Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process

The assessment of undifferentiated psychological distress is a daily aspect of primary care practice. Primary care practitioners’ underlying values influence the priorities, process and content of assessment. Currently there is a lack of definition of these values in primary care clinical mental health assessment. This paper presents the case for adopting the philosophical values and principles of holistic transdisciplinary generalism to influence practice worldwide. Furthermore, it raises awareness of current constraints on practice, including an overreliance on the psychiatric paradigm of care and resulting criteria-based diagnoses. Finally, the paper seeks to promote discussion among primary care practitioners and researchers globally about how to define primary care clinical mental health assessment priorities, process and content.

► At present there are important aspects of personal experience missing from primary care mental health assessment.
► Clinical mental health assessment in primary care should not be limited to symptomatic pathology or disordered behavioural responses.
► Transdisciplinary generalism could be a guiding principle in defining priorities, content and processes in primary care clinical mental health assessment.