Have you ever heard that old saying, “The more things change, the more they stay the same?” This definitely applies to the ever-fluctuating connection between psychiatry and primary care. As we see more and more therapy-related scenarios play out in primary care offices across the globe, there still seems to be a barrier.

Imagine a wide cavern, with therapists, psychiatrists and other mental healthcare professionals all on one side. On the other, envision physicians, nurses and administrative personnel who play numerous roles in ensuring that we all stay healthy. Yet, somewhere in the middle, wouldn’t it be fantastic if these two healthcare facets could assist one another? Could they achieve even more success in patient outcomes along the way?

At Mentegram, we can clearly see the type of bridge that needs to be built. Fortunately, more and more clinicians are realizing this as a reality in their own practices, as well. Yet, it is extremely exciting when major organizations not only recognize the changes that need to be made within the system, but they actively work to educate other professionals.

PsychU is a community that is made up of mental health professionals who are absolutely dedicated to the improvement of healthcare. In achieving this, they provide information, set up discussions and find innovative new ways for interested individuals to collaborate. In a recent webinar, they did just that.

Entitled “Bridging the Gap Between Primary Care & Psychiatry in the Treatment of MDD”, this webinar showcases three speakers (Venus Miller, MSN, ARNP, FNP-BC, PMHNP-BC, Roland Larkin, PhD, NP and Kimberly Lonergan, RN, MSN) who share their knowledge of the best ways to build a deeper connection between mental healthcare and primary care.

Even though many of us know the figures, sometimes seeing them filter across a presentation at a slideshow really sends the message home. Take a look at these percentages for illnesses that are accompanied by depression:

  • High blood pressure 24%  
  • Asthma 17%  
  • Diabetes 9%  
  • Heart Disease 7%  
  • Stroke 3%

On the other end of the spectrum, depression makes up 5 to 10% of the reasons people are seen at a primary care clinic. Yes, that’s right, seeing your PCP (primary care physician) is not just for flu symptoms or migraines! In fact, 79% of antidepressant medications are prescribed by a health professional, and 60% of people with depression are seen by a PCP.

The idea of seeing a primary care professional for mental health disorders will even be more successful depending upon the attitude of the physician and how the patient is responding to the care. However, there are a few things that are currently standing in the way of closing this gap.



  • The attitude of the physician plays a key role in a successful outcome, especially how open they are to discussing mental health disorders. If a physician has a difficult time asking the hard questions, then the answers they receive will not paint a very clear picture.
  • The time that a physician has available for mental health issues will play a key role. If there’s only a moment for, “Hi, how are you feeling?”, then it will be extremely difficult to gather the information that is needed to set forth a treatment plan.
  • It is not only important to ask the right questions, but to document them in a way that saves everyone time, while still providing the patient a chance at the best care possible. The physicians must set a plan in motion that involves screening patients for mental health care problems, preferably with survey-style forms like the PHQ-9.



  • With patients, their failure to seek this kind of care normally pertains to the stigma that is often associated with reaching out for mental health assistance. It’s often an easier first step for the patient to ask their PCP a few questions about their anxiety, rather than sit down for a full session with a therapist.
  • Some patients have lack of access to such treatment. If it is not made available to them, then there can be absolutely no chance of a successful outcome.
  • The most difficult factor for some patients to overcome is their complete lack of awareness that there is a problem. Again, if they aren’t asked the questions, then they are never prompted to reflect upon their own mental health.


A survey shows that collaborative care within a primary care office works best when utilizing screening tools like the PHQ-9 and support provided by a care manager. When a patient has high blood pressure or heart disease, there are tests and tools used to gauge their responsiveness or the success of their treatment. It should be no different in mental healthcare, especially with the ability to use screening tools for depression and anxiety, like the PHQ-9.

Venus Miller, one of the webinar speakers, is a Family & Psychiatric Nurse Practitioner at SMC Medical Center in Miami and Infinite Behavioral Health in Hollywood, Florida. Her clinical areas of expertise include family and psychiatric medication assessment and treatment across the lifespan, as well as substance abuse disorders in dual diagnosis clients. Therefore, she is the perfect person to address the changes that could be coming down the pipeline in the mental healthcare industry.

Venus stated, “There’s no more time for not addressing this issue.” And she’s right. This is one of the most prolific statements made when looking at the urgency of bridging this gap between primary care providers and mental healthcare personnel.

As we strive toward a deeper connection between primary care and mental health, we must first look at what services are offered by the PCPs, and then decipher the best ways to conduct screenings to offer those services.

If you’re looking for  way for patients to be screened for mental healthcare disorders from the waiting room, with little or no administrative assistance, take a look at what Mentegram has to offer. Bridging this gap might not be as difficult as you might think.