Health Programs

Primary Care Initiative

Research shows that many patients seen in primary care settings in the United States also suffer from a behavioral or emotional health problem such as anxiety, depression, or problem drinking. Yet, primary care physicians often do not have the tools necessary to diagnose or treat patients with mental illnesses. Many cases of depression are incorrectly diagnosed and only a third of patients treated for depression in the primary care setting show meaningful improvement.

As a result, millions of Americans with symptoms of mental illness and addiction continue to suffer, even if they've visited a doctor. Without adequate treatment, people with mental illnesses suffer unnecessarily, impacting job performance and relationships with friends and family.

"This is a hidden crisis in American health care that hasn't really been discussed when we talk about our broken health care system," said Dr. John Bartlett, Carter Center senior project adviser for the initiative. "There is no reason why today, with better parity in insurance coverage and excellent treatment options for primary care settings, anyone with depression or a substance abuse problem should have to go untreated."

Responding to these worrying trends, the Carter Center's Mental Health Program launched the Primary Care Initiative (PCI) in 2008 as a two-year project to increase the early detection and treatment of depression, anxiety, and substance abuse in primary care settings.

By bringing together national leaders, providers, and advocates to address issues of common concern, PCI has facilitated substantive and ongoing discussions and the development of concrete action steps to improve mental health and substance abuse services in the primary care setting. (Read materials from PCI's 2009 Medical Home Summit.) The initiative complements ongoing work of the Center's Mental Health Program to reduce stigma and discrimination against people with mental illnesses and to achieve greater equity for mental health in the health care system.

"At the root of this problem is one of the Carter Center's key issues – stigma," said Dr. Thomas Bornemann, director of the Carter Center's Mental Health Program. "We are very excited about the Center's new role in helping to address this critical aspect of access to mental health care as health reform discussions continue in Congress."