par Amiel, Roger
Référence Social Psychiatry, 17, 2, page (67-75)
Publication Publié, 1982
Article révisé par les pairs
Résumé : Demographic change and economic recession, with increasing numbers of vulnerable subjects and progressively more severe forms of social pathology, have necessitated revision of most health and social policies over the last decade. Contributions from research have included data on the extent of illness (prevalence rates), the nature of health care demands (using inception rates) and the response to demand (treatment rates). Conceptually the need is to move beyond statistical concepts of morbidity and mortality towards a more dynamic view of individual responsibility for health. Hospital-centred overprotection is being reduced in favour of health care closer to the population, either in their homes or in polyclinics. The notion of treatment is being replaced by that of prevention, with the medical role being more closely related to that of social and political leaders. Consumer satisfaction is not a sufficient guide to progress, and objective evaluations of therapeutic efficacy and of cost effectiveness are necessary. Primary care must become more efficacious and psychiatry less institutionalised. The psychiatrist may thereby devote more time to specialised techniques while the general practitioner can give more attention to high risk groups. This paper seeks to define the place of primary care physicians and the help they can gain from certain diagnostic tests and indicators of mental health.