studies to philosophical articles. Many identified a perceptual gap between primary care and psychiatry as the basis for problems of contextual relevance in psychiatric education for primary care practitioners. There were few empirical studies; most reported only results of satisfaction surveys or simple tests of knowledge. Long-term outcomes were less positive; there were important negative findings. CONCLUSIONS An extensive literature published over five decades identified a strong need for ongoing mental health training for primary care physicians. Helpful recommendations exist related to objectives, methods, and evaluation. However, there are organizational and attitudinal issues that may be equally or more important for educators to consider than the selection of educational methods.