Chances are you’ve made visits to a Primary Care Physician (PCP) many times for physical concerns, but did you know your PCP can also support your mental health?
In addition to treating physical symptoms, PCPs can screen for and treat a variety of mental health conditions and even provide ongoing support. We talked with Lillian Holloway, MD, FAAFP, a PCP at Arise, to get her insights as to what mental health support PCPs can provide, who this support is appropriate for, and how to access this sort of care.
What sort of mental health support can PCPs provide?
PCPs can provide an array of behavioral health support including screening for and treating depression, anxiety, PTSD (Post-Traumatic Stress Disorder), substance use disorders, peripartum mood disorders, eating disorders, and intimate partner violence. Dr. Holloway notes that many of her patients “have complex mental health needs, and primary care providers are often part of a multidisciplinary team to provide those patients with treatment and support.” These treatment teams can include therapists, psychiatrists, and other types of specialists.
Dr. Holloway mentions that because PCPs often are addressing multiple long- and short-term conditions in one brief visit, addressing solely behavioral health issues can be challenging; however, when appropriate, a PCP will often suggest follow-up visits where only the behavioral health concern will be addressed.
In addition to single appointments, PCPs can even provide ongoing mental health support for conditions such as depression, anxiety, postpartum depression, and substance use disorders. Ongoing treatment for these issues through primary care providers “allows for increased access to care, especially in communities where specialists are scarce,” says Dr. Holloway.
Can I receive a mental health diagnosis and medication from a primary doctor?
Of course! Primary care providers prescribe 79% of antidepressant medications and see 60% of people being treated for depression in the US. Dr. Holloway notes that the close relationships PCPs have with their patients create environments that encourage clients to speak up about whatever challenges they’re facing and often makes them uniquely equipped to first detect mental health symptoms. “We also are keenly aware of how chronic conditions such as heart disease, chronic pain and menopause for example can affect a person’s mental health,” she said.
Dr. Holloway added that family physicians pride themselves on following their patients from youth to adulthood and in all scenarios and locations from well-child visits in the clinic, to delivering babies, to attending to the elderly during home visits. “That continuity of care allows for patients to feel safe in discussing symptoms that often make them feel vulnerable.”
Although PCPs are uniquely equipped to screen for and diagnose many common mental health conditions, more complicated needs should be referred out to a specialist. Your PCP can work with you to determine when a referral is necessary.
When should I contact a therapist or psychiatrist rather than my PCP for mental health support?
A PCP is a great place to start when it comes to mental health concerns because they can help assess the severity of your symptoms and will refer you to a therapist or psychiatrist if appropriate. PCPs can also help patients distinguish between physical and mental health symptoms such as fatigue, poor concentration, and sleep issues.
Dr. Holloway notes that therapists are vital members of the mental health treatment team in addition to PCPs or psychiatrists. Therapists often delve into deeper reasons for mental health symptoms and can provide resources and help identify coping mechanisms. Although medications can provide relief from many symptoms of depression, anxiety, and other conditions, the combination of medication and therapy is usually recommended for deeper and longer-lasting improvements.
When it comes to psychiatrists, Dr. Holloway told us that referrals are often made for patients who have a complex mental health diagnosis or a diagnosis that requires more frequent monitoring and combinations of medications, such as bipolar disorder or schizophrenia. She notes that psychiatrists are often consulted when patients have multiple diagnoses, when medications do not seem to be working for a patient, or when multiple medications are required.
How can I request mental health support from my PCP?
Don’t be surprised if it is your PCP that brings it up to you! Dr. Holloway shares that screenings for depression, anxiety, alcohol and substance use, eating disorders and trauma are frequent standardized scales that are included in the paperwork that you fill out before your visit. These screenings are also often a routine part of well-child, well-adult and prenatal/postpartum visits.
In addition to these screenings, you can also bring your symptoms up during any of your visits or make an appointment just to address your mental health needs. “PCPs want to take care of the beautifully complex person that is you,” shares Dr. Holloway.